REMINERALIZING POTENTIAL OF SALIVA ON PATIENTS HAVING DENTAL EROSIONS DUE TO WINE CONSUMPTION salts, action of enzyme released by bacteria. Also other early studies focused on factors and processes related to dental erosions. 5-7 The success of dental erosions therapy depends on the preventive and therapeutical strategy that must be focused on the risk assessment, oral hygiene practices, diet, lifestyle, medical factors. The long-term success is related to the possibilities to improve the saliva environment quality and regular application of remineralising protocols. Some studies 8-15 proved the effectiveness of products based on calcium and phosphate in the erosion lesion onset. Initially, dental erosion is associated with enamel loss of a few micrometers, a process known as demineralization. Demineralization is associated to a decrease in the calcium and phosphate ions concentration. In time, the loss can affect the entire enamel layer. Factors like the remineralisation process and acquired pellicle formation can reduce the rate of dental erosion. De- and remineralisation processes alternate on long time intervals. Remineralization is influenced by the concentration of calcium and phosphate ions in saliva. Previous studies 16-19 showed a direct correlation between the remineralizing capacity of saliva and the aspect of saliva crystals on microscopy analysis. Patients having high remineralizing capacity of saliva presented, in 93.5 % of the cases, an aspect of fern-shaped crystals, with the highest crystals concentration in the middle of saliva drop. Patients with low remineralising capacity of saliva presented no such this structure or it was difuse in 87 % of the cases and saliva presented a few crystals in the visual field or some needle-shaped crystals, homogeneously distributed or grouped
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to the periphery of the saliva drop. Dental erosion is influenced by a lot of internal and external factors. 20-25 The most important factor is considered the frequent consumption of beverages, including cola-like drinks, high acid
26, 27 drinks and wine. The frequent consumption of wine( alcoholism) or professional exposure to wines represent major factors in the dental erosions onset. 28-30 The erosive potential of red wine, white wine, and champagne is related to the presence of lactic acid, citric acid, malic acid, and tartaric acid. The treatment of dental erosions is based on the removal of etiological factors and the use of remineralizing products containing calcium,
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phosphate, fluoride, magnesium, and zinc. The aim of study was to assess the action of a remineralizing product( calcium-phosphatefluoride based varnish) on the remineralizing capacity of saliva on patients having dental erosions related to frequent wine consumption.
2. Metodology
The study group was made up of 15 patients who are frequent wine consumers( minimum 5 times a day), age 30-50, having dental erosions. The patients were selected from patients treated in the Dental Clinic of the Dental Medicine Faculty,“ Gr. T. Popa” University of Medicine and Pharmacy, Jassy. After clinical examination the remineralizing capacity of saliva was evaluated using microcrystallization index( IMK). For IMK evaluation, unstimulated saliva was collected in a test tube before 12 a. m. From this saliva, 0.5 ml were applied on a microscope slide; the saliva liquid was dried for 30 minutes in 37 o C temperature. The microscopy analysis was performed using Nikon Eclipse E 600, and images were recorded and stored in a computer. The IMK micro-crystallization index was calculated using the following formula:
IMK = number of points of numbering grill projected on crystals
number of points of numbering grill projected on saliva drop
The IMK values were divided in three types, namely high, moderate and low level of crystallization. The basic criteria for the crystals evaluation were the diameter, shape and number. The mean values of IMK between 0.6 and 1were included in type I of crystallization, values between 0.4 and 0.6 were included in type II and values between 0 and 0.4 were included in type III. The treatment plan for each patient included a weekly application of MI Varnish( GC Corporation, Tokyo, Japan) for 5 weeks. Saliva was evaluated at the baseline and after 5 weeks.
3. Results
The IMK values before and after treatment are presented in Tabel 1. The mean value of IMK increased from 0.33 before treatment to 0.83 after treatment after treatment. The distribution of the micro-crystallization categories varied from 86 % Type II before treatment to 93 % Type I after treatment. The types of micro-crystallization were represented by needle-shaped, fern-shaped, tree-shaped, flakeshaped, oval-shaped or cubic-shaped crystals, as well as their multiple points or combinations( Figs 1-6). Before treatment 86 % of the IMK values were included in type II category of micro-crystallization and 14 % in type III. After treatment 93 % of the IMK values were included in type I and 7 % in type II. The IMK values before and after treatment were statisticaly analysed using the Wilcoxon test. Statisticaly significant results were obtained when comparing the IMK values before and after teatment( p < 0.05).
4. Discussion
Saliva acts as a buffer agent for various beverages. However beverages like fruit juices or wine are resistent to the acid neutralizing action of saliva and have the capacity to prolong the time of
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