REMINERALIZING POTENTIAL OF SALIVA ON PATIENTS HAVING DENTAL EROSIONS DUE TO WINE CONSUMPTION pH dropping. The development, evolution and prognostic of dental erosion depend on the frequency and duration of the acid exposure. The protective biological factors against erosive factors are saliva and acquired pellicle. 31-33 The remineralizing ability of saliva is influenced both by the minerals levels and the quality and levels of salivary mucins. Mucins are proteins that participate in the saliva bio-crystallization processes and influence directly the increase and development of salivary biocrystals. Salivary mucins also influence the diameter and shape of the anorganic deposits and the type of crystallization in IMK test. Lennon AM et al. 34 assessed in vitro the protective ability of a casein-calcium phosphate tooth against dental erosions. The researchers concluded that 12500 ppm AMF gels supply the most effective protection against dental erosion. The mechanism by which the products containing casein-calcium phosphate reduce erosion is not clearly established yet. Except for the prevention of dental hard tissues demineralization, it was suggested that the product also remineralizes( repairs) eroded enamel and dentine crystals. Ramalingam observed a superficial granular structure formed on the enamel surface. It is highly possible for these structures to represent remineralized enamel crystals. 11 Our study proved that local treatment with RECALDENT™( CPP-ACP) MI Varnish™ influences the remineralizing potential of saliva for patients with dental erosions by increasing the mean IMK value after treatment. The crystallization types also improved significantly. In our study, prior to treatment, most of the patients presented the highest crystals concentration in the middle of saliva droplet. Other studies showed that patients having dental erosions presented separated crystals in the form of a branch or stem, placed relatively evenly over the whole surface of the dried droplet or a large amount of separated stellate crystals of an oval and irregular shape located isometrically. 35
The major components of the varnish that we tested were casein phosphopeptide, calcium phosphate, amorphous calcium phosphate and fluoride. They can contribute to increase the remineralising potential of saliva and to arrest the erosive effect. Previous studies showed that other products having similar components( Tooth Mousse, GC Corporation, Tokyo, Japan) have good control on tooth erosion, possibly due to anticariogenic remineralizing agent represented by casein phosphopeptide-amorphous calcium phosphate( CPP-ACP) nanocomplex. 36 The reduction in tooth erosion induced by white wine consumption was clearly demonstrated by Manton( 2010) and Piekarz C( 2008). 9, 10 In the absence of a device focused on the early detection of dental erosions, the clinical aspect and the practitioner’ s experience contribute to the
6, 9-13, 34
accurate detection in the early stages. IMK evaluation is an affordable test to monitor the effectiveness of the non-operative, preventive metods. The methodology is simple, accesible and inexpensive. The principal components of this varnish, casein phosphopeptide( CPP- ACP) calcium phosphate, amorphous calcium phosphate and fluoride, can contribute to the increase of saliva remineralising potential and to arresting the erosive effect. GC Recaldent MI Varnish can be recommended to counteract the erosive effect of wine and acid beverages.
5. Conclusions
The use of varnishes containing casein phosphopeptide, calcium phosphate, amorphous calcium phosphate and fluoride increases the remineralizing potential of saliva for patients having dental erosions related to frequent wine consumption.
Acknowledgments
The authors declare no conflict of interest related to this study. There are no conflicts of interest and no financial interests to be disclosed.
REFERENCES
1. Fauchard P. The Surgeon Dentist or Treatise on the Teeth. Lindsay L. translation from 1746 2nd ed. London, England: Butterworth; 1946; 20, 21,40,46,47. 2. Bell T. Abrasion and erosion on the teeth, part 3. Litch WF. ed. The Anatomy, Physiology and Diseases of the Teeth, Philadelphia, PA: Carey & Lea; 1831. 3. Miller WD. Experiments and observations on the wasting of tooth tissue previously designated as erosion, abrasion, chemical abrasion, denudation, etc. Dental Cosmos 1907; XLIX No. 1:1-23, XLIX No. 2:109-124, XLIX No. 3:225-247. 4. Black GV. A work on operative dentistry. Vol. 1. Pathology of the Hard Tissues of the Teeth. 1st ed. Chicago, IL: Medico- Dental Publishing; 1907:39-59. 5. Lussi A, Jaeggi T. Erosion – diagnosis and risk factors. Clin Oral Invest. 2008; 12( 1): S5-S13.
6. Lussi A, Jaeggi T. Chemical factors. Monogr Oral Sci. 2006; 20:77-87. 7. Imfeld T. Dental erosion. Definition, classification and links. Eur J Oral Sci. 1996; 104( 2( Pt 2)): 151-155. 8. Lennon AM, Pfeffer M, Buchalla W, Becker K, Lennon S, Attin T. Effect of a casein / calcium phosphate-containing tooth cream and fluoride on enamel erosion in vitro. Caries Res. 2006; 40( 2): 154-157. 9. Manton DJ, Cai F, Yuan Y, Walker GD, Cochrane NJ, Reynolds C, Brearley-Messer LJ, Reynolds EC. Effect of casein phosphopeptide-amorphous calcium phosphate added to acidic beverages on enamel erosion in vitro. Aust Dent J. 2010; 55( 3): 275-279.
19