探索唾液酸碱度和流速与牙齿磨损严重程度的关系：一项横断面研究。

Exploring the relationship of salivary pH and flow rate with tooth wear severity: A cross-sectional study.

作者信息

Madariaga Víctor I, Pereira-Cenci Tatiana, van Gennip Lucky L A, van Leeuwen Stephanie J M, Walboomers X Frank, Loomans Bas A C

机构信息

Radboudumc, Department of Dentistry, P.O. Box 9101, Nijmegen, NL 6500HB, The Netherlands.

出版信息

J Dent. 2025 Jan;152:105499. doi: 10.1016/j.jdent.2024.105499. Epub 2024 Dec 1.

DOI:10.1016/j.jdent.2024.105499

PMID:39626840

Abstract

BACKGROUND

Tooth wear is the loss of dental hard tissue due to chemical and mechanical processes, and its prevalence ranges from 13 to 80 % in the general population. Management depends on understanding potential risk factors; however, the role of saliva as one of them is not completely understood. The aim of this study was to explore the relationship between salivary pH and flow, and tooth wear in patients referred to a specialized dental clinic for tooth wear management.

METHODOLOGY

Data used in this study included stimulated (SWS) and unstimulated whole salivary (UWS) pH and flow rate. Dependent variables were the average occlusal Tooth Wear Index (TWI) and the average of the surfaces with the maximum Tooth Wear Evaluation System 2.0 score (TWES). Univariate and multivariate linear regression models were utilized, including a multivariate analysis without outliers. Sex and age were added as confounders.

RESULTS

A total of 159 patients were included in this study. The average age of the individuals was 37.1 (± 9.1) years and 34 (21 %) were female. Univariate models showed a statistically significant association between both TWI and SWS pH. Multivariate models showed that the negative associations between SWS (β = -0.20, C.I. = -0.36 - -0.03 [TWI]; β = -0.12, C.I. = -0.22 - -0.02 [TWES]) and UWS pH (β = -0.12, C.I. = -0.26 - 0.02 [TWI]; β = -0.09, C.I. = -0.18 - 0.00 [TWES]) and tooth wear were largely unaffected by confounders. These associations were also robust against outliers. A relevant association with flow rate was not detected.

CONCLUSION

This study shows that salivary pH was inversely associated with tooth wear severity even after correction for confounders, such as flow rate, age, and sex. This association was especially significant for SWS. Although no causal relationship can be established, the results suggest a role of salivary pH in tooth wear in patients with moderate to severe tooth wear. No association was found between tooth wear and flow rate.

摘要

背景

牙齿磨损是由于化学和机械过程导致的牙体硬组织丧失，在普通人群中的患病率为13%至80%。其治疗取决于对潜在风险因素的了解；然而，唾液作为其中一个风险因素的作用尚未完全明确。本研究的目的是探讨在因牙齿磨损治疗而转诊至专业牙科诊所的患者中，唾液pH值和流量与牙齿磨损之间的关系。

方法

本研究使用的数据包括刺激全唾液（SWS）和非刺激全唾液（UWS）的pH值和流速。因变量为平均咬合面牙齿磨损指数（TWI）以及牙齿磨损评估系统2.0评分（TWES）最高的表面的平均值。采用单变量和多变量线性回归模型，包括无异常值的多变量分析。将性别和年龄作为混杂因素纳入。

结果

本研究共纳入159例患者。患者的平均年龄为37.1（±9.1）岁，女性有34例（21%）。单变量模型显示TWI与SWS pH值之间存在统计学上的显著关联。多变量模型显示，SWS（β = -0.20，置信区间 = -0.36 - -0.03 [TWI]；β = -0.12，置信区间 = -0.22 - -0.02 [TWES]）和UWS pH值（β = -0.12，置信区间 = -0.26 - 0.02 [TWI]；β = -0.09，置信区间 = -0.18 - 0.00 [TWES]）与牙齿磨损之间的负相关在很大程度上不受混杂因素影响。这些关联对异常值也具有稳健性。未检测到与流速的相关关联。