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胃食管反流病(GERD)患者牙齿侵蚀和敏感的再矿化治疗:随机临床试验

Remineralizing Treatments for Dental Erosion and Sensitivity in Patients Suffering from Gastroesophageal Reflux Disease (GERD): Randomized Clinical Trial.

作者信息

Scribante Andrea, Pardo Alessia, Pascadopoli Maurizio, Biagi Federico, Schiepatti Annalisa, Giammona Valentina, Vecchio Marco, Alquati Christian, Modica Gioia Giada, Casu Cinzia, Butera Andrea

机构信息

Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.

Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.

出版信息

J Clin Med. 2025 May 18;14(10):3525. doi: 10.3390/jcm14103525.

Abstract

Gastroesophageal reflux disease (GERD) is a chronic condition that causes an abrupt decrease in salivary pH in the oral cavity, which can lead to demineralization, erosion, hypersensitivity, functional impairment, and possibly fracture of dental elements. The aim of this clinical study is to compare two types of treatment in patients with dental erosion diagnosed with gastroesophageal reflux. Thirty patients were enrolled in this randomized clinical trial. Each patient underwent clinical evaluation and esophageal pH measurement, in order to diagnose GERD. After an initial examination and assessment by an experienced dentist, the Trial group (15 patients) was assigned to home treatment with a zinc hydroxyapatite-based toothpaste and a hydroxyapatite-based paste, while the Control group (15 patients) was assigned to home treatment with zinc hydroxyapatite-based toothpaste only. The following indices were measured: Basic Erosive Wear Examination Index (BEWE); Schiff Air Index (SAI); Plaque Index (PI); and Bleeding Score (BS). Each index was assessed at T0 during the first visit, one month (T1), three months (T2), six months (T3), nine months (T4), and 12 months (T5). The Kolmogorov-Smirnov test was used to analyze the normality of the data, while Friedman's test followed by Dunn's post hoc test were used to compare the two groups (significance threshold: < 0.05). : The results showed no statistically significant change in the BEWE and SAI indexes ( > 0.05). However, an improvement in dentin sensitivity and BS was observed. Plaque control also improved. : The results of this study indicate that the additional hydroxyapatite paste did not significantly improve the outcomes of the study in respect to hydroxyapatite toothpaste alone. However, there was an improvement in the oral health of GERD patients using hydroxyapatite-based remineralizing treatment in terms of oral and periodontal indices calculated.

摘要

胃食管反流病(GERD)是一种慢性疾病,可导致口腔唾液pH值急剧下降,进而引发牙体组织脱矿、侵蚀、过敏、功能障碍,并可能导致牙齿折断。本临床研究的目的是比较两种治疗方法对诊断为胃食管反流且伴有牙齿侵蚀的患者的疗效。30名患者参与了这项随机临床试验。每位患者均接受了临床评估和食管pH值测量,以诊断GERD。在经过经验丰富的牙医进行初步检查和评估后,试验组(15名患者)被分配使用含羟基磷灰石的牙膏和含羟基磷灰石的糊剂进行家庭治疗,而对照组(15名患者)仅被分配使用含羟基磷灰石的牙膏进行家庭治疗。测量了以下指标:基本侵蚀磨损检查指数(BEWE);希夫空气指数(SAI);菌斑指数(PI);以及出血评分(BS)。在首次就诊时的T0、1个月(T1)、3个月(T2)、6个月(T3)、9个月(T4)和12个月(T5)对每个指标进行评估。采用柯尔莫哥洛夫-斯米尔诺夫检验分析数据的正态性,而采用弗里德曼检验并随后进行邓恩事后检验来比较两组(显著性阈值:<0.05)。结果显示,BEWE和SAI指数无统计学显著变化(>0.05)。然而,观察到牙本质敏感性和BS有所改善。菌斑控制也有所改善。本研究结果表明,额外使用羟基磷灰石糊剂相对于单独使用羟基磷灰石牙膏而言,并未显著改善研究结果。然而,就所计算的口腔和牙周指数而言,使用含羟基磷灰石的再矿化治疗对GERD患者的口腔健康有改善作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f753/12111895/e90de41a8754/jcm-14-03525-g001.jpg

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