Milosevic A, Dawson L J
Department of Clinical Dental Sciences, University of Liverpool School of Dentistry, UK.
Caries Res. 1996;30(5):361-6. doi: 10.1159/000262343.
The increased occurrence of dental erosion from self-induced vomiting in bulimia nervosa is not linearly associated with the frequency or the duration of vomiting. Possible changes in the buffering and lubricating role of saliva in bulimia nervosa and their relationship to erosion have not been previously investigated. Chewing-gum-stimulated salivary flow rate, pH, bicarbonate concentration and viscosity were compared between two groups of vomiting bulimics and with 10 healthy controls. One bulimic group (n = 9) had pathological tooth wear present according to the criteria of the Tooth Wear Index and the other bulimic group (n = 10) did not. The influence of salivary pellicle on enamel acid dissolution by perchloric acid was also assessed by an enamel biopsy method. Bicarbonate was measured in a Natelson microgasometer. Both the bulimic groups had mean initial 3-min flow rates and overall 9-min flow rates significantly lower (p < 0.01) than the healthy subjects. The mean pH values were not significantly different between the two bulimic groups or the control group. However, the mean bicarbonate concentration in both bulimic groups was significantly less (p < 0.01) than in the control group. The mean salivary viscosity of 7.4 centipoise (cP), measured by a DV1 Brookfield viscometer, was significantly greater (p < 0.05) in the pathological tooth-wear-present group than in the tooth-wear-absent group (4.5 cP) and the control group (4.1 cP). Slightly more calcium was released from the pellicle-free surface in both groups but this was not statistically significant, whilst the dissolved calcium in enamel biopsies was significantly lower (p < 0.05) in the tooth-wear-present group.
神经性贪食症患者因自我催吐导致牙齿侵蚀的发生率增加，这与呕吐频率或持续时间并非呈线性相关。此前尚未对神经性贪食症患者唾液缓冲和润滑作用的可能变化及其与侵蚀的关系进行研究。比较了两组呕吐型贪食症患者以及10名健康对照者咀嚼口香糖刺激后的唾液流速、pH值、碳酸氢盐浓度和粘度。一组贪食症患者（n = 9）根据牙齿磨损指数标准存在病理性牙齿磨损，另一组贪食症患者（n = 10）则没有。还通过釉质活检方法评估了唾液薄膜对高氯酸溶解牙釉质的影响。用纳特尔森微量气体测定仪测量碳酸氢盐。两组贪食症患者的初始3分钟平均流速和9分钟总平均流速均显著低于健康受试者（p < 0.01）。两组贪食症患者与对照组之间的平均pH值无显著差异。然而，两组贪食症患者的平均碳酸氢盐浓度均显著低于对照组（p < 0.01）。用DV1布鲁克菲尔德粘度计测得的平均唾液粘度，存在病理性牙齿磨损组为7.4厘泊（cP），显著高于无牙齿磨损组（4.5 cP）和对照组（4.1 cP）（p < 0.05）。两组无薄膜表面释放的钙略多，但无统计学意义，而存在牙齿磨损组釉质活检中溶解的钙显著较低（p < 0.05）。
