Reduced statherin in acquired enamel pellicle on eroded teeth compared to healthy teeth in the same subjects: An in-vivo study

Acquired pellicle engineering: a fascinating approach to prevent demineralization

The acquired enamel pellicle (AEP) consists of an organic, acellular, and bacteria-free film, formed in vivo as a result of biomolecules adsorption onto the tooth surface. It is composed of proteins, glycoproteins, lipids, phospholipids, and other macromolecules, such as carbohydrates. The AEP formation process is complex and can be divided into three stages: initiation, development, and maturation. The pellicle has two main layers: the globular and basal layers. The basal layer offers the most protection against demineralization, as the subsequent globular layer is weaker and less tenacious. The formation of the AEP can be influenced by various factors, such as the physicochemical properties of the teeth, location in the oral cavity, pathologies, and even the oral microbiota. With the advancement of "omics" techniques, it has been possible to observe the presence of acid-resistant proteins in the AEP, which allowed the development of the "acquired pellicle engineering" strategy. This strategy involves enriching and modifying the basal layer with acid-resistant proteins. Among these proteins, hemoglobin, statherin-derived peptide, and a protein derived from sugarcane stand out. The objective of this literature review is to provide a comprehensive overview of the AEP, detailing its composition, formation process, and protective functions. Additionally, the review aims to explore recent advances in the field of "acquired pellicle engineering," highlighting the acid-resistant proteins of the AEP and their potential applications in dentistry. Finally, the review intends to highlight the clinical implications of these findings and how they may contribute to the development of new strategies for the prevention and treatment of dental pathologies according to published studies.

The preventive effect of silver diamine fluoride-modified salivary pellicle on dental erosion

OBJECTIVE

To investigate the preventive effect of silver diamine fluoride (SDF) modified salivary pellicle (SP) against dental erosion.

METHODS

Enamel and dentin blocks allocated into 4 groups (n = 30 each). Blocks in Group SDF+SP were treated with SDF and SP. Blocks in Group SDF were treated with SDF. Blocks in Group DW+SP were treated with deionized water (DW) and SP. Blocks in Group DW were treated with DW. The blocks were subjected to an erosive challenge at pH 3.2 for 2 mins, 5 times per day for 14 days. Salivary pellicle morphology was assessed by atomic force microscopy (AFM). Crystal characteristics, percentage microhardness loss (%SMHL), surface loss, and surface morphology were assessed by X-ray diffraction (XRD), microhardness test, profilometry, and scanning electron microscopy (SEM), respectively.

RESULTS

AFM revealed a modified pellicle morphology in Group SDF+SP. XRD of both blocks revealed hydroxyapatite, silver chloride, silver phosphate, and silver fluoride in Groups SDF+SP and SDF. Fluoroapatite was found in Group SDF+SP only. %SMHL ( ± Standard deviation in %) of Groups SDF+SP, SDF, DW+SP, and DW were 33.4 ± 2.2, 38.6 ± 2.2, 50.3 ± 2.2, and 58.3 ± 2.4 in enamel and 16.1 ± 2.2, 19.7 ± 2.1, 32.8 ± 2.1, and 39.0 ± 2.3 in dentin, respectively. The presence of SDF and SP reduced %SMHL in both blocks (p < 0.001). The surface loss ( ± Standard deviation in μm) of Groups SDF+SP, SDF, DW+SP, and DW were 3.6 ± 0.7, 4.1 ± 0.4, 5.3 ± 0.5, and 7.0 ± 0.6 in enamel and 5.4 ± 0.6, 6.1 ± 0.5, 9.1 ± 0.7, and 9.2 ± 0.5 in dentin, respectively. The presence of SDF and SP reduced surface loss in enamel and dentin blocks (p = 0.031 and p = 0.002, respectively). SEM showed enamel surface remained relatively smooth and partially dentinal tubule occlusion on dentin blocks in Groups SDF+SP and SDF.

CONCLUSION

SDF had a positively synergistic effect with SP. SDF-modified salivary pellicle provided a superior protective effect against dental erosion.

Proteome of the 2-h in vivo Formed Acquired Enamel Pellicle of Adolescents with Erosive Tooth Wear, Caries, or Sound

INTRODUCTION

Acquired pellicle (AP) acts as a membrane preventing acids from coming into direct contact with the tooth. Possibly, individuals with different dental health status present changes in its composition that could disrupt this function. Thus, the aim of this study was to compare the protein composition of the AP in adolescents with erosive tooth wear (ETW), caries, or sound.

METHODS

Calibrated examiners in BEWE index and ICDAS-merged Epi criteria assessed ETW and caries in a sample of 454 systemically healthy adolescents aged 12-15 years old. Thirty subjects from that sample were selected for this study: ETW group (n = 10; total BEWE ≥9 and absence of dentinal caries lesions); caries group (n = 10; total BEWE <9 and with at least one dentinal caries lesion), and sound group (n = 10; total BEWE <9 and absence of dentinal caries lesions). Two-hour-formation AP samples were taken from buccal, occlusal/incisal, palatal/lingual tooth surfaces. Protein composition was analysed by liquid chromatography-tandem mass spectrometry. Using mean reporter ion values, relative abundances of proteins were compared among the three groups to calculate for fold changes. Twofold protein increases or decreases were reported (t test, p < 0.05). Gene Ontology (GO) of included proteins was assigned.

RESULTS

Mean age of participants was 13.1 ± 1.14 years and 56.6% were females. The prevalence of ETW was of 66.6% and of dentinal caries of 33.3%. The GO analyses showed that the majority of detected proteins were stress response related. The ETW group disclosed upregulated relative abundance of antileukoprotease (2.85-fold in ETW vs. sound and 2.34-fold in ETW group vs. caries group); histatin (2.42-fold in ETW group vs. sound group and 2.20-fold in ETW group vs. caries group), and prolactin-induced protein (2.30-fold in ETW group vs. sound group and 2.06-fold in ETW group vs. caries group) (p < 0.05). Hemoglobin subunits alpha (HBA) and beta (HBB) showed decreased relative abundances in the ETW and caries groups when compared to the sound group (HBA: 0.42-fold in ETW group and 0.40-fold in caries group; HBB: 0.45-fold in ETW group and 0.38-fold in caries group; p < 0.05).

CONCLUSION

AP from individuals with ETW showed differences when compared to other dental conditions, with relative abundance increasing of some stress response-associated proteins in ETW and a decrease in proteins related to salivary protection against acid challenges.

Salivary Proteins in Human Acquired Enamel Pellicle (AEP) on Eroded and Uneroded Teeth in Patients with Gastro-Oesophageal Reflux Disease (GORD)

The aim of this in vivo study was to compare total protein present in the salivary films (F) and acquired enamel pellicle (AEP) on eroded and non-eroded surfaces in patients suffering from GORD symptoms with and without GORD diagnosis (GORD, No-GORD). Thirty-nine patients suffering from GORD symptoms and erosive tooth wear on lower first molars and an unaffected posterior occlusal surface in the same quadrant were recruited from Guy's hospital, London. Salivary film and AEP were collected from the eroded and uneroded occlusal surfaces, using 0.5% sodium dodecyl sulphate (SDS)-soaked filter papers. Total protein concentration was analysed using bicinchoninic acid assay (BCA). Statistical analysis was conducted using Shapiro-Wilk, ANOVA, and Tukey's tests (p < 0.05), comparing four GDS sample types and GORD vs. No-GORD groups. The level of significance was set as p < 0.05. Data were compared between eroded and uneroded surfaces in the same patient with GORD symptoms, as well as between those with or without a GORD diagnosis (GORD, No-GORD). The AEP total protein concentration from the eroded [2.17 (0.49) mg/mL] and uneroded surfaces [2.24 (0.66) mg/mL] of the GORD group were statistically significantly lower than those on eroded [3.27 (1.01) mg/mL] and uneroded [3.33 (1.57) mg/mL] surfaces in the No-GORD group (p = 0.007) (p = 0.008), respectively. No statistically significant differences were observed for film and AEP between eroded and uneroded surfaces (p > 0.05).

Protease-inhibitors added to saliva in vitro influence the erosion protective effect of enamel pellicles

In contrast to pellicles formed in vivo, pellicles formed in vitro provide little to no erosion protection for enamel, possibly due to protein degradation from proteases during pellicle formation. With the objective to achieve a more similar effect as observed for in vivo pellicles, the effects of adding protease inhibitors (PI) to saliva in vitro, and/or exchanging saliva repeatedly during pellicle formation were investigated in a cyclic model of pellicle formation and erosion with human enamel specimens. We repeatedly assessed surface microhardness (SMH), measured initial and final surface reflection intensity (SRI), and determined calcium released during erosion. For all the parameters tested, we observed a clear positive effect on erosion protection when adding PI to saliva for pellicle formation: SMH remained harder, SRI remained higher, and less calcium was released. Additionally, exchanging saliva with fresh one during pellicle formation led to a protective effect, but not as strong as the addition of PI. We conclude that adding protease inhibitors to saliva in vitro for pellicle formation leads to an erosion protective effect, which was further increased by repeatedly exchanging the saliva. Whether the pellicle itself more closely resembles in vivo pellicles remains to be investigated.

New insights into the protective effect of statherin-derived peptide for different acquired enamel pellicle formation times on the native human enamel surfaces

OBJECTIVES

This study evaluated the protective impact of acquired enamel pellicle (AEP) engineering with statherin-derived peptide (StatpSpS), considering different AEP formation times.

DESIGN

A total of 120 native human enamel specimens were divided into 2 main groups: 1) No AEP engineering and 2) AEP engineering with StatpSpS (pretreatment for 1 min; 37 °C, under agitation). Each group was further divided into 4 subgroups: No pellicle, or 1, 60-and-120 min AEP formation times (human saliva; 37 °C). The specimens were then subjected to an erosive challenge (1% citric acid; pH 3.6; 1 min; 25 °C). This procedure was repeated for 5 cycles. Relative surface reflection intensity (%SRI) was measured and scanning electron microscopy (SEM) of the enamel surface was done.

RESULTS

All AEP engineering groups protected against initial dental erosion in comparison with No pellicle (p < 0.001), likewise all groups with AEP, independent of engineering or formation times (p 0.001). Furthermore, engineering with StatpSpS even without the presence of AEP protected the enamel when compared to the No engineering/No pellicle group (p < 0.0001). No difference was observed regarding the protection from the different AEP formation times (p > 0.05). Regarding the SEM analysis, in the "No AEP engineering & No AEP" group, a more severe effect of citric acid was observed, with more enamel prism heads and scratches on the surface when compared with the other groups.

CONCLUSIONS

AEP provides almost instant protection at formation times even as short as 1 min, protecting the native enamel against erosion. Treatment with StatpSpS by itself provides similar protection as the AEP.

Novel bacterial proteolytic and metabolic activity associated with dental erosion-induced oral dysbiosis

BACKGROUND

Dental erosion is a disease of the oral cavity where acids cause a loss of tooth enamel and is defined as having no bacterial involvement. The tooth surface is protected from acid attack by salivary proteins that make up the acquired enamel pellicle (AEP). Bacteria have been shown to readily degrade salivary proteins, and some of which are present in the AEP. This study aimed to explore the role of bacteria in dental erosion using a multi-omics approach by comparing saliva collected from participants with dental erosion and healthy controls.

RESULTS

Salivary proteomics was assessed by liquid-chromatography mass spectrometry (LC-MS) and demonstrated two altered AEP proteins in erosion, prolactin inducible protein (PIP), and zinc-alpha-2 glycoprotein (ZAG). Immunoblotting further suggested that degradation of PIP and ZAG is associated with erosion. Salivary microbiome analysis was performed by sequencing the bacterial 16S rRNA gene (V1-V2 region, Illumina) and showed that participants with dental erosion had a significantly (p < 0.05) less diverse microbiome than healthy controls (observed and Shannon diversity). Sequencing of bacterial mRNA for gene expression (Illumina sequencing) demonstrated that genes over-expressed in saliva from erosion participants included H + proton transporter genes, and three protease genes (msrAB, vanY, and ppdC). Salivary metabolomics was assessed using nuclear magnetic resonance spectrometry (NMR). Metabolite concentrations correlated with gene expression, demonstrating that the dental erosion group had strong correlations between metabolites associated with protein degradation and amino acid fermentation.

CONCLUSIONS

We conclude that microbial proteolysis of salivary proteins found in the protective acquired enamel pellicle strongly correlates with dental erosion, and we propose four novel microbial genes implicated in this process. Video Abstract.

Erbu Zhuyu decoction improves endometrial angiogenesis via uterine natural killer cells and the PI3K/Akt/eNOS pathway a mouse model of embryo implantation dysfunction

BACKGROUND

We investigated the effect of Erbu Zhuyu decoction (EBZY) on angiogenesis via uterine natural killer (uNK) cells and the PI3K/Akt/eNOS pathway in embryo implantation dysfunction (EID) mice.

METHODS

Pregnant mice were randomly divided into blank, model, EBZY, progynova, and aspirin groups. Uteri were excised on the 5th day of pregnancy for analysis.

RESULTS

Mice in the model group showed pale uteri, a reduced implantation rate, and lower expression levels of phosphatidylinositol-3-kinase (PI3K), protein kinase B (Akt), endothelial nitric oxide synthase (eNOS) and nitric oxide (NO). Compared to the model group, implantation rates in the medium-dose and high-dose groups of EBZY were significantly higher (P < .05), PI3K and Akt mRNA expression levels in the low-dose group were significantly higher (P < .05, P < .01), and the expression of p-PI3K, p-Akt, and p-eNOS proteins in all treatment groups were significantly increased (P < .01, P < .05). The expression of NO was significantly increased in the low-dose and high-dose groups (P < .01, P < .05, respectively). The level of p-Akt protein in the high-dose group was significantly higher than those in the other treatment groups (P < .01, P < .05). There was no significant difference in the density of uNK cells (P > .05).

CONCLUSIONS

EBZY facilitated embryo implantation in EID mice by enhancing endometrial angiogenesis via activation of the PI3K/Akt/eNOS pathway, at least in part. There was no evidence to indicate that EBZY could adjust the expression of uNK.

Caries Management-The Role of Surface Interactions in De- and Remineralization-Processes

BACKGROUND

Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions.

CONCLUSIONS

Despite the fact that organic-inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry.

Knowledge and attitude on tooth wear among Najran population, KSA

Tooth wear is the loss of a hard dental surface. This condition might occur due to some external or internal factors. The physiological, as well as pathological factors also caused loss of tooth surface. The aim of the following survey was to evaluate the knowledge and attitude of the Najran population about tooth wear. A questionnaire-based study was conducted among the people of Najran. Questions regarding attitude and knowledge about tooth wear were asked from the participants. Data were collected and statistically analyzed. It has been seen that participants of both genders almost have the same knowledge about tooth wear. However, females were more concerned with their dietary habits and the use of fluoride toothpaste. The participants of all age groups were well familiar with tooth wear and its prevention. It has been clear from the results that residents of Najran have good knowledge about the causes of tooth wear and its prevention but there is a need to increase their practices and change their food habits to avoid the severity of Tooth wear.

The interplay of saliva, erosion and attrition on enamel and dentine

Purpose

This investigation aimed to compare the protective role of saliva against erosion and attrition challenges.

Method

Polished enamel and dentine samples (n = 160) were prepared and randomly assigned to either the saliva or saliva-free group (n = 40 enamel and n = 40 dentine/group). Within each subgroup, they were allocated to four subgroups: negative control (deionized water exposure 10 min), erosion (0.3% citric acid 10 min), attrition (120 S of 300 g force), or combined erosion/attrition (0.3% citric acid 10 min then 120 S of 300 g force). Experimental cycles were repeated three times. Data analysis was performed using SPSS.

Results

The mean and standard deviation (SD) of step heights produced by the attrition and erosion/attrition groups in enamel in the saliva-free group were 5.6 µm (2.4) and 13.4 µm (2.8), respectively, while they were 2.4 µm (3.8) and 12.9 µm (3.5) in the saliva group, with no significant difference between the saliva and saliva-free groups. For dentine, the corresponding step heights were 25.2 µm (5.5) and 35.9 µm (7.9) for the saliva-free group, but 21.8 µm (5.3) and 27.3 µm (6.4) for the saliva group (p < 0.001).

Conclusion

There was a trend that saliva decreased wear, but this was only statistically significant for erosion/attrition dentine wear.

Evaluation of possible biomarkers for caries risk in children 6 to 12 years of age

Background: Electrolytes, proteins, and other salivary molecules play an important role in tooth integrity and can serve as biomarkers associated with caries. Objective: To determine the concentration of potential biomarkers in children without caries (CF) and children with caries (CA). Methods: Unstimulated saliva was collected, and the biomarkers quantified in duplicate, using commercial Enzyme Linked Immunosorbent Assay (ELISA) kits to determine IgA, fibronectin, cathelicidin LL-37, and statherin levels, as well as colorimetric tests to detect formate and phosphate. Results: Significantly higher concentrations of statherin was detected in the CF group (Median: 94,734.6; IQR: 92,934.6-95,113.7) compared to the CA2 group (90,875.0; IQR: 83,580.2-94,633.4) (p = 0.03). Slightly higher median IgA (48,250.0; IQR: 31,461.9-67,418.8) and LL-37 levels (56.1; IQR 43.6-116.2) and a lower concentration of formate were detected in the CF group (0.02; IQR 0.0034-0.15) compared to the group with caries (IgA: 37,776.42; IQR: 33,383.9-44,128.5; LL-37: 46.3; IQR: 40.1011-67.7; formate: 0.10; IQR: 0.01-0.18), but these differences were not statistically significant. Conclusion: The fact that these compounds have been identified as good markers for caries among European adults highlights the difficulty of identifying universal biomarkers that are applicable to all ages or to different populations.

Functional biomedical materials derived from proteins in the acquired salivary pellicle

In the oral environment, the acquired salivary pellicle (ASP) on the tooth surface comprises proteins, glycoproteins, carbohydrates, and lipids. The ASP can specifically and rapidly adsorb on the enamel surface to provide effective lubrication, protection, hydration, and remineralisation, as well as be recognised by various bacteria to form a microbial biofilm (plaque). The involved proteins, particularly various phosphoproteins such as statherins, histatins, and proline-rich proteins, are vital to their specific functions. This review first describes the relationship between the biological functions of these proteins and their structures. Subsequently, recent advances in functional biomedical materials derived from these proteins are reviewed in terms of dental/bone therapeutic materials, antibacterial materials, tissue engineering materials, and coatings for medical devices. Finally, perspectives and challenges regarding the rational design and biomedical applications of ASP-derived materials are discussed.

The salivary pellicle on dental biomaterials

The salivary pellicle, an adlayer formed by adsorption of salivary components on teeth and dental biomaterials, has direct consequences on basic outcomes of dentistry. Here, we provide an overview of salivary pellicle formation processes with a critical focus on dental biomaterials. We describe and critique the array of salivary pellicle measurement techniques. We also discuss factors that may affect salivary pellicle formation and the heterogeneity of the published literature describing salivary pellicle formation on dental biomaterials. Finally, we survey the many effects salivary pellicles have on dental biomaterials and highlight its implications on design criteria for dental biomaterials. Future investigations may lead to rationally designed dental biomaterials to control the salivary pellicle and enhance material function and patient outcomes.

The interrelationship between xerogenic medication use, subjective oral dryness and tooth wear

OBJECTIVE

To investigate the association between xerogenic medication use and tooth wear among American adults and whether this association can be explained by subjective oral dryness.

METHODS

We used data from 3578 adults who participated in the National Health and Nutritional Examination Survey (NHANES). Tooth wear was clinically determined using the modified Tooth Wear Index. Information on xerogenic medication use, subjective oral dryness (amount of saliva in mouth and feeling the mouth dry when eating) and potential confounders (sociodemographic factors, dental insurance coverage, gastroesophageal reflux disease medication use and soft drinks intake) were self-reported. The associations among xerogenic medication use, subjective oral dryness and tooth wear were assessed in regression models adjusting for confounders.

RESULTS

Adults taking xerogenic medication had greater odds of reporting too little amount of saliva and feeling the mouth dry when eating. In addition, participants taking one and multiple (two or more) xerogenic medications had, respectively, 1.53 (95 % CI: 1.01-2.32) and 1.44 (95 % CI: 0.62-3.33) greater odds of having tooth wear than those taking no xerogenic medications. In a regression model including all explanatory variables, the association of xerogenic medication use with tooth wear was fully attenuated whereas subjective oral dryness (amount of saliva in mouth but not feeling the mouth dry when eating) remained positively associated with prevalence of tooth wear. Similar findings were obtained with long-term use of xerogenic medication (in the past month and for three or more years).

CONCLUSION

Current (last month) use of xerogenic medication was associated with the presence of tooth wear. This association was accounted for by subjective indicators of oral dryness.

CLINICAL SIGNIFICANCE

Dentists should be familiar with the possible connection between patient's medical prescription and tooth wear. Changing prescriptions to non-xerogenic alternatives, whenever possible, could improve patients' oral condition. The findings also suggest that patients may recognise, through the perception of dry mouth, when medication is placing them at risk.

Optimizing the formation of the acquired enamel pellicle in vitro for proteomic analysis

Saliva is the major contributor for the protein composition of the acquired enamel pellicle (AEP), a bacteria-free organic layer formed by the selective adsorption of salivary proteins on the surface of the enamel. However, the amount of proteins that can be recovered is even smaller under in vitro condition, due to the absence of continuous salivary flow.

Asthma, long-term asthma control medication and tooth wear in American adolescents and young adults

OBJECTIVE

This study explored the associations of asthma and long-term asthma control medication with tooth wear among American adolescents and young adults.

METHODS

Data from 2186 participants of the National Health and Nutrition Examination Survey (NHANES) were used. Asthma and prescribed long-term medication were collected through questionnaires. The number of surfaces with tooth wear was determined during clinical examinations. Associations were tested in Hurdle regression models adjusting for confounders.

RESULTS

The prevalence of tooth wear was 58%, with an average of 6.1 (SD: 4.0) surfaces affected among those with the condition. The prevalence of asthma was 10.3%, with 2.9% of participants using long-term medication for asthma control. In the adjusted regression model, asthma was not associated with tooth wear. However, long-term control medication was associated with greater odds of having tooth wear (odds ratio: 3.33; 95%CI: 1.24-8.97), but it was not associated with the number of surfaces with tooth wear among those with the condition (rate ratio: 1.01; 95% CI: 0.58-1.75).

CONCLUSION

This cross-sectional analysis of national data shows that taking long-term asthma medication was positively associated with having tooth wear.

Differences in the Natural Enamel Surface and Acquired Enamel Pellicle following Exposure to Citric or Hydrochloric Acid

OBJECTIVES

The aim of this study was to investigate variations in the interaction between enamel, that is, the acquired enamel pellicle (AEP) and citric or hydrochloric acid.

MATERIALS AND METHODS

A 24-h AEP was formed on natural enamel specimens (n = 40) from pooled whole mouth human saliva. Samples were randomly allocated to citric (0.3%, pH 3.2) or hydrochloric (HCl) acid (0.01 M, pH 2.38) exposure for 30 or 300 s. The total protein concentration (TPC), and phosphorous and calcium concentrations of the pellicle were determined before and after acid exposure, and again after re-immersion in saliva. Surface roughness and tandem scanning confocal microscopy imaging were used to assess enamel changes.

RESULTS

After 300 s of citric acid exposure, the mean ± SD TPC reduced from 5.1 ± 1.1 to 3.5 ± 1.1 mg/mL (p < 0.05). In contrast, after 300 s of HCl exposure, the mean TPC did not reduce significantly from baseline (6.6 ± 1.1 to 5.7 ± 0.7 mg/mL) but was significantly reduced in the reformed pellicle to 4.9 ± 1.2 mg/mL (p < 0.001). This reduction occurred after significant release of calcium and phosphorous from the enamel surface (p < 0.001). Thirty seconds of exposure to either acid had no obvious effect on the AEP. The surface roughness of the enamel decreased after acid exposure but no differences between groups was observed.

CONCLUSIONS

These findings indicate that citric acid interacted with proteins in the AEP upon contact, offering enamel protection. In contrast, HCl appeared to bypass the pellicle, and reduced protein was observed only after changes in the enamel chemical composition.

We Do Not Eat Alone: Formation and Maturation of the Oral Microbiota

From the earliest moments of life, contact with the outside world and with other individuals invalidates the sterility of the oral cavity. The oral cavity passes from a sterility condition, that is present only during intrauterine life, to a condition in which a microbiota organizes and evolves itself, accompanying the person throughout their life. Depending on a patient’s age, systemic conditions and/or oral conditions, different characteristics of the oral microbiome are shown. By verifying and analyzing this process it is possible to understand what is at the basis of the etiopathogenesis of some oral pathologies, and also the function of the oral microbiome.

Erosive tooth wear: Knowledge among young adults and their preferred information sources

OBJECTIVES

The aim of this study was to learn more about levels of knowledge relating to erosive tooth wear and about the most desirable way of disseminating dental information among young adults.

METHODS

The research was a cross-sectional study of 331 young adults (20-25 years old) attending 25 dental care practices. Participants were asked to fill out a questionnaire with questions about their background, knowledge relating to erosive tooth wear and the preferred way of acquiring information about erosive tooth wear.

RESULTS

The results showed that there are gaps in the knowledge of young adults about erosive tooth wear. The knowledge score depended on educational level and dental information received in the past. The preferred way of acquiring information was chairside information from an oral health care professional complemented by tailored information in writing.

CONCLUSION

There is a lack of knowledge among young adults about erosive tooth wear. They prefer to receive information from the oral health care professionals accompanied by tailored information in writing. Further research should focus on developing this tailored information in line with the advice given by the oral health care professional.