Longitudinal study of gastroesophageal reflux and erosive tooth wear

Wilder-Smith, Clive H; Materna, Andrea; Martig, Lukas; Lussi, Adrian (2017). Longitudinal study of gastroesophageal reflux and erosive tooth wear. BMC gastroenterology, 17(1), p. 113. BioMed Central 10.1186/s12876-017-0670-1

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BACKGROUND Approximately 60% of patients presenting to dentists with erosive tooth wear have significant gastroesophageal reflux (GERD), despite minor reflux symptoms. No longitudinal studies of reflux-associated erosive tooth wear and of reflux characteristics have been reported to date. The aim of this study was to characterize the longitudinal course of GERD and of associated erosive tooth wear, as well as factors predictive of its progression, in a large group of patients. METHODS Seventy-two patients presenting to dentists with clinically significant erosive tooth wear and increased esophageal acid exposure by 24-h multichannel intraluminal pH-impedance measurement (MII-pH) were re-assessed clinically and by MII-pH after 1 year treatment with esomeprazole 20 mg twice-daily. Predictive factors for erosive tooth wear were assessed by logistic regression. RESULTS At follow-up, no further progression in erosive tooth wear was observed in 53 (74%) of patients. The percentage of time with a pH < 4, the number of acid reflux episodes and the percentage of proximal esophageal reflux off-PPI did not change significantly after one year, but the number of weakly acidic reflux episodes decreased significantly in the large subgroup without progression. None of the baseline demographic, clinical, endoscopic or esophageal acid exposure characteristics were significantly associated with progression of erosive tooth wear at follow-up. CONCLUSIONS In this longitudinal study in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year, erosive tooth wear did not progress further in the majority of patients. Background acidic esophageal reflux exposure appeared stable over time, whereas weakly acidic exposure decreased significantly in patients without erosion progression. MII-pH measurements on-PPI and with healthy controls will be useful in the further elucidation of the causal role of reflux in erosive tooth wear. TRIAL REGISTRATION ClinicalTrials.gov , retrospectively registered: NCT02087345 .

Item Type:

Journal Article (Original Article)

Division/Institute:

08 Faculty of Science > Department of Mathematics and Statistics > Institute of Mathematical Statistics and Actuarial Science
04 Faculty of Medicine > School of Dental Medicine > Department of Preventive, Restorative and Pediatric Dentistry

UniBE Contributor:

Martig, Lukas and Lussi, Adrian

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 510 Mathematics
600 Technology > 610 Medicine & health

ISSN:

1471-230X

Publisher:

BioMed Central

Language:

English

Submitter:

Hendrik Meyer-Lückel

Date Deposited:

23 Jul 2019 11:00

Last Modified:

28 Jul 2019 02:29

Publisher DOI:

10.1186/s12876-017-0670-1

PubMed ID:

29070010

Uncontrolled Keywords:

Dental erosion Esomeprazole GERD Gastroesophageal reflux Proton pump inhibitor pH-impedance

BORIS DOI:

10.7892/boris.122923

URI:

https://boris.unibe.ch/id/eprint/122923

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