title: Does erosion progress differently on teeth already presenting clinical signs of erosive tooth wear than on sound teeth? An in vitro pilot trial.
abstract: BACKGROUND
  Erosive tooth wear (ETW) is clinically characterized by a loss of tooth surface, and different enamel depths may have different susceptibility to demineralization. Therefore, the aim of this in vitro pilot study was to assess if the progression of erosive demineralization is faster on teeth already presenting signs of ETW when compared to originally sound teeth.
  
  
  METHODS
  We selected 23 central incisors: 14 were clinically sound (Sound) and 9 presented clinical signs of early erosive tooth wear (ETW-teeth). The teeth were embedded in resin, leaving an uncovered window of native enamel (6.69 ± 2.30 mm(2)) on the incisal half of the labial surface. We measured enamel surface reflection intensity (SRI) initially and after each consecutive erosive challenge (1 % citric acid, total of 4, 8, 12, 16, 20 and 24 min). Calcium released to the citric acid was measured with an atomic absorption spectrometer.
  
  
  RESULTS
  We observed higher initial SRI values in ETW-teeth than in Sound teeth (p = 0.007). During in vitro erosive demineralization, we observed that erosion on originally Sound teeth progressed significantly slower (p = 0.033) than on ETW-teeth: SRI decreased by 75 % (from 100 to 25 %) on Sound teeth, and by 89 % (from 100 to 11 %) on ETW-teeth. Calcium release increased during erosion, but presented no significant differences (p = 0.643) between originally Sound (0.031 μmol/mm(2)) and ETW-teeth (0.032 μmol/mm(2)). There was satisfactory correlation between calcium release and rSRI values (r s  = -0.66).
  
  
  CONCLUSIONS
  The optical reflectometer distinguished originally sound teeth from those with signs of ETW, and the results suggest that acid demineralization progresses differently on teeth already presenting clinical signs of ETW than on sound teeth.
authors.affiliation: Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland. thiago.saads@zmk.unibe.ch.
authors.forename: Thiago Saads
authors.initials: TS
authors.lastname: Carvalho
authors.affiliation: Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
authors.forename: Tommy
authors.initials: T
authors.lastname: Baumann
authors.affiliation: Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
mesh_terms: D003743:Dental Enamel; D006801:Humans; D010865:Pilot Projects; D019217:Tooth Attrition; D014077:Tooth Erosion; D057085:Tooth Wear
keywords: Assessment; Calcium; Dental erosion; Diagnostics; Enamel; Optical reflectometer; Reflection analysis; Susceptibility