Gastro-oesophageal Reflux in Oligosymptomatic Patients With Dental Erosion
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Dental erosions, the chemical dissolution of enamel without bacterial involvement, are considered to be an established complication of gastroesophageal reflux disease (GERD) by the Montreal global consensus statement. Given the high prevalence of dental erosions and the absence of any pH-impedance data or medical management guidelines for GERD-associated dental erosions, reflux characteristics will be characterized using questionnaires, endoscopy and esophageal pH-impedance testing, in successive patients dental erosions referred by dentists for evaluation of GERD. For assessment of the role of additional factors besides H+ activity in the refluxate, a sample of gastric juice will be aspirated during endoscopy and frozen for analysis of pepsin and other proteases. Prognostic factors for progression of dental erosions will be determined by repeating the evaluation after chronic dosing with esomeprazole 20mg twice-daily, which is prescribed to all patients.
The % of time with pH<4 and 5.5 during 24-hour pH-impedance [ Time Frame: 1 year ]
Secondary Outcome Measures :
The number of acidic and weakly acidic reflux episodes during 24-hour pH-impedance [ Time Frame: 1 year ]
Other Outcome Measures:
Association between dental erosion grades, gastric juice pepsin conc. and reflux episodes and % time with pH<4 and <5.5 during 24-hour pH-impedance [ Time Frame: 1 year ]
the % of reflux episodes reaching 15cm above the lower esophageal sphincter, concentration of pepsin and the tooth wear (BEWE) score: multivariate analysis with forward and backward elimination model to assess the best predicting variables.
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Layout table for eligibility information
Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Successive male and female patients with dental erosions
Successive male and female patients
Over 18 years of age presenting to the University of Bern Department of Dentistry and affiliated dentists
Non-reflux causes of erosion
Reduced salivary flow and buffering capacity
History of bruxism, eating disorders, recurrent vomiting, severe obesity (BMI>35kg/m2) or past bariatric surgery