Impact of the digestive enzyme pepsin on enamel erosion and the protective efficacy of surface pre-reacted glass-ionomer particle gel

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-06 DOI:10.1016/j.jdent.2025.105890

Mayron Guedes Silva , Klícia Kallynne Cutrim Sousa , Alan Silva de Menezes , Leily Macedo Firoozmand

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Abstract

Objectives

To evaluate in vitro the impact of pepsin on enamel erosion in the presence of an acquired pellicle and assess the protective efficacy of a bioactive gel containing surface pre-reacted glass-ionomer (S-PRG) particles by measuring surface hardness loss.

Methods

Bovine enamel blocks were prepared, standardized, and randomly assigned to two groups (n = 24/group): HCl-only erosive model and HCl+Pep – an erosive model with pepsin. Each group was further divided into two pre-treatment conditions (n = 12/group): SPRG (exposure to S-PRG bioactive gel) and DW (immersion in deionized water, control). Baseline enamel superficial microhardness was measured. Acquired pellicle was formed using human saliva and the samples were subjected to an erosive challenge for 9 days. Surface hardness loss (%SHL), morphological and mineral composition changes (scanning electron microscopy [SEM]/energy-dispersive X-ray spectroscopy), and crystal characteristics (X-ray diffraction [XRD]) were analyzed. Statistical analysis was performed using one-way analysis of variance (p < 0.05).

Results

The HCl+Pep group exhibited significantly higher %SHL than the HCl-only group (p < 0.001). Pre-treatment with S-PRG gel did not significantly reduce %SHL (p > 0.05). SEM images revealed severe mineral loss in the interprismatic regions of the HCl+Pep/DW group, whereas the HCl/SPRG group exhibited less degradation. XRD analysis indicated modifications in hydroxyapatite (HAp) microstructure, with the formation of octacalcium phosphate, in the HCl/SPRG.

Conclusions

Pepsin exacerbates enamel erosion by increasing %SHL and altering the morphology and structural pattern of HAp crystals. Although S-PRG gel pre-treatment did not prevent %SHL, it facilitated the formation of a new crystalline phase and reduced enamel degradation.

Clinical significance

Pepsin exacerbates enamel erosion by intensifying mineral loss despite the acquired pellicle. Although it does not prevent hardness loss, bioactive materials are emerging as a promising supportive strategy - minimizing surface degradation through possible crystal structure modification, particularly in gastroesophageal reflux-related erosion conditions.

Abstract Image

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消化酶胃蛋白酶对釉质侵蚀的影响及表面预反应玻璃离子颗粒凝胶的保护作用。

目的：在体外评价胃蛋白酶对获得性牙釉质膜存在的牙釉质侵蚀的影响，并通过测量表面硬度损失来评估含有表面预反应玻璃离子（S-PRG）颗粒的生物活性凝胶的保护作用。方法：制备标准的牛牙釉质块，随机分为两组（n = 24/组）：HCl-纯侵蚀模型和HCl+Pep -加胃蛋白酶侵蚀模型。每组进一步分为两个预处理条件（n= 12/组）：SPRG（暴露于S-PRG生物活性凝胶）和DW（浸泡在去离子水中，对照组）。测量基线牙釉质表面显微硬度。使用人唾液形成获得的膜，并对样品进行9天的侵蚀挑战。分析了表面硬度损失（%SHL）、形貌和矿物组成变化（扫描电镜[SEM]/能量色散x射线光谱）以及晶体特征（x射线衍射[XRD]）。采用单因素方差分析进行统计学分析（p < 0.05）。结果：HCl+Pep组SHL %明显高于单纯HCl组（p0.05）。SEM图像显示，HCl+Pep/DW组在柱间区域有严重的矿物质损失，而HCl/SPRG组则表现出较少的降解。XRD分析表明，在HCl/SPRG中羟基磷灰石（HAp）的微观结构发生了变化，形成了磷酸八钙。结论：胃蛋白酶通过增加%SHL和改变HAp晶体的形态和结构模式而加剧牙釉质侵蚀。虽然S-PRG凝胶预处理不能预防%SHL，但它促进了新晶相的形成，减少了牙釉质的降解。临床意义：胃蛋白酶通过强化矿物质流失而加剧牙釉质侵蚀，尽管获得了牙釉质膜。虽然它不能防止硬度损失，但生物活性材料正在成为一种有希望的支持策略-通过可能的晶体结构修饰来减少表面降解，特别是在胃食管反流相关的侵蚀条件下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.