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      BARIATRIC SURGERY IMPACT ON GASTROESOPHAGEAL REFLUX AND DENTAL WEAR: A SYSTEMATIC REVIEW Translated title: IMPACTO DA CIRURGIA BARIÁTRICA NO REFLUXO GASTROESOFÁGICO E NO DESGASTE DENTAL: UMA REVISÃO SISTEMÁTICA

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          ABSTRACT

          Introduction:

          Several oral problems may be perceived in individuals who were submitted to bariatric surgery, due to metabolic and behavioral changes relative to diet and oral hygiene. Tooth wear appears to suffer impact after bariatric surgery, because there may be an increase in gastroesophageal reflux.

          Objective:

          To systematically review the literature regarding the impact of bariatric surgery on gastroesophageal reflux and tooth wear.

          Method:

          The following databases were accessed by two independent, calibrated examiners: PubMed, Medline, Lilacs, Scielo and Cochrane using the following descriptors: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. After excluding duplicate studies, 12 studies were initially evaluated by the title and abstract. The excluded studies were those without relevance to the present research, literature review studies and case reports. Thus, four articles were included in this study. All the articles evaluated indicated high association between gastroesophageal reflux and tooth wear in patients submitted to bariatric surgery. Association of these outcomes was more evident six months after the surgical procedure.

          Conclusion:

          Patients submitted to bariatric surgery showed higher prevalence of gastroesophageal reflux and tooth wear.

          RESUMO

          Introdução:

          Diversos problemas bucais podem ser percebidos nos indivíduos que foram submetidos à cirurgia bariátrica, frente às mudanças metabólicas e comportamentais referentes à alimentação e higienização. O desgaste dentário parece sofrer impacto após a cirurgia bariátrica, uma vez que pode ocorrer o aumento do refluxo gastresofágico após a operação.

          Objetivo:

          Analisar o impacto da cirurgia bariátrica no refluxo gastresofágico e no desgaste dentário por meio de uma revisão sistemática da literatura.

          Método:

          As seguintes bases de dados foram acessadas por dois examinadores independentes e calibrados: PubMed, Medline, Lilacs, Scielo e Cochrane usando os descritores: “bariatric surgery” AND “dental erosion” OR “bariatric surgery” AND “dental erosion” AND “gastroesophageal reflux disease”. Após a exclusão dos estudos duplicados, 12 estudos foram avaliados inicialmente pelo título e resumo. Foram excluídos os sem relevância para a presente pesquisa, os de revisão da literatura e os relatos de caso. Sendo assim, foram incluídos neste estudo quatro artigos. Todos os artigos avaliados indicaram uma alta associação entre refluxo gastresofágico e desgaste dentário em pacientes submetidos à cirurgia bariátrica. A associação destes desfechos foi mais evidente após seis meses do procedimento cirúrgico.

          Conclusão:

          Pacientes submetidos à cirurgia bariátrica mostram maior prevalência de refluxo gastresofágico e desgaste dentário.

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          Most cited references27

          • Record: found
          • Abstract: found
          • Article: not found

          Dental erosion--an overview with emphasis on chemical and histopathological aspects.

          The quality of dental care and modern achievements in dental science depend strongly on understanding the properties of teeth and the basic principles and mechanisms involved in their interaction with surrounding media. Erosion is a disorder to which such properties as structural features of tooth, physiological properties of saliva, and extrinsic and intrinsic acidic sources and habits contribute, and all must be carefully considered. The degree of saturation in the surrounding solution, which is determined by pH and calcium and phosphate concentrations, is the driving force for dissolution of dental hard tissue. In relation to caries, with the calcium and phosphate concentrations in plaque fluid, the 'critical pH' below which enamel dissolves is about 5.5. For erosion, the critical pH is lower in products (e.g. yoghurt) containing more calcium and phosphate than plaque fluid and higher when the concentrations are lower. Dental erosion starts by initial softening of the enamel surface followed by loss of volume with a softened layer persisting at the surface of the remaining tissue. Dentine erosion is not clearly understood, so further in vivo studies, including histopathological aspects, are needed. Clinical reports show that exposure to acids combined with an insufficient salivary flow rate results in enhanced dissolution. The effects of these and other interactions result in a permanent ion/substance exchange and reorganisation within the tooth material or at its interface, thus altering its strength and structure. The rate and severity of erosion are determined by the susceptibility of the dental tissues towards dissolution. Because enamel contains less soluble mineral than dentine, it tends to erode more slowly. The chemical mechanisms of erosion are also summarised in this review. Special attention is given to the microscopic and macroscopic histopathology of erosion. Copyright © 2011 S. Karger AG, Basel.
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            • Record: found
            • Abstract: found
            • Article: not found

            Dental erosion. Definition, classification and links.

            An overview of tooth wear, i.e. of non-carious destructive processes affecting the teeth including abrasion, demastication, attrition, abfraction, resorption and erosion is presented. The nomenclature and classification of dental erosion commonly used in the dental literature are summarized. They are based on etiology (extrinsic, intrinsic, idiopathic), on clinical severity (Classes I to III), on pathogenetic activity (manifest, latent) or on localization (perimolysis). Interactions between erosion and abrasion, demastication, attrition, and abfraction as well as caries and low salivary flow rate are highlighted.
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              Enamel mineral loss.

              To summarise the chemical, biological and host factors that impact enamel mineral loss, to highlight approaches to contemporary management of clinical conditions involving mineral loss and summarise emerging trends and challenges in this area.
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                Author and article information

                Journal
                Arq Bras Cir Dig
                Arq Bras Cir Dig
                abcd
                Arquivos Brasileiros de Cirurgia Digestiva : ABCD
                Colégio Brasileiro de Cirurgia Digestiva
                0102-6720
                2317-6326
                20 December 2019
                2019
                : 32
                : 4
                : e1466
                Affiliations
                [1 ]Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
                Author notes
                Correspondence: Silvia Helena de Carvalho Sales Peres E-mail: shcperes@ 123456usp.br

                Conflict of interest: none

                Author information
                http://orcid.org/0000-0003-0674-8522
                http://orcid.org/0000-0003-4760-8948
                http://orcid.org/0000-0003-3811-7899
                Article
                00501
                10.1590/0102-672020190001e1466
                6918764
                31859919
                86072201-e96b-4502-803e-f0f3aff7d59f

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 18 January 2019
                : 09 April 2019
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 24
                Categories
                Review Article

                bariatric surgery,gastroesophageal reflux,tooth wear,tooth erosion,cirurgia bariátrica,refluxo gastroesofágico,desgaste dentário,erosão dentária

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