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Longitudinal study of gastroesophageal reflux and erosive tooth wear.

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eMediNexus    04 November 2017

The objective of a new study published in BMC Gastroenterology was to characterize the longitudinal course of gastroesophageal reflux GERD and of associated erosive tooth wear as well as factors predictive of its progression in a large group of patients. In this longitudinal study 72 patients presenting to dentists with clinically significant erosive tooth wear and increased esophageal acid exposure by 24 hour 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. It was observed that at follow up there was no further progression in erosive tooth wear in 74 of patients. In addition the percentage of time with a pH 4 the number of acid reflux episodes and the percentage of proximal esophageal reflux off proton pump inhibitor PPI did not change significantly after one year while the number of weakly acidic reflux episodes decreased significantly in the large subgroup without progression. Furthermore none of the baseline demographic clinical endoscopic or esophageal acid exposure characteristics were significantly associated with progression of erosive tooth wear at follow up. Thus it was inferred that in patients with erosive tooth wear and oligosymptomatic GERD receiving esomeprazole for one year erosive tooth wear did not progress further in most patients. Background acidic esophageal reflux exposure appeared stable over time whereas weakly acidic exposure decreased significantly in patients without erosion progression. It was stated that MII pH measurements on PPI and with healthy controls will be useful in the further interpretation of the causal role of reflux in erosive tooth wear.1 Reference 1. Wilder Smith C Materna A Martig L Lussi A. Longitudinal study of gastroesophageal reflux and erosive tooth wear. BMC Gastroenterology. 2017 17 1 . doi 10.1186 s12876 017 0670 1.

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