Epidemiological and laboratory investigations of the hazardous effects of wine on human enamel

Chikte, Usuf M. E. (2005-04)

Thesis (PhD)--Stellenbosch University, 2005

Thesis

ENGLISH ABSTRACT: The purpose of this study was to investigate the erosive effect of wine on human permanent teeth. A multidimensional research approach utilising epidemiological investigations, Microhardness tests, Scanning Electron Microscopy and Confocal Laser Scanning Electron Microscopy (CLSM) were employed. The combination of these three scientific methods enabled the researcher to arrive at new concepts about the physical characteristics of the influence wine has on the dentition with special reference to enamel. A difference in erosion between teeth of wine-makers (and/or wine-tasters) and those who are not wine-makers, was clearly demonstrated. It is, however, possible that this difference might partially be attributed to the fact that the two main comparative groups were of opposite genders. In comparative epidemiological studies the design is constructed to have the groups similar with respect to background aetiology and different only to the factor under investigation, in this instance the frequent exposure to wine (high frequency and long duration of contact between wine and the teeth). In all likelihood the continuous, frequent exposure of wine-makers to wine is the major factor in the differences obtained (e.g. tooth surface loss and dentition status) in this study. A strong positive relationship was noted between statistically weighted tooth surface loss and the chronological age of wine-makers. A similar positive relationship could not be demonstrated in the case of years employed in the wine industry and tooth surface loss. All the Microhardness tests and microscopic investigations conducted confirmed the deleterious influence of wine on enamel. A clear 'dose-response' relationship was demonstrated by means of the Microhardness tests. The Scanning Electron Microscope and the Confocal Scanning Laser Electron Microscope (CLSM) work both corroborated the effects determined by the Microhardness tests. Differences were also demonstrated in the surface morphology of enamel with respect to the exposure to the wines investigated in the Scanning Electron Microscope (SEM) (three wines) and CLSM (two wines) studies. Differences with respect to severity were well established by means of the SEM investigations. Surface and subsurface lesions were observed with the aid of CLSM on the enamel exposed to the two wines.

AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om ondersoek in te stel na die effek van wyn op permanente tande by mense. 'n Multidimensionele benadering is gevolg waarin epidemiologiese ondersoeke, mikro-hardheid toetse, skandering elektronmikroskopie en konfokale laserskandering elektronmikroskopie gebruik is. Die kombinasie van hierdie drie wetenskaplike metodes stel die navorser in staat om nuwe konsepte te vorm ten opsigte van die eienskappe rondom die invloed van wyn op tande, met spesiale verwysing na glasuur. 'n Verskil in die erosie van glasuur tussen die tande van die wynmakers (wynproewers) en niewynmakers, is duidelik aangetoon. Dit is egter moontlik dat die verskil gedeeltelik toegeskryf kan word aan die feit dat die twee hoofgroepe hoofsaaklik uit teenoorgestelde geslagte bestaan het. In vergelykende epidemiologiese studies is die groepe gewoonlik dieselfde met betrekking tot agtergrond etiologie en slegs verskillend wat betref die faktor wat ondersoek word; in hierdie geval die frekwensie van blootstelling aan wyn (hoë frekwensie en langdurige kontak van wyn met tande ). In alle waarskynlikheid is die aanhoudende blootstelling van wynmakers aan wyn die hooffaktor in die verskille (bv. tandoppervlak verlies en tandstatus) in hierdie studie verkry. 'n Sterk positiewe verband is gevind tussen die statisties-geweegde tandoppervlakverlies en die chronologiese ouderdom van wynmakers. Daar kon egter geen positiewe verband gevind word tussen die aantal diensjare in die wynindustrie en tandoppervlakverlies nie. Al die mikro-hardheid toetse en mikroskopiese ondersoeke wat ondemeem is, het die nadelige invloed van wyn op glasuur bevestig. 'n Duidelike dosis-respons verwantskap is deur middel van die Mikro-hardheid toetse gedemonstreer. Die werk gedoen met die Skandeer Elektronmikroskoop (SEM) en die Konfokale Laser Skandeer Elektronmikroskoop (CLSM) het beide die effek deur die Mikro-hardheid toets vasgestel, bevestig. Die SEM (drie wyne) en CLSM (twee wyne) ondersoeke het ook verskille in die oppervlak morfologie van glasuur ten opsigte van die blootstelling aan die wyne gedemonstreer. In die geval van die SEM is dit met drie wyne gedemonstreer, terwyl dit in die geval van CSLM twee wyne was. Daar is wel verskille in graad vasgestel deur middel van SEM-ondersoeke. Oppervlak- en benede-oppervlak letsels op glasuur wat blootgestel is aan die twee wyne, is waargeneem met behulp van CSLM.

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