Effect of sucralfate against hydrochloric acid-induced dental erosion

• Published in: Clinical oral investigations Vol. 23; no. 5; pp. 2365 - 2370
• Main Authors: Turssi, Cecilia P., Amaral, Flávia L. B., França, Fabiana M. G., Basting, Roberta T., Hara, Anderson T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2019; Springer Nature B.V
• Subjects: Animals; Cattle; Crystals; Data processing; Dental enamel; Dental Enamel - drug effects; Dental erosion; Dentin - drug effects; Dentistry; Dissolution; Durapatite; Fluorides; Gastric juice; Hydrochloric acid; Hydrochloric Acid - adverse effects; Hydroxyapatite; Medicine; Original Article; pH effects; Remineralization; Saliva; Sodium; Sodium Fluoride; Sucralfate - pharmacology; Teeth; Tooth Erosion - chemically induced; Tooth Erosion - prevention & control; Sucralfate; Dental erosion; Dentine; Enamel; Surface loss
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2694-5

Objective Devising effective measures for the prevention of hydrochloric acid (HCl)-induced erosion is of great significance. This is even more important in dentine, in which products have limited diffusion. Therefore, agents that can bind to proteins forming an acid-resistant gel-like coat, such as sucralfate, may stand out as a promising alternative. This study investigated the protective effect of sucralfate suspensions against HCl-induced dental erosion. Materials and methods In the first experiment, hydroxyapatite (HAp) crystals were pre-treated with a commercial sucralfate suspension (CoSS, pH 5.9), a stannous-containing sodium fluoride solution (NaF/SnCl 2 pH 4.5), two prepared sucralfate suspensions (PrSS, pH 5.9 and 4.5), or deionized water (DI, control). HAp dissolution was measured using a pH-stat system. In a subsequent experiment, embedded/polished enamel and root dentine slabs were allocated into five groups to be treated with one of the tested substances prior to and during erosion-remineralization cycles (HCl-2 min + artificial saliva 60 min, two times per day, 5 days). Surface loss was assessed profilometrically. Data were analyzed by ANOVA and Tukey’s tests. Results HAp dissolution was as follows: NaF/SnCl 2  < CoSS < PrSS/pH 4.5, while PrSS/pH 5.9 = DI and both did not differ from CoSS and PrSS/pH 4.5. In enamel, surface loss did not differ between CoSS and PrSS/pH 4.5, with both having lower surface loss than PrSS/pH 5.9 and DI and NaF/SnCl 2 differing only from DI. In root dentine, surface loss was as follows: CoSS < PrSS/pH 5.9 < (NaF/SnCl 2  = DI), while PrSS/pH 4.5 = CoSS = PrSS/pH 5.9. Conclusion Sucralfate suspension provided anti-erosive protection to HCl-induced erosion. Clinical relevance Sucralfate may protect teeth against erosion caused by gastric acid.