Dental erosion

Dentalna erozija podrazumijeva postupni, nepovratni gubitak tvrdih zubnih tkiva uzrokovan djelovanjem kiselina. Etiologija je višefaktorijalna, a rizične čimbenike dijelimo na vanjske i unutarnje. Ekstrinzični uzroci u organizam se unose iz okoline, a najčešće se povezuju s kiselim napitcima i hranom, lijekovima te proizvodima za oralnu higijenu. Intrinzični uzroci dentalne erozije predstavljaju kiseline želučanog podrijetla, a njihov povratak u usnu šupljinu uzrokovan je želučanim refluksom, povraćanjem u trudnoći ili u sklopu poremećaja prehrane. Egzogeni čimbenici dovode do erozivnih promjena na labijalnim i incizalnim plohama gornjih sjekutića i očnjaka, dok su kod primarno endogenog izvora kiseline najprije zahvaćene palatinalne i okluzijske plohe svih zuba gornje čeljusti. U početnom stadiju erozija može biti asimptomatska. Temeljitom anamnezom zdravstvenog stanja pojedinca, prehrambenih navika te profesionalnog okruženja moguće je prepoznati rizične faktore i djelovati na njih. Preventivnim i interceptivnim mjerama moguće je remineralizirati početne lezije i zaustaviti njihovu progresiju, dok se veća oštećenja zbrinjavaju restorativno ili protetski. Prikazan je slučaj pacijentice s dentalnom erozijom nakon izlječenja anoreksije i bulimije. Kompozitnim restauracijama zaustavljeno je daljnje trošenje zubnog tkiva i postignut je estetski učinak. S obzirom na to da je erozija zuba u porastu u suvremenom društvu i zahvaća sve mlađu populaciju, doktor dentalne medicine ima važnu ulogu u njezinu prepoznavanju i prevenciji.Dental erosion means progressive, ireversible loss of hard teeth substance caused by acid action. Etiology of dental erosion is multifactorial and risk factors include extrinsic and intrinsic factors. Extrinsic causes taken (in organism) from the environment are most commonly associated with acidic beverages and food, medicines and oral hygiene products. Intrinsic causes of dental erosion are gastric acid, its return to the oral cavity by gastric reflux, vomiting in pregnancy or as part of eating disorders. Extrinsic factors lead to erosive changes on labial and incisical surfaces of incisors and canines, more often in upper jaw, while palatal and occlusal surfaces in all upper jaw teeth are the first to be affected in patients with primay endogenous source of acid. In the initial stage an erosion can be asymptomatic. Through extensive anamnesis of the health condition of each individual, his dietary habits and profesional environment it is possible to recognize the risk factors and how to influence them. With preventive and interceptive measures it is possible to remineralize initial lesions and to stop further progression. With progressive tooth wear the approach is restorative and prothetic treatment. This thesis shows a case of a patient with dental erosion after recuperating from anorexia and bulimia. Treatment with composite restorations stopped further tooth wear and aesthetic effect was achieved. Considering that dental erosion is increasing in the modern society and affects the younger population, the dentist has an important role in recognizing and preventing it