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      Perimolysis: case report Translated title: Perimólise: relato de caso clínico

      case-report

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          Abstract

          <p>Perimolysis is a form of dental erosion, characterized by dental tissue demineralization without bacterial involvement. It can be of intrinsic or extrinsic origin. Extrinsic origin is considered when it is caused by excessive consumption of acid drinks and foods such as soft drinks, alcoholic beverages, acid fruit and prescription drugs for daily use. When caused by gastrointestinal disorders, such as those resulting from bulimia, anorexia nervosa and gastroesophageal reflux, it is considered of intrinsic origin. The acid action can cause erosion on palatal/lingual incisor surfaces, and occlusal and palatal/lingual posterior tooth surfaces causing pain (dental hyperesthesia). Treatment is often multidisciplinary, and the causes should be identified, eliminated or controlled. In dentistry, the approach must include preventive measures to reduce future risks, and restorative intervention using materials such as glass ionomer cement, resin composite, or endodontic and prosthetic rehabilitation in more complex cases. The aim of this study was to describe the restorative treatment in the case of a patient with this condition.</p>

          Translated abstract

          <p>Perimólise é uma forma de erosão dentária, caracterizada pela desmineralização do tecido dental sem envolvimento bacteriano, de origem intrínseca ou extrínseca. É considerada de origem extrínseca quando causada pelo consumo excessivo de bebidas, alimentos e substâncias ácidas, como refrigerantes, bebidas alcoólicas, frutas ácidas e medicamentos de uso contínuo. Denomina-se intrínseca quando causada por distúrbios gastrintestinais como os que ocorrem como conseqüência da bulimia, da anorexia nervosa e do refluxo gastresofágico. A ação ácida pode causar erosão nas faces palatina/lingual dos incisivos e palatina/lingual e oclusal dos dentes posteriores levando a dor, ou seja, hiperestesia dental. O tratamento geralmente é multidisciplinar, devendo identificar e eliminar ou controlar as causas. A abordagem odontológica deve associar medidas preventivas para diminuir riscos futuros e intervenção restauradora utilizando materiais como cimento ionômero de vidro, resina composta ou até mesmo endodontia e reabilitação protética para casos mais complexos. Este trabalho teve como objetivo descrever o tratamento restaurador de um caso clínico de paciente com esta patologia.</p>

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          Most cited references25

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          Gastroesophageal Reflux Disease and Tooth Erosion

          The increasing prevalence of gastroesophageal reflux disease (GERD) in children and adults, and of “silent refluxers” in particular, increases the responsibility of dentists to be alert to this potentially severe condition when observing unexplained instances of tooth erosion. Although gastroesophageal reflux is a normal physiologic occurrence, excessive gastric and duodenal regurgitation combined with a decrease in normal protective mechanisms, including an adequate production of saliva, may result in many esophageal and extraesophageal adverse conditions. Sleep-related GERD is particularly insidious as the supine position enhances the proximal migration of gastric contents, and normal saliva production is much reduced. Gastric acid will displace saliva easily from tooth surfaces, and proteolytic pepsin will remove protective dental pellicle. Though increasing evidence of associations between GERD and tooth erosion has been shown in both animal and human studies, relatively few clinical studies have been carried out under controlled trial conditions. Suspicion of an endogenous source of acid being associated with observed tooth erosion requires medical referral and management of the patient as the primary method for its prevention and control.
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            The worn dentition--pathognomonic patterns of abrasion and erosion.

            Historically, the dental literature has revealed various causes of tooth wear, yet it has failed to provide a conclusive method of differentiation and diagnosis of the condition. The categories of tooth wear encountered most commonly in dental practice are abrasion and erosion. The major causes of wear from abrasion are bruxism and toothpaste abuse, and the major causes of wear from erosion are regurgitation, coke-swishing and fruit-mulling. Through in-depth clinical study of these causes, this paper provides a diagnostic system that will enable dental professionals to determine and differentiate the exact aetiology of the worn dentition simply by the recognition of the pathognomonic wear patterns on diagnostic casts, which are based upon the position and quantity of the non-carious loss of tooth structure.
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              Esthetic and functional dental rehabilitation in a paient with gastroesophageal reflux

              (2008)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rgo
                RGO - Revista Gaúcha de Odontologia
                RGO, Rev. Gaúch. Odontol.
                Faculdade São Leopoldo Mandic (Campinas )
                1981-8637
                June 2015
                : 63
                : 2
                : 213-218
                Affiliations
                [1 ] Universidade Estadual Paulista Brazil
                [2 ] Centro Universitário de Araraquara Brazil
                [3 ] Universidade Paulista Brazil
                Article
                S1981-86372015000200213
                10.1590/1981-863720150002000122397
                a032c860-ce81-47f8-b344-7ae61ceaaa63

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1981-8637&lng=en
                Categories
                DENTISTRY, ORAL SURGERY & MEDICINE

                Dentistry
                Acidity,Dental enamel,Esthetics,Tooth erosion,Acidez,Esmalte dentário,Estética,Erosão dentária
                Dentistry
                Acidity, Dental enamel, Esthetics, Tooth erosion, Acidez, Esmalte dentário, Estética, Erosão dentária

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