The natural history of the dental pellicle and its relationship to dental erosion

牙齿侵蚀(DE)通常是由饮食中的酸引起的，并会影响生活质量。我们的数据显示，45%的精英运动员受到影响，特别是由于酸性运动饮料和环境挑战，尽管总体人群患病率很高。简单地提高运动饮料的酸碱度会使它们变得不可口。研究问题：1.牙齿膜在牙齿侵蚀中的作用是什么？2.牙齿膜和牙齿侵蚀能否在实验室中模拟？3.牙釉质表面的变化如何在体外表征？4.体外定量牙釉质变化的方法如何用于临床和体内评估牙齿侵蚀？5.牙齿膜的成分/结构能否被修改以降低牙齿侵蚀的风险？方法1.牙齿侵蚀的体外模拟将开发新的方法来模拟口腔条件，无论有没有牙膜糖蛋白层的贡献。通过光学扫描、显微层析成像和表面扫描等方法对模型和检测系统的有效性进行了研究。一旦成功的DE模型得到验证，运动补充剂、饮料和凝胶将在该模型中进行测试，以对照标准对照，研究它们在有和没有牙膜的情况下的侵蚀特性。3.侵蚀检测方法将基于可能在口腔中用于临床(活体)评估侵蚀的技术，因此可能在未来引入临床实践。我们还将收集运动员在大强度训练前后的唾液，以调查薄膜形成是否发生了可能促进侵蚀的变化。在上述研究的基础上，我们将制定干预措施，以改变牙膜的结构和成分，以减少牙釉质的侵蚀。它们将在体外进行活性筛选，然后使用体外研究中开发的牙釉质侵蚀检测方法进行临床测试。预期的结果是一种新的方法来改变釉质膜的结构，以降低侵蚀的风险，可以用于精英运动和普通人群。

Dental erosion (DE) is usually caused by dietary acids and can affect quality of life. Our data show that 45% of elite athletes are affected particularly due to acidic sports drinks and environmental challenges although general population prevalence is high. Simply raising sports drinks pH makes them unpalatable. Research questions: 1. What is the role of the dental pellicle in dental erosion?2. Can dental pellicle and dental erosion be modelled in the laboratory?3. How can changes to dental enamel surface be characterised in vitro?4. How can in vitro methods of quantifying dental enamel changes be used clinically, in vivo to assess dental erosion?5. Can the dental pellicle composition/structure be modified to reduce risk of dental erosion?Approach1. In vitro modelling of dental erosion will develop new methods to simulate oral conditions both with and without the contribution of a glycoprotein layer of the dental pellicle. The validity of the model and detection system has been investigated with optical scanning methods as well as microtomography and surface scanning methods.2. Once a successful model of DE has been validated, sport supplements, drinks and gels will be tested in the model against a standard control for their erosive characteristics with and without dental pellicle. 3. The erosion detection methods will be based on technology that could potentially be used in the mouth to assess erosion clinically (in vivo) and might therefore be introduced into clinical practice in the future.4. We will also collect saliva from athletes before and after intensive training to investigate whether changes occur to pellicle formation that might promote erosion.5. Based on the above studies, we will create interventions for modifying the structure and composition of the dental pellicle with the potential to reduce erosion of the enamel. These will be screened for activity in vitro and then tested clinically using the enamel erosion detection approach developed in the in vitro studies6. The expected outcome is a new approach to modifying the structure of the enamel pellicle to reduce erosive risk that can be used in elite sport and the general population.