胃食管反流病患者侵蚀性磨损病变的患病率——一系列病例

Prema Sukumaran, Siti Nurshakina Abdul Kamar, Nur Azwa Nadia M Zalani, D. Nambiar, R. Vaithilingam, K. Goh
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摘要

胃食管反流病(GERD)的食管外表现包括侵蚀性磨损性牙齿病变。这组患者的早期侵蚀性磨损病变很容易被遗漏,因为它们几乎没有临床症状。本病例系列旨在报告马来西亚GERD患者样本中侵蚀性磨损病变的患病率和严重程度。本病例系列包括11名根据改良反流病问卷(RDQ)或内窥镜检查诊断的GERD特征良好的受试者。使用基本侵蚀磨损检查(BEWE)指数进行标准化口腔内临床检查,以评估牙齿表面侵蚀磨损病变的存在和严重程度。BEWE评分为1的病变主要分布在上颌前牙,其次是上颌后牙和下颌牙。BEWE评分2的病变在上颌前牙中最为普遍,没有观察到BEWE得分3的病变。根据临床结果,GERD患者的上颌和下颌牙齿颊面有更多的侵蚀性磨损。该病例系列进一步证实了GERD与侵蚀性磨损病变之间的联系。作者想强调的是,医学和牙科从业者都需要了解GERD和侵蚀性磨损病变的早期临床表现。早期诊断允许对这些情况进行干预和保守管理。
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Prevalence of erosive wear lesions in Gastro-Esophageal Reflux Disease patients – A case series
Extra esophageal manifestation of Gastro-esophageal reflux disease (GERD) include erosive wear dental lesions. Early erosive wear lesions in this group of patients can be easily missed as they are accompanied by few clinical signs and hardly any symptoms. This case series aims to report the prevalence and severity of erosive wear lesions amongst a sample of GERD patients in Malaysia. Eleven subjects with well characterized GERD, diagnosed based on modified Reflux Disease Questionnaire (RDQ) or via endoscopy, were included in this case series. A standardized intra oral clinical examination was performed to assess presence and severity of erosive wear lesions on tooth surfaces using Basic Erosive Wear Examination (BEWE) index. Majority of BEWE score 1 lesions were distributed in maxillary anterior teeth, followed by maxillary posterior and mandibular teeth. BEWE score 2 lesions were most prevalent in maxillary anterior teeth and there were no BEWE score 3 lesions observed. Based on the clinical findings, more erosive wear lesions were found on the buccal surfaces of maxillary and mandibular teeth in GERD patients. This case series further confirms the link between GERD and erosive wear lesions. The authors would like to highlight the need for both medical and dental practitioners to be aware of early clinical presentations of GERD and erosive wear lesions. Early diagnoses allow for intervention and conservative management of these conditions.
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