Calcium Carbonate Reacts With Hcl
J Clin Exp Paring. 2018 Aug; 10(8): e776–e780.
Anti-erosive result of calcium carbonate suspensions
Priscila Scandiffio
1DDS, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, xiii, Campinas, SP, Brazil
Tais Mantilla
twoDDS, MSc, PhD student, School of Dentistry, Academy of São Paulo, Av. Professor Lineu Prestes 2227, São Paulo, SP, Brazil
Flávia Amaral
3DDS, MSc, PhD, Banana Professor, São Leopoldo Mandic Plant and Dental Inquiry Heart, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
Fabiana França
3DDS, MSc, PhD, Banana Professor, São Leopoldo Mandic Institute and Dental Research Center, Rua José Rocha Junqueira, thirteen, Campinas, SP, Brazil
Roberta Basting
threeDDS, MSc, PhD, Banana Professor, São Leopoldo Mandic Institute and Dental Inquiry Eye, Rua José Rocha Junqueira, thirteen, Campinas, SP, Brazil
Cecilia Turssi
3DDS, MSc, PhD, Banana Professor, São Leopoldo Mandic Institute and Dental Research Heart, Rua José Rocha Junqueira, 13, Campinas, SP, Brazil
Received 2018 May 7; Accustomed 2018 Jul five.
Abstract
Background
This study aimed to investigate the power of unlike concentrations of calcium carbonate (CaCO3) suspensions to control enamel surface loss.
Cloth and Methods
Lxx-5 enamel slabs were embedded, basis and polished in a pneumatic grinder-polisher machine. Reference areas were created with UPVC record and the specimens were randomly allocated into five groups (n = 15) for exposure to hydrochloric acid solution to simulate gastric juice (0.01 M, pH 2) for 2 minutes. The samples were then exposed to suspensions containing 0.0001, 0.001, 0.01 or 0.1 mmol/L CaCO3 for ane infinitesimal. Bogus saliva was used every bit command. The samples were subjected to a total of five erosive cycles followed by treatment with CaCO3 suspension. Surface loss was measured (in µm) using optical profilometry.
Results
One-way ANOVA (p = 0.009) and Tukey's test showed a significant reduction in surface loss when compared to the group not exposed to CaCO3 (0.74, +/- 0.23 µm), and the 0.01 mmol/L (0.40; +/- 0.23 µm) and 0.1 mmol/L suspensions (0.37; +/- 0.26 µm).
Conclusions
The lower concentrated suspensions were incapable of significantly reducing enamel surface loss. Rinsing with 0.01 and 0.1 mmol/L calcium carbonate suspensions was revealed as a potentially promising strategy to forbid enamel erosion.
Key words:Tooth erosion, gastric acrid, calcium carbonate, prevention and control.
Introduction
Despite the inhomogeneity in the incidence and prevalence of dental erosion (1), cantankerous-exclusive, prospective and meta-analytic studies (2-4) have shown that approximately xxx% of the population may accept signs of wear due to intrinsic and extrinsic acids of non-bacterial origin. This situation underscores the need to improve understand the etiology and management of dental erosion.
A crusade of severe erosive lesions is the presence of muriatic acid from gastric juice (5), which may achieve the dental surface due to episodes of recurrent emesis (vomiting), regurgitation of gastric contents acquired by gastro esophageal reflux disease, as a upshot of bariatric surgery, due to anorexia and/or bulimia, via chronic alcoholism, and during pregnancy (6-9).
Hydrochloric acrid is completely ionizable, which provides an exaggerated fall in oral pH, approximately 2.0 (10). In the presence of such acid, saliva becomes subsaturated in relation to the hydroxyapatite and fluorapatite crystals (11). Afterwards, the molar undergoes mineral dissolution via erosive wear until oral homeostasis is restored past the rinsing, diluting and buffering furnishings of saliva (12). During this time, it is important to minimize erosion by implementing strategies that both prevent its occurrence and control the progression of existent lesions (13).
It is well accepted that the most important approach to control dental erosion caused by hydrochloric acid is the treatment of underlying medical conditions (thirteen). However, information technology is important to highlight that while the cause behind the recurrent episodes of emesis is addressed, a dental surgeon should be included within the multidisciplinary team in order to educate the patient, besides as to provide preventive and/or therapeutic measures to reduce the damage caused by the contact between hydrochloric acid and the teeth (xiv-16).
The employ of neutralizing agents, which contribute to alkalization of acids nowadays within the oral cavity following erosive challenges, is one of the suggested approaches for erosion control (13,15,17-nineteen). With this concept in mind, it has been reported that following challenges provided by solutions that simulate gastric juices, antacids reduced the time needed for the salivary pH to render to baseline (14,twenty). In vitro (21) and in situ (22,23) studies on neutralizing capacity have shown that following an erosive episode with simulated gastric juice, the use of alkaline solutions or suspensions, such as sodium bicarbonate and aluminum or magnesium hydroxide, significantly decreased enamel wear.
Calcium carbonate mouthwash suspensions may also potentially control dental erosion due to their strong buffering capacity, and hence may exist considered a neutralizing agent. When hydrochloric acid comes into contact with calcium carbonate, the post-obit chemical reaction ensues: CaCO3 + 2HCl → CaCl + CO2 + Water, which provides acid neutralization alongside the germination of byproducts.
The potential of calcium carbonate to annul dental erosion has still non been investigated. In addition, the possibility of a dose-dependent relationship between the calcium carbonate suspension and dental erosion command, explained by a college or lower base availability to react with the acidic component, remains to exist elucidated. Therefore, the aim of the present study, therefore, was to investigate the capacity of calcium carbonate suspensions at varying concentrations on the control of enamel surface loss post-obit simulated erosive challenges.
Textile and Methods
-Experimental blueprint
A randomized complete cake study with a unifactorial structure was designed. The study factor was Concentration of Calcium Carbonate Pause at four experimental levels (0.0001 mmol/L; 0.001 mmol/L; 0.01 mmol/50; 0.1 mmol/L), every bit well as a command level, in which artificial saliva was used in place of the calcium carbonate pause. Each grouping was composed of 15 test specimens (n = xv) obtained from slabs of bovine enamel. Sample size calculation, obtained using the GPower three.one.9.2 software, was based on a pilot written report with five samples per grouping, which suggested that for a 1-way analysis of variance, an consequence size of 0.48, and a significance level of 0.05, a total of 75 samples would exist necessary to accomplish a power of 90%. The response variable was surface loss, measured in µm. Effigy ane presents a flowchart of the experimental procedures in this study.
Flowchart of the experimental procedures.
-Dental slab collection
Following blessing past the Ethics Committee in Beast Research of the São Leopoldo Mandic Institute and Dental Inquiry Heart (#2013/0118), 30 bovine incisor teeth were obtained. Each tooth was cleaned with a scalpel blade, polished at depression-speed with a pumice attached to a Robinson brush, and stored in 0.one% thymol solution.
In order to split up the roots from the crown, the teeth were cut with a precision saw (Isomet 1000, Buehler Ltd., Lake Bluff, IL, United states of america) at the dentin-enamel junction. Further cuts were fabricated to the crown, providing ninety enamel slabs each measuring 3 x iii ten 2 mm (width 10 length 10 depth).
-Dental slabs planning and polishing
The dental slabs were embedded in epoxy resin (Epoxicure, Buehler Ltd., Lake Bluff, IL, USA), and ground wet with aluminum oxide papers (600 and 1200 grit) using a grinder-polisher machine equipped with a pneumatic system (Ecomet/Automet 250, Buehler Ltda., Lake Bluff, IL, U.s.a.). Polishing was achieved using felt discs and 0.3 µm alumina suspension (Alfa Micropolish, Buehler Ltd., Lake Barefaced, IL, U.s.). Specimens were ultrasonically cleaned after each grinding and polishing step.
-Option and grooming of specimens
Specimens were pre-tested using a HVS-1000 microhardness tester (Panambra Zwick Com. Máq. Equip. Ltda, São Paulo, SP, Brazil). V Knoop microhardness indents (50 thou, xv s) were made in a linear fashion along the vertical center line, spaced 200 µm apart. The values obtained were submitted to descriptive analysis to obtain a frequency distribution bend, from which 75 test specimens were selected.
Adhesive unplasticised polyvinyl chloride (UPVC) tapes (Graphic Record; Chartpak, Leeds, Us) were then placed along the correct- and left-hand margins of the specimens leaving an exposed primal area of one ten 3 mm.
-Erosive episodes and application of calcium carbonate solutions
The specimens were subjected to erosive episodes using twenty µL of a 0.01 M hydrochloric acid solution (pH 2.0). Each sample was exposed to the acid for two minutes, after which the backlog was removed.
Specimens were then arranged co-ordinate to a random distribution into the command group (artificial saliva) or into i of the four experimental groups to be treated with of the following calcium carbonate suspensions – 0.0001 mmol/L; 0.001 mmol/L; 0.01 mmol/50; 0.1 mmol/L. The specimens (n = 15) were exposed to 20 µL of one of 4 calcium carbonate suspensions (pH ten) or artificial saliva for one minute afterwards which they were rinsed with bogus saliva for ten seconds and afterward stored in artificial saliva for 24 hours at 37oC. Bogus saliva used comprised sodium hydroxymethylbenzoate, sodium carboxymethylcelullose, potassium chloride (KCl), MgCl2.6H2O, CaCl2.2H2O, K2HPO4 and KH2PO4 (24-26).
-Surface loss analysis
Surface loss measurements were performed using an optical profilometer (Proscan 2000, Scantron, Venture Style, Taunton, United Kingdom). In the x-axis, the footstep size and number of steps were set at 0.01 mm and 200, respectively; while, in the y-axis settings were 0.05 mm and twenty, respectively. The accuracy on height measurements is 0.01 µm. The correct and left lateral surfaces, which had been isolated with UPVC tape, were used equally the reference areas. Images demonstrating the vertical loss formed betwixt the reference areas and the regions submitted to handling (µm) were analyzed using the Proscan Application software (version ii.0.17).
-Statistical analysis
Post-obit descriptive analysis and confirmation of homogeneity of variance and normality, the data were subjected to inferential statistical analysis using one-manner analysis of variance. Multiple comparisons were performed using the Tukey's examination. All statistical analyses were performed using the SPSS 20 software (SPSS Inc., Chicago, IL, U.s.a.), bold a significance level of 5%.
Results
As confirmed by one-way analysis of variance, with a statistical ability of 85.8%, surface loss of enamel post-obit exposure to hydrochloric acid was afflicted by the use of calcium carbonate suspensions (p = 0.009). The Tukey's test revealed that the enamel exposed to simulated gastric juices and so subjected to 0.01 and 0.1 mmol/L calcium carbonate suspensions showed a significantly subtract in surface loss when compared to the control grouping (artificial saliva). Figure 2 substantiates such difference. At concentrations of 0.0001 and 0.001 mmol/L, the calcium carbonate suspensions did not produce a significant effect when compared to control ( Tabular array 1).
Profile corresponding to the scan area over the reference and worn areas of samples treated with 0.one mmol/Fifty CaCO3 interruption (A) and artificial saliva (B).
Table 1
Net enamel loss co-ordinate to the concentration of CaCO3 suspension used.
Discussion
Despite the fact that saliva plays an important part in dental erosion, past rinsing, diluting and buffering both intrinsic and extrinsic acids (12), also as allowing mineral degradation within these lesions (12), its capacity to prevent the formation and progression of dental erosions is limited. Therefore, new measures, such every bit those based on acid neutralization, have been adopted (21-23,26). With this in mind, the present study tested the hypothesis that calcium carbonate suspensions, in a dose-dependent manner, would have the power to control enamel surface loss acquired by hydrochloric acid, simulating gastric juices.
The results of this report confirmed the tested hypothesis, since article of clothing acquired by muriatic acid was significantly reduced depending on the concentration of calcium carbonate suspension used. These effect is based on the chemical reaction CaCO3 + 2HCl → CaCl2 + H2O + CO2, in which hydrochloric acid and calcium carbonate, the base component, grade water, carbon dioxide and calcium chloride, therefore neutralizing the acrid by consuming the H+ radicals. Consequently, an increase in pH of the dental surface is observed, and therefore a supersaturation in calcium and phosphate ions and decreased dissolution of hydroxyapatite and fluorapatite crystals are seen.
Information technology is of import to highlight that the result of calcium carbonate suspensions is not restricted to dilution and rinsing of balance muriatic acid that remained on the enamel surface. This is proven by the fact that with artificial saliva (control group) a significantly junior outcome was observed compared to the two highest concentrations of calcium carbonate used, which decreased surface loss by approximately 46 and 50% for the 0.01 and 0.1 mmol/L suspensions, respectively. It is worth speculating that like for fluoride mouthrinses, the protection exerted by such CaCO3 suspensions may depend on the number of erosive challenges (27). Under continuation of the erosive episodes, we speculate that the level of protection found for the two tested highly-full-bodied CaCO3 suspensions might exist reduced.
At lower calcium carbonate concentrations, 0.0001 and 0.001 mmol/L, the outcome of the suspensions was not unlike from that of artificial saliva. This may exist due to the fact that for the acid radical (H+) to exist consumed in a way that impacts the control of enamel erosion there is a demand of a minimum level of calcium carbonate, which was likely non offered by the 0.0001 and 0.001 mmol/L suspensions. Therefore, it tin can be stated the calcium carbonate suspensions tested in the present written report exerted a concentration-dependent event. One should reiterate, yet, that there was no significant deviation between the two lower concentration suspensions and the effect of artificial saliva.
The consequence of neutralizing agents, such equally the calcium carbonate used in this study, has been demonstrated for other suspensions. Sodium bicarbonate was used in the in situ model developed by Messias et al. (22), where the capacity to significantly reduce enamel wearable past 27% was observed. Also the fact that some other experimental model was used in the quoted paper and may explain the deviation between the efficacy of CaCO3 and sodium bicarbonate, it has been known since a long time agone that the equivalent power of CaCO3 is higher than that presented by sodium bicarbonate (28). Such property provides the former a stronger antacid power. In addition, in terms of commercially available products, sodium bicarbonate and magnesium hydroxide-based antacid suspensions, among others, have been highlighted as being capable of controlling erosion by up to 39% (21). A calcium carbonate interruption associated with sodium bicarbonate and alginate has as well been shown to subtract enamel erosion by 38% (23).
At their higher concentrations (0.01 and 0.one mmol/L), calcium carbonate suspensions have been shown to precipitate when left to rest. This is most likely due to the fact that at college concentrations, the suspensions remains very close to its maximum value of solubility in water at 25ºC (0.12 mmol/L). In order to remove calcium carbonate residues that may have been present on the enamel slab surface, the test specimens were rinsed in an ultrasonic bath prior to existence measured for surface loss. For such measurements we used profilometry, which has been considered the gold standard method for measuring step height germination in in vitro erosion studies (29).
To improve ones understanding of the efficacy of calcium carbonate suspensions, i would need to investigate the presence of a fourth dimension-dependent effect as well. In add-on, information technology would exist relevant to investigate whether CaCO3 formulations suspended in polymers would afford additional protection.
Although the effective management of the presence of gastric acid in the oral cavity demands the identification and treatment of the underlying pathology, the use of 0.01 and 0.1 mmol/50 calcium carbonate mouthwashes seems a promising option to minimize the loss of the dental structure caused by hydrochloric acid. For that, further studies, including in situ and in vivo testing, are needed.
Acknowledgments
This research was supported by PIBIC/CNPq (grant n. 12641520137).
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Calcium Carbonate Reacts With Hcl,
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174013/#:~:text=When%20hydrochloric%20acid%20comes%20into,alongside%20the%20formation%20of%20byproducts.
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