歯牙糜爛の病因--内因性要因

Etiology of dental erosion--intrinsic factors.

抄録

内因性歯牙糜爛は、嘔吐や胃食道逆流の結果、胃酸が口腔内や歯牙に到達することによって引き起こされる。歯牙侵食の臨床症状は、胃酸が数年にわたり定期的に歯牙硬組織に作用しないと起こらないため、内因性要因による歯牙侵食は、慢性的な嘔吐や長期にわたる胃食道逆流を伴う疾患においてのみ観察されてきた。そのような状態の例としては、上部消化管の障害、特定の代謝および内分泌障害、薬の副作用および薬物乱用のケース、ならびに特定の心身症、例えばストレスによる心身症性嘔吐、神経性食欲不振症および過食症または反芻がある。本書では、医学・歯学文献のレビューに基づき、歯牙侵食の本質的な病因として考慮すべきすべての疾患の主な症状について、臨床像、有病率、侵食のリスクに関して徹底的に考察しています。

Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must be taken into account as possible intrinsic etiological factors of dental erosion are thoroughly discussed with respect to the clinical picture, prevalence and risk of erosion.