Çocuklarda Yaygın Kullanılan Şurup Formundaki İlaçların Karyojenik ve Eroziv Potansiyellerinin Değerlendirilmesi

Yıl 2024, , 211 - 217, 19.08.2024

Behiye Bolgül , Rukiye Arıkan , Oyku Peker

https://doi.org/10.15311/selcukdentj.1387296

Öz

Giriş ve Amaç: Bu çalışma, akut veya kronik hastalığı olan çocuklarda kullanımı giderek artan pediatrik sıvı ilaçların (PLM) süt dişlerinin minesi üzerindeki karyojenik ve aşındırıcı etkilerini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Bu çalışma için uzun süreli ve yaygın olarak kullanılan beş pediatrik ilaç (Augmentin, Zimaks, Calpol, Vitabiol ve Ferro Sanol B) seçildi. İlaçların eroziv ve karyojenik potansiyellerini değerlendirmek amacıyla, sükroz konsantrasyonları, pH değerleri ve mine dokusundan çözdükleri kalsiyum konsantrasyonları belirlendi. Numuneler MARS XPress (CEM Marka) Mikrodalga fırın ile asit yakma işlemine tabi tutuldu. Kalsiyum konsantrasyonları daha sonra İndüktif Eşleşmiş Plazma-Kütle Spektroskopisi (ICP MS) ile ölçüldü. Bulgular: Pediatrik sıvı ilaçların çoğunun (%80) pH'ı 5,5'un altındadır. Bu nedenle emayenin etkilenmesi kritik öneme sahiptir. Asitlik değeri en yüksek olan şurup Ferro sanol B (ortalama pH 2,96±0,01), en düşük asitlik değeri ise Calpol (ortalama pH 6,42±0,03) oldu. Çalışmamızda kullandığımız pediatrik şurup örneklerinin tamamı sakkaroz içermektedir.
Sonuç: Sonuç olarak erken çocukluk döneminde çeşitli nedenlerle kullanılan şurupların farklı pH ve asitlik değerlerinde diş yüzeylerinde erozyona neden olabileceği görülmüştür. İncelenen tüm şuruplar sakkaroz içerdikleri için karyojenik etkiye sahiptirler. Tüm pediatrik sıvı ilaçlar için her üç zaman aralığında da mineden tüm solüsyonlara kalsiyum geçişi gözlemlendi. Genel olarak bekletme süresi arttıkça çözünme miktarı da arttı. En düşük kalsiyum çözünme hızı 1. dakikada Augmentin şurup örneğinde (15,87 mg/L), en yüksek kalsiyum çözünme hızı ise sekizinci saatte Zimaks şurup örneğinde (609,69 mg/L) görüldü. Şurupların pH değerleri ile minede çözünen kalsiyum miktarı arasında istatistiksel bir korelasyon yoktur.)

Anahtar Kelimeler: Pediatrik şuruplar, ICP-MS, Ph metre

Anahtar Kelimeler

Pediatrik şuruplar, ICP-MS, Ph metre

Etik Beyan

Ethics Committee Approval: This study was approved by the clinical research ethics committee of the Hatay Mustafa Kemal University. Date: 04.10.2021, number:29

Destekleyen Kurum

Mustafa Kemal University, Hatay, Turkey.

Teşekkür

The authors acknowledge support from the Mustafa Kemal University, Hatay, Turkey.

Evaluation of Cariogenic and Erosive Potentials of Pediatric Liquid Medicines

Öz

Introduction and Aim: This study aims to evaluate the cariogenic and erosive effects of pediatric liquid medicines (PLM) on the enamel of primary teeth, which have been increasingly used in children with acute or chronic diseases.
Materials and Methods: Five long-term and widely used pediatric drugs (Augmentin, Zimaks, Calpol, Vitabiol, and Ferro Sanol B) were selected for this study. In order to evaluate the erosive and cariogenic potentials of the drugs, the sucrose concentrations, pH values and calcium concentrations they dissolve from the enamel tissue were determined. The samples were subjected to acid incineration with MARS XPress (CEM Brand) Microwave oven. Calcium concentrations were then measured by Inductively Coupled Plasma-Mass Spectroscopy (ICP MS). Results: Most of the pediatric liquid drugs (80%) have a pH of less than 5.5. It is therefore critical for enamel to be affected. The syrup with the highest acidity value was Ferro sanol B (average pH 2.96 ± 0.01) and the lowest acidity value was Calpol (average pH 6.42 ± 0.03). All of the pediatric syrup samples we used in our study contain sucrose.
Conclusion: As a result, it has been observed that syrups used for various reasons in early childhood may cause erosion on tooth surfaces at different pH and acidity values. All syrups examined have cariogenic effects as they contain sucrose. Calcium transition from enamel to all solutions was observed in all three time intervals for all pediatric liquid drugs. In general, the amount of dissolution increased as the holding time increased. The lowest calcium dissolution rate was observed in the Augmentin syrup sample at the first minute (15.87 mg/L), the highest calcium dissolution rate was observed in the Zimaks syrup sample (609.69 mg/L) at the eighth hour. There is no statistical correlation between the pH values of the syrups and the amount of calcium dissolved from the enamel.)

Keywords: Pediatric syrup drugs, ICP-MS, Ph meter

Anahtar Kelimeler

Pediatric syrup drugs, ICP-MS, Ph meter

Kaynakça

• 1. Sharma A. Deshpande S. Effect of Sucrose in Different Commonly Used Pediatric Medicines upon Plaque pH in Human Subjects. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2011, p 144. https://doi.org/10.4103/0970-4388.84688.
• 2. Lussi A. Ganss C. Erosive Tooth Wear: From Diagnosis to Therapy; Karger Medical and Scientific Publishers, 2014.
• 3. Moyer VA. US Preventive Services Task Force. Prevention of Dental Caries in Children from Birth through Age 5 Years: US Preventive Services Task Force Recommendation Statement. Pediatrics 2014, 133 (6), 1102–1111.
• 4. Imfeld T. Dental Erosion. Definition, Classification and Links. EUR. J. Oral Sci. 1996, 104 (2 ( Pt 2)), 151–155.
• 5. Zero DT, Lussi A. Behavioral Factors. monogr. Oral Sci. 2006, 20, 100–105.
• 6. Girish Babu K, Rai K, Hedge A. Pediatric Liquid Medicaments – Do They Erode The Teeth Surface? An In Vitro Study: Part I. Journal of Clinical 2008.
• 7. Joshi RR. Editorial [Hot Topic: Protein Peptide Informatics and Drug Designing - Some Computational Techniques for Structural Genomics Based Approaches (Part II) (Guest Editor: Rajani R. Joshi)]. Protein & Peptide Letters. 2007, pp. 625–625. https://doi.org/ 10.2174/092986607781483949.
• 8. Bigeard L. The Role of Medication and Sugars in Pediatric Dental Patients. Dent. Clin. North Am. 2000, 44 (3), 443–456.
• 9. Zhao D, Tsoi JK-H, Wong HM, Chu CH, Matinlinna JP. Paediatric Over-the-Counter (OTC) Oral Liquids Can Soften and Erode Enamel. Dent. J. 2017, 5 (2). https://doi.org/ 10.3390/dj5020017.
• 10. Pierro VS da S, Abdelnur JP, Maia LC, Trugo LC. Free Sugar Concentration and pH of Paediatric Medicines in Brazil. Community Dent. health 2005, 22 (3), 180–183.
• 11. Maguire A, Baqir W, Nunn JH. Are Sugars-Free Medicines More Erosive than Sugars-Containing Medicines? An in Vitro Study of Paediatric Medicines with Prolonged Oral Clearance Used Regularly and Long-Term by Children. int. J. Paediatr. Dent. 2007, 17 (4), 231–238.
• 12. Taji S, Seow WK. A Literature Review of Dental Erosion in Children. aust. Dent. J. 2010, 55 (4), 358–367; quiz 475.
• 13. Bavbek AB, Dogan OM, Yilmaz T, Dogan A. The Role of Saliva in Dental Erosion and a Prosthetic Approach to Treatment: A Case Report. J. Contemp. Dent. practice 2009, 10 (3), 74–80.
• 14. Almeida, ICS; Costa Filho, LC Erosive Effect of an Antihistamine‐containing Syrup on Primary Enamel and Its Reduction by Fluoride Dentrifice. International Journal of 2006.
• 15. Opening Ceremonies of the 72nd General Session and Exhibition of the International Association for Dental Research (IADR), the 23rd Annual Meeting and Exhibition of the American Association for Dental Research (a Division of the IADR), and the 18th Annual Meeting of the Canadian Association for Dental Research (a Division of the IADR), March 9,1994, in the Washington State Convention & Trade Center, Seattle, Washington, USA. J Dent. pic. 1994, 73 (7), 1244–1246.
• 16. Bamise CT, Olusile AO, Oginni AO. An Analysis of the Etiological and Predisposing Factors Related to Dentin Hypersensitivity. J. Contemp. Dent. practice 2008, 9 (5), 52–59.
• 17. Gillam DG. Dentine Hypersensitivity: Advances in Diagnosis, Management, and Treatment ; Springer, 2015.
• 18. Sahgal J, Sood PB, Raju OS. A Comparison of Oral Hygiene Status and Dental Caries in Children on Long Term Liquid Oral Medications to Those Not Administered with Such Medications. J. Indian Soc. pedod. Prev. Dent. 2002, 20 (4), 144–151.
• 19. Babu KLG, Rai K, Hegde A. pH of Medicated Syrups–Does It Really Matter? – An in-Vitro Study: Part-II. J. Clin. Pediatric Dent. 2008, 33 (2), 137–142.
• 20. McCLURE FJ, Ruzicka SJ. The Destructive Effect of Citrate vs. Lactate Ions on Rats' Molar Tooth Surfaces, in Vivo. J Dent. pic. 1946, 25, 1–12.
• 21. Nankar M, Walimbe H, Ahmed Bijle MN, Kontham U, Kamath A, Muchandi S. Comparative Evaluation of Cariogenic and Erosive Potential of Commonly Prescribed Pediatric Liquid Medicaments: An in Vitro Study. J. Contemp. Dent. practice 2014, 15 (1), 20–25.
• 22. Nankar M, Walimbe H, Ahmed Bijle MN, Kontham U, Kamath A, Muchandi S. Comparative Evaluation of Cariogenic and Erosive Potential of Commonly Prescribed Pediatric Liquid Medicaments: An in Vitro Study. J. Contemp. Dent. practice 2014, 15 (1), 20–25.
• 23. Sunitha S, Prashanth GM, Chandu GN. Subba Reddy, VV An Analysis of Concentration of Sucrose, Endogenous pH, and Alteration in the Plaque pH on Consumption of Commonly Used Liquid Pediatric Medicines. J. Indian Soc. pedod. Prev. Dent. 2009, 27 (1), 44–48.
• 24. Nunn JH, Ng SK, Sharkey I, Coulthard M. The Dental Implications of Chronic Use of Acidic Medicines in Medically Compromised Children. Pharm. WorldSci. 2001, 23 (3), 118–119.
• 25. Siddiq H, Pentapathy KC, Shenoy R, Velayutham A, Acharya S. Evaluation of Sugar Content and Erosive Potential of the Commonly Prescribed Liquid Oral Medications. pesquis brass. Odontopediatria Clin. Integr. 2020, 20. https://doi.org/ 10.1590/pboci.2020.023.
• 26. from Cate, JM Chemistry of Remineralization and Demineralization of Enamel and Dentine. 2000 .
• 27. Linnett V, Seow WK. Dental Erosion in Children: A Literature Review. Pediatric Dent. 2001 , 23 (1), 37–43.
• 28. Costa CC, Almeida ICS, Costa Filho LC. Erosive Effect of an Antihistamine-Containing Syrup on Primary Enamel and Its Reduction by Fluoride Dentrifice. int. J. Paediatr. Dent. 2006 , 16 (3), 174–180.
• 29. Fejerskov O, Kidd E. Dental Caries: The Disease and Its Clinical Management; John Wiley & Sons, 2009.
• 30. da Silva Pierro VS, Barcelos R, Maia LC, da Silva AN. Pediatricians' Perception about the Use of Antibiotics and Dental Caries--a Preliminary Study. J. Public Health Dent. 2004, 64 (4), 244–248.
• 31. Lewis CW, Grossman DC, Domoto PK, Deyo RA. The Role of the Pediatrician in the Oral Health of Children: A National Survey. Pediatrics 2000, 106 (6), E84.
• 32. Neves BG, Pierro VS da S, Maia LC. Pediatricians' Perceptions of the Use of Sweetened Medications Related to Oral Health. J. Clin. Pediatric Dent. 2008, 32 (2), 133–137.
• 33. Durward C, Thou T. Dental Caries and Sugar-Containing Liquid Medicines for Children in New Zealand. NZ Dent. J. 1997, 93 (414), 124–129.
• 34. Meyer-Lueckel H, Paris S, Extrand K. Caries Management - Science and Clinical Practice; Thieme, 2013.
• 35. Fejerskov O, Nyvad B, Kidd E. Dental Caries: The Disease and Its Clinical Management; John Wiley & Sons, 2015.
• 36. Cavalcanti AL, Sousa RIM, Clementino MA, Vieira FF, Cavalcanti CL, Xavier AFC. In Vitro Analysis of the Cariogenic and Erosive Potential of Pediatric Antitussive Liquid Oral Medications. Tanzania Journal of Health Research. 2012. https://doi.org/ 10.4314/thrb.v14i2.7.
• 37. Hellwig E, Lussi A. Oral Hygiene Products, Medications and Drugs - Hidden Aetiological Factors for Dental Erosion. monogr. Oral Sci. 2014, 25, 155–162.
• 38. Trivedi K, Bhaskar V, Ganesh M, Venkataraghavan K, Choudhary P, Shah S, Krishnan R. Erosive Potential of Commonly Used Beverages, Medicated Syrup, and Their Effects on Dental Enamel with and without Restoration: An in Vitro Study. Journal of Pharmacy and Bioallied Sciences. 2015, p 474. https://doi.org/10.4103/0975-7406.163508.
• 39. Marcdante K, Kliegman RM. Nelson Essentials of Pediatrics E-Book; Elsevier Health Sciences, 2018.
• 40. Ozbek N, Akman S. A Slurry Sampling Method for the Determination of Iron and Zinc in Baby Food by Flame Atomic Absorption Spectrometry. Food Addit. my seal. Part A Chem. Anal. Control Expo. Risk Assess. 2012, 29 (2), 208–216.
• 41. Arora R, Mukherjee U, Arora V. Erosive Potential of Sugar Free and Sugar Containing Pediatric Medicines given Regularly and Long Term to Children. Indian J. Pediatr. 2012, 79 (6), 759–763.
• 42. Singana T, Suma NK. An In Vitro Assessment of Cariogenic and Erosive Potential of Pediatric Liquid Medicaments on Primary Teeth: A Comparative Study. International Journal of Clinical Pediatric Dentistry. 2021, pp. 595–599. https://doi.org/10.5005/jp-journals-10005-1824.
• 43. Mahmoud EF, Omar OM. Erosive and Cariogenic Potential of Various Pediatric Liquid Medicaments on Primary Tooth Enamel: A SEM Study. Dent Med Proble 2018, 55 (3), 247–254.
• 44. Lima K, Almeida I, Senna E. [citation needed] Pediatric Medication-Sweetener Agents and pH. J Bras Odontoped Odonto Bebe 2000.
• 45. Kenny DJ, Somaya P. Sugar Load of Oral Liquid Medications on Chronically Ill Children. J. Can. Dent. Assoc. 1989, 55 (1), 43–46.
• 46. Santos-Pinto L, Uema AP, Galassi MA, Ciuff NJ. [EXIT] What Do Pregnant Women Know about Oral Health. J Bras Odontoped Odonto Bebe 2001.
• 47. Pomarico L, Czauski G, Portela MB, de Souza IPR, Kneipp L, de Araújo Soares RM, de Araújo Castro GFB. Cariogenic and Erosive Potential of the Medication Used by HIV-Infected Children: pH and Sugar Concentration. Community Dent. health 2008, 25 (3), 170–172.
• 48. Subramaniam P, Nandan N. Cariogenic Potential of Pediatric Liquid Medicaments--an in Vitro Study. J. Clin. Pediatric Dent. 2012, 36 (4), 357–362.
• 49. Passos IA, Sampaio FC, Martinez CR, Freitas CHS de M. Sucrose Concentration and pH in Liquid Oral Pediatric Medicines of Long-Term Use for Children. Rev. Panama. Salud Publica 2010, 27 (2), 132–137.