Art-6
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Review Articles
DENTIN DEGRADOMICS IN DENTIN EROSION
Günçe Ozan1a* , Meriç Berkman2b , Hande Șar Sancaklı1c
1
Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University, TR-34116 Fatih/Istanbul, Turkey
2
Department of Restorative Dentistry, Faculty of Dentistry, Bahçeşehir University, TR-34349 Beşiktaş/İstanbul, Turkey
a
DDS, PhD, Research Assistant; e-mail: gunce.saygi@istanbul.edu.tr; ORCHID ID: https://orcid.org/0000-0003-1018-3173
b
DDS, PhD, Assistant Professor; e-mail: mericberkman@gmail.com; ORCHID ID: https://orcid.org/0000-0002-9269-4868
c
DDS, PhD, Professor; e-mail: handesar@istanbul.edu.tr; ORCHID ID: https://orcid.org/0000-0001-8063-0413
ABSTRACT https://doi.org/10.25241/stomaeduj.2022.9(1).art.6
Background Dentin degradomics are the enzymes found in dentin endogenously and are aimed at attacking
organic compounds of the relevant tissue. During dentin demineralization, these enzymes could turn into
the reaction phase and may step up the degradation. Thus, their connection with dentin erosion and tissue
loss should be explained.
Objective The aim of this review was to describe the mechanisms of dentin degradomics, their relation to
dentin erosion, and recent approaches on inhibiting their action.
Data sources A narrative review was performed with a literature search in the PubMed and Google Scholar
electronic databases.
Study selection Reference lists included full papers of any study design, published in peer-reviewed journals
in English till November 2021.
Data extraction Current literature indicates the term of dentin degradomics, and the mechanism of dental
erosion of both enamel and dentin tissues. The inhibition of matrixmetalloproteinase (MMP) enzymes, which
constitute the subgroup of dentin degradomics, was gained from the recent papers listed in the reference
section.
Data synthesis Biocorrosion covers more of the pathological process of the tissue loss however, most
of the dentin degradomics such as MMPs are not covered by the term, biocorrosion. So, the definitions
of biocorrosion and dentin degradomics were discussed in detail. Green tea, chlorhexidine and fluorides
have the ability to inhibit the reaction of MMPs during dentin demineralization with a different state of
mechanisms. Nowadays, other naturally-derived compounds were included in studies such as polyphenols
and flavonoids. Still, more studies are necessary to clarify their mechanism of action and rates of efficiency.
KEYWORDS
Dental Erosion; Dentin Degradomics; Biocorrosion; MMP İnhibitors; Polyphenols.
1. INTRODUCTION a surface phenomenon but it showed a mineral
With the transformation of lifestyle dynamics dissolution beneath the surface [2-4]. It was proved
and dietary habits, dental erosion has become an that surface wear in the erosion process was
increased concern recently. Erosive tooth wear is an heightened with the friction of acidic solution thus,
important oral health problem when considering the dental erosion was not only a chemical dissolution but
prolongation of human life and the survival of healthy also a pathodynamic surface alteration [5]. Including
dentition with the overall wellness approach. Regarding the whole chemical, biochemical, and electrochemical
the ultraconservative dental concept, updated changes within the dental tissues, ‘bio-corrosion’ was
preventive strategies, and the recent technological recommended to be used in terms of dental erosion [6].
improvements in the evaluating methods of enamel The term bio-corrosion, which is used in the same sense
surface characteristics at both elemental and physical as the term “microbiological corrosion” in engineering
levels, dental researchers and clinicians have spent branches, has entered the field of dentistry in its
significant efforts to clarify the mechanisms of dental broadest sense under its definition. While corrosion
erosion. While only a few articles were available during alone describes the chemical, electrochemical,
the 1970s, today there are dozens of researches and physicochemical dissolution of inanimate
either in vivo or in vitro about dental erosion [1]. substances, the definition of bio-corrosion includes
Dental erosion was previously defined as a sole all the chemical, biochemical, and electrochemical
substance loss by exogenous or endogenous acids changes seen in both hard and soft tissues and body
without bacterial involvement. However, it was fluids in living organisms. These changes are seen
revealed in 2012 that dental erosion was not only as either dissolution of the tissue or cell apposition
OPEN ACCESS This is an Open Access article under the CC BY-NC 4.0 license.
Peer-Reviewed Article
Citation: Ozan G, Berkman M, Sar Sancaklı H. Dentin degradomics in dentin erosion. Stoma Edu J. 2022;9(1):55-62.
Received: December 30, 2021; Revised: January 30, 2022; Accepted: February 15, 2022; Published: February 28, 2022.
*Corresponding author: Dr. Günçe Ozan, Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University, TR-34116 Fatih/Istanbul, Turkey
Tel.: +902124142020; Fax: +902125312230; e-mail: gunce.saygi@istanbul.edu.tr
Copyright: © 2022 the Editorial Council for the Stomatology Edu Journal.
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Ozan G, et al.
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by inducing tissue growth. Ulcers, vascular ruptures, through deeper layers of both enamel and dentin
Review Articles or muscle injuries in living organisms as a result of tissues [1]. With the non-ionized acidic exposure, the
tissue dissolution or induction of tissue growth, even inorganic part of dentin dissolves and collagens of the
cancer cases may develop [7]. In the field of dentistry, organic structure are revealed. Thus, the pathodynamic
pathologic stages of bio-corrosion reveal mostly on process of the erosion continues with the surface
the development of dental caries and erosion. In alterations leading to wear and substance losses.
the following parts of the current review, the term Although it was reported that “bio-corrosion”, which
“bio-corrosion”, its relation to dentin degradomics, reveals all pathological changes comprehensively,
and recent updates on inhibiting endogenous has not yet replaced the term “dental erosion” but
etiologies of dentin erosion are clarified in detail. is thought to become widespread in the fields of
dentistry [6].
2. METHODOLOGY Table 1. Processes in bio-corrosion.
Processes in Bio-corrosion
The article search for this literature review utilized
1) Endogenous Dental plaque (biofilm) &
PubMed and Google Scholar, and the selection
acid intake Gingival crevicular fluid
included articles published in peer-reviewed journals
in English. The terms used for the introduction part Gastric hydrochloric acid
were “Dentin Erosion” and “Dentin Degradomics”. Due 2) Exogenous acid Diet /Nutrition style
to explaining the terms in detail and to the terms intake Profession/Occupation
being highly up-to-date, no time limit was applied and
published articles were looked through till November 3) Proteolysis Enzymatic lysis (In dental caries
2021. To reach a clinical point of action, a branch of formation)
dentin degradomics, matrix metalloproteinase (MMP) Proteases (Pepsin and Trypsin)
enzymes, which have been appearing in many studies
4) Electrochemical Piezoelectric effect on dentin
for a while, and recent chemical compounds used
effect
to inhibit MMPs were also considered. The search
excluded: monographs and case reports. Just as the histology of erosion differs from caries, the
morphology of dentin is mainly varied from enamel.
3. RESULTS Thus, the responses of the two tissues with different
contents against acid attacks are highly distinctive.
Dental caries is a pathology caused by bacterial Compared to enamel, the mineral content of dentin
acids that have settled and grown in the biofilm of diminished, and its organic content is higher. The major
the dental–mostly enamel- hard surfaces. Dental component of its organic matrix is Type 1 collagen and
caries begin with the dissolution of hydroxyapatites other components that are contributed to trace are
of enamel, and a small amount of destruction non-collagenous phosphoprotein, glycoprotein, lipid,
(proteolysis) occurs in the proteins in the enamel. and proteoglycan. While the amount of carbonate is
Simply, the pathology of dental caries is again a approximately 3% in the enamel, this value is 5-6%
bio-corrosion process, as it includes a biochemical in dentin, therefore dentin dissolves more easily with
beginning (acid production of bacteria) and protein acids. On the other hand, the crystals in dentin are
degradation (proteolysis). smaller than those in enamel; thus, the surface area of
The term “erosion” does not include material losses dentin exposed to acid attacks is relatively higher [8].
caused by biochemical and electrochemical processes Erosion in enamel tissue, which has 95% inorganic
on dental hard surfaces. The biochemical changes structure, starts with a softening on the surface by the
induced by “proteolysis” and the electrochemical dissolution of the structure and results in permanent
reactions that occur as a result of the piezoelectric loss of demineralized tissue with ongoing acid attacks
effect on the surface are better defined by the term (Fig. 1) [9]. However, erosion comprises two separate
“bio-corrosion”. To sum up, bio-corrosion is caused by events in dentin, the dissolution of the existing
acids coming from both internal and external sources, inorganic structure and the realization of proteolytic
proteolytic enzymes (pepsin and trypsin), piezoelectric destruction with the endogenous enzymes (Fig. 2).
effects - in the dentin because of releasing Ca+2 ions
from the tooth surface during dentinal wear- [5], and
factors that cause dissolution in the inorganic and
organic matrix of dentin after enamel degradation.
Enzymes such as matrix metalloproteinases, which are
endogenously found in the structure, are not included Figure 1. Dental erosion limited to enamel tissue of teeth #21 and slight
in the bio-corrosion mechanism. The biochemical changes in the surface of teeth #11.
events covered by bio-corrosion are shown in Table 1. The beginning of dentin erosion, inorganic struc-ture,
This pathodynamic process begins subsurface by because of their structural differences, acts distinctively
dissolving minerals likewise caries lesions. In the as well. At first, peritubular and intertubular dentin
sequel, ionized H+ ions are released from the enamel begin to dissolve at the same rate. However, after
tissue by acid attacks and non-ionized H+ ions pass the first minute, the intertubular dentin area remains
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Review Articles
more stable, but the peritubular dentin continues to demineralization by also considering the histological
dissolve rapidly, and the dentinal tubules expand. structure of dentin [15,16]. Ganss et al. (2014) reported
that when the organic matrix is chemically removed
by either enzymes or mechanical forces (abrasion)
[16], the erosive agent directly encounters the
mineralized tissue, which dissolves quickly. However,
in the presence of an organic matrix, the pH decrease
in the environment slows down, and accordingly, the
erosion rate reduces as well. Thus, the organic matrix
has the feature of limiting the mineral outflow (ionic
diffusion) towards the external environment from the
tooth surface [17]. For these reasons, it is clear that the
organic matrix has a protective role in erosive wear.
DOM is resistant to brushing forces up to 4 Newtons
(N) so that it can protect the remaining dentin surface
Figure 2. Dental erosion passed through dentin and loss of structure. against mechanical trauma such as toothbrush
As the acid attack continues, the mineral loss abrasion [18]. However, although this layer is
is significantly reduced due to the decreasing resistant to physical factors, it can be dissolved by
demineralization rate and the demineralized area enzymatic reactions [16]. Considering that erosive
reaches a certain thickness [10]. The degree of mineral demineralization does not occur in the presence of
loss is supplied by the buffering feature of collagens bacteria, it is certain that host-derived enzymes are
so that further loss of substance is prevented by responsible for the destruction of DOM, which has
the dissolved minerals, which brings the ionic level been proven by clinical studies [14,19].
of the environment to the approximate saturation Recently, a new category of enzymes has been found
level. While acid attacks continue to a clinically and named “Dentin Degradomics” which were aimed
significant concentration and time, the inorganic part to degrade the organic matrix, the collagen layer,
dissolves easily as well. Depending on the potential endogenously [20]. It was shown in the studies that
and duration of action of the erosive agent, at first, a degradomics consist of collagenolytic enzymes and
completely demineralized layer and then a partially MMPs which are stable in the organic matrix from
demineralized layer of dentin appears, followed by a the formation of dentin tissue. These enzymes are
completely sound dentin layer. However, the partially mainly responsible for the catabolic reactions of
demineralized area in the middle is not present in the organic matrix and their mechanism of action
every case [1]. depends on the pH of the environment [21,22].
Although the inorganic content dissolves away with When the pH decreases at erosive demineralization,
the erosive attack, the organic matrix remains intact these enzymes become activated and when it turns
and forms a barrier against acid attacks, preventing neutral, they start to degrade the collagens of the
further mineral release from the dental tissue and organic matrix and contribute to the improvement of
stopping the progression of the erosive lesion as erosive demineralization [23]. These MMPs are found
mentioned above [11-13]. However, it is thought in various tissues of the body and they have been
that some of the proteolytic enzymes in the dentin secreted when tissue remodeling is needed without
structure are activated by acidic pH and these enzymes any pathological circumstances. MMPs are divided
increase the rate of erosion by causing the dissolution into 6 groups according to their structural properties
of the demineralized organic matrix (DOM). For and substrate specificity: Collagenases, Type IV
this reason, a new field has emerged to investigate collagenases (gelatinases), stromelysins, matrilysins,
the functions and mechanisms of these enzymes membrane-type MMPs (MT-MMP) and others such as
called “Dentin Degradomics” [14]. Subsequently, enamelysine (MMP-20) [24]. Not all of these enzymes
many studies have been developed to clarify the are found in dentin but the ones which are presented
role of the organic matrix in the stages of erosive in the dentin are shown in Table 2.
Table 2. Classification of various degradomic enzymes (Endogenous collagenolytic dentinal enzymes).* [14,24]
Group Enzyme Nomenclature Function
Neutrophile It is found frequently at dentinal levels and related highly to carious
Collagenases MMP-8
collagenase activity in dentin.
Gelatinase A MMP-2 Telopeptidase activity to Type I collagen in organic matrix.
Gelatinases
Gelatinase B MMP-9 Odontoblasts may express these gelatinases.
It has the proteoglycanase activity which may affect the activity of
Stromelysins Stromelysin 1 MMP-3
some of the cathepsins.
It has shown to process dentinsialophosphoprotein* and found in
Other MMPs Enamelisin MMP-20
dentinal tubules of caries-affected dentin.
Cysteine Cathepsin B
Cathepsin They show the gelatinolytic activity.
cathepsins Cathepsin K
*Not related to carious or erosive demineralization.
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Another family of collagenolytic enzymes, cysteine may be better in order to understand their role in the
Review Articles cathepsins (CC), are activated at neutral pH, unlike progression of erosive lesions.
MMPs. However, they need slightly acidic pH to
function [25]. Because of these properties, it is known 4. DISCUSSION
that MMPs start to function at the point where CCs
lose their functions. Since acidic pH is only durable for The protection of DOM by MMP inhibitors is the
a while in dentin erosion, MMPs are thought to play a recent approach to the prevention of dentin erosion
superior role in collagen degradation than cathepsins [26]. Among the different types of MMP inhibitors,
[26]. Cysteine cathepsins found in the dentin are also chlorhexidine (CHX), and epigallocatechin gallate
shown in Table 3. (EGCG) as a polyphenolic compound, have been
Table 3. Matrixmetalloproteinase (MMP) inhibitors. the most common compounds evaluated as part
MMP of preventive strategies to reduce erosive dentin
Type Function demineralization. Indeed, their mechanism of action is
inhibitor
Found to have
yet to be estimated. MMP inhibitors that have recently
inhibitory properties been reported in studies are summarized in Table 3.
Epigallocatechin- Polyphenols are used frequently in many research
Polyphenols against MMP-2 and-
3-gallate (EGCG) projects and specifically polyphenols isolated from
9 and the activation
of MMP-8 [1,26,27]. green tea, especially epigallocatechin-3-gallate
Reported to inhibit (EGCG) that was found to have inhibitory properties
Theaflavin against MMP-2 and -9 [27] and the activation of MMP-
MMP-2 and -9 [50].
8, which acts for the remineralization in demineralized
Showed
dentin [1,28]. According to the information obtained,
collagenolytic
Phenolic acid Anacardic acid these catechins accumulate on the organic material
activity against
MMP-2 [52]. in dentin [29] and run by masking the catalytic site of
MMP-2 or cause structural changes with its hydrogen
Natural Reported to inhibit
Quercetin bonds and hydrophobic linkages to collagenase [28].
flavonoids MMP-2 and -9 [54].
The effect of EGCG against degradomics was proven
Has the ability to in previous studies [23,29,30,31] and its effectiveness
Non-flavonoid
Resveratrol reduce MMP-9 was compared usually to various formulae of
polyphenol
expression [56].
fluorides or CHX. These compounds have also shown
Has the ability to efficiency against MMPs but with distinctive targeting
inhibit MMP-2 and -9 procedures. To better explain, MMP enzymes are
at the concentration zinc-activated and calcium-dependent enzymes.
Chlorhexidine
Bisbiguanide of 0.03% completely,
(CHX) By chelating these cations, chlorhexidine binds to
and MMP-8 at the
the sulfhydryl groups and/or cysteines in the active
concentration of
0.01-0.02% [27]. parts of MMPs and inhibits the enzyme activity [32].
However, the inhibitory activity of chlorhexidine is
Some of
Inhibit the activation directly related to its concentration. CHX can cause
the fluoride
Fluorides of MMPs by ion- protein denaturation at saliva concentrations above
compounds (eg.
blocking [32]. 0.2%, reduce the solubility of dentin collagen and
NaF)*
prevent the progression of dentin erosion. Besides,
* Not all of the fluoride compounds are enlightened to contribute
chlorhexidine could completely inhibit MMP-2 and
MMP inhibition.
-9 at the concentration of 0.03%, and MMP-8 at
In the acidic environment, dentin demineralization the concentration of 0.01-0.02% [28]. Furthermore,
occurs, collagen fibrils are exposed, and the MMPs it was reported that fluorides, thanks to their high
in dentin and saliva are activated simultaneously. electronegativity, prevent Zn2+ and Ca2+ ions, which
However, when the pH rises to neutral, MMPs degrade are necessary for the activation of MMPs, from entering
the triple helix structure of collagens, start to dissolve the catalytic activities as similar as the inhibitory
organic matrix and increase the rate of dentin loss [26]. activity of CHX [33].
In addition, these enzymes cause structural changes The effect of different types of ion-containing fluoride
in existing collagens. The parts called “telopeptides” at compounds (such as stannous fluoride, titanium
the ends of the collagens are dissolved and removed, tetrafluoride, amine fluoride) on dental erosion is
thus, spaces are created in the internal structure of the attributed to the protective layer formed on the dentin
molecule. The relevant structural dissolution prevents surface, it is not yet clear whether or not they perform
interfibrillar remineralization, which is crucial for MMP inhibition. Since sodium (Na+) ion does not form
strengthening the mechanical properties of dentin. a layer similar to other ionic fluoride components
It also causes the loss of non-collagen matrix proteins, on dentin surface, the most widely used fluoride
which act as nuclei for remineralization. Still, the exact compound in studies is NaF. In a study, it was found
contribution of these highly collagenolytic enzymes to that by using the gelatin zymography ,may inhibit the
the progression of erosion is not known so far. Using activity of MMP-2 and -9 in a dose-dependent manner
specific inhibitors for these distinct classes of enzymes [34]. 200 ppm fluoride can inhibit pro and active forms
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of MMP-2 and active forms of MMP-9 by 100%. If these the collagenolytic activity of anacardic acids against
Review Articles
rates are constant at 225 ppm, the pro-form of MMP- MMP-2 had also been proven by zymographic analysis
9 could be inhibited approximately by 85%; pro and and in vitro evaluation revealed reduced dentinal wear
active forms of salivary MMP-9 were inhibited by 55%. compared to EGCG and NaF [51,52].
While the inhibitory activity of NaF against MMP-2 On the other hand, another approach to inhibit
and -9 is reversible at low concentrations, it has been erosive wear has exhibited promising results which
reported that it is irreversible at high concentrations aimed to enhance protecting properties of acquired
such as 5000 ppm [34]. pellicle. The adsorbtion of polyphenolic compounds
There have been studies comparing the effect of (EGCG, epicatechin-3-gallate (ECG), and theaflavin)
fluorides (especially sodium fluoride, NaF), on EGCG, onto the pellicle may lead to stabilize the structure
and CHX [35,36]. Regarding the variances differed [38] and increase its thickness [53] resulting in an
highly in the methodological section of the studies, anti-erosive effect. So that, dental materials such
most of them could not be compared directly with as gels or varnishes including polyphenols were
one-to-another. One of the differences encountered demonstrated in studies [33,38] which were tested
in the studies is the frequent application of the against both enamel and dentin erosion. However,
contact profilometer to measure dentin loss [30,36,37]. due to the structural variations of enamel and
However, some controversies have arisen regarding its dentin, such as the higher porosity of dentin, the
usage at erosive dentin surfaces because of the tip of preventive effect of the acquired pellicle could be
the profilometer that could cause damage by pressing reduced. Methodologies involving gels usually engage
the DOM [38]. Thus, to overcome this problem, some polyphenolic compounds as active compounds and
studies have used non-contact [39,40] or digital compare their effect against a fluoride gel [30,38].
microscopy [41]. As another solution, to minimize However no commercial products have figured yet,
the shrinkage of DOM, some analysis of the contact except the mouthwashes with green tea aromas. For
profilometer had been done at 100% humidity [38]. instance, gels containing EGCG and CHX showed to
Another variation among studies with respect to the increase a protein (Statherin) in the acquired pellicle,
method is that the erosive cycles. Most of the cycles which increased the saturation of oral fluids by
were done with Cola [35,42,43] but some studies releasing Ca+2 and PO-4 ions following acid attacks [38].
have used various acidic solutions, such as citric acid Another study reported that resin materials containing
[40,44] or hydrochloric acid [45,46]. Moreover, many EGCG increased basic isoforms of salivary proteins
of the studies have used not only the erosive cycle which may perform to improve the acid resistance of
but also ‘erosive+abrasive’ cycles [38,45] so, within demineralized surfaces [54].
the changes in the methodology, the scores of dentin More recently, flavonoids, which are from the
losses highly vary. Besides, the concentrations of the subgroups of polyphenolic compounds, have
active ingredients or the ratios of the extractions have been frequently investigated in studies comprising
varied following the type of formula, such as gels [30], MMP inhibition [44,55]. Quercetin is one of the
toothpaste [37], and mouthwashes [28,35], as well. natural flavonoids which is found highly in fruits
Still, the main outcome of these studies is that MMP and vegetables and has been reported to have the
inhibitors play an active role in reducing dentin loss potential to protect against degradation of the
by protecting DOM. collagen matrix by inhibiting MMP-2 and MMP-9
Within the differences among studies evaluating [56]. An in vitro study showed that quercetin showed
EGCG, CHX, and NaF, one point is described that significantly lower microhardness loss than CHX,
EGCG had slightly more action against dentin erosion EGCG, and NaF groups and revealed a thicker DOM
in another different way. Previous studies [30,47] than control dentin [44]. This dose-dependant
suggest that the protease inhibitors have the ability outcome of quercetin was explained by its improving
to minimize the degradation of DOM against dentin effect on collagen resistance as a result of inhibiting
demineralization. Besides, polyphenols are reported both free- and collagen-bound degradomics (MMPs)
to improve the mechanical properties of the organic in dentin [57]. On the other hand, previous studies
matrix and resist enzymatic degradation [42]. So have shown that resveratrol significantly reduces
recently, plant polyphenols have been investigated MMP-9 expression [58], which is a non-flavonoid
against dentin erosion so that potential benefits polyphenol found in many of the plants. Since there
could be gained. One of them is ‘theaflavin’, which is is no study that has investigated its protective effect
the most frequent polyphenol in black tea, formed against MMPs, there are studies reporting its benefit
by the oxidation of catechins during manufacturing on dentin bonding durability [55,59] and as anticaries
[48]. Aside from the antifungal [48], antioxidant, and agent [60].
antimutagenic effects of theaflavins, they were also
reported to inhibit MMP-2 and MMP-9 [49,50]. In an in 5. CONCLUSION
vitro study, the aflavins showed similar dentin losses
to EGCG and commercial green tea with no significant Since dental erosion is a complex situation, there are
difference [46]. Anacardic acid is also one of the debates on terming it as “bio-corrosion” in order to
phenolic acids obtained from the shell of the cashew explain the process more comprehensively. Besides,
nut. Accompanied by the antioxidant capacity [50], endogenous enzymes called degradomics have
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also detrimental effects on the process if they reach AKNOWLEDGEMENTS
Review Article exposed dentin surfaces. There have been inhibitory None.
materials such as fluorides, chlorhexidine, and green
tea extracts that were proved to protect demineralized CONFLICT OF INTEREST
collagen matrix. Studies are being carried out on
The authors have certified that there is no conflict of interest.
the novel polyphenolic compounds that could be
beneficial to collagenolytic processes. Their effect
should be further investigated and comparably AUTHOR CONTRIBUTIONS
evaluated with recently known MMP inhibitors in GO: conceptualization, resources, writing-original draft preparation,
various concentrations. So that, research may solve visualization, project administration. GO,MB: methodology,
the inhibition mechanism and clinicians may benefit software, investigation, data curation. GO,MB,HSS: formal analysis,
from the enhancement of their process. writing-review and editing. MB,HSS: validation. HSS: supervision.
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Stoma Edu J. 2022;9(1):55-62 pISSN 2360-2406; eISSN 2502-0285 61
Ozan G, et al.
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Günçe OZAN
Review Articles
DDS, PhD, Research Assistant
Department of Restorative Dentistry
Faculty of Dentistry
Istanbul University
TR-34116 Fatih/Istanbul, Turkey
CV
Günçe Ozan received her DDS in 2011 from the Faculty of Dentistry at Istanbul University, Istanbul, Turkey. She immediately
started her PhD at the Restorative Dentistry Department of the same university. After studying on the fields of dental erosion
and preventive dentistry, she had her PhD degree in 2017. She worked at the Young Dentists' Commission of the Turkish Dental
Association for 2 years. She is now continuing her career at the Istanbul University as a Research Assistant.
Questions
1. The difference between the terms, “Dental erosion” and “Bio-corrosion” distinguishes
from the certain reactions that were occurred during dental erosion?
q a. Piezoelectric effect;
q b. Proteolysis;
q c. Piezoelectric effect & Proteolysis;
q d. Electrochemical effect.
2. Demineralization occurs... in dental erosion.
q a. Subsurface;
q b. Surface and subsurface;
q c. Surface;
q d. Beneath the surface.
3. Which of the enzyme groups of degradomics are not localized in the “dentin”?
q a. Enamelisin;
q b. MT-MMP;
q c. MMP-2;
q d. MMP-3.
4. MMP enzymes activated at … ph but, functioned at… ph.
q a. Acidic / basic;
q b. Basic / neutral;
q c. Neutral / acidic;
q d. Acidic / neutral.
https://eapdcongress.com/
62 Stoma Edu J. 2022;9(1): 55-62 pISSN 2360-2406; eISSN 2502-0285