Antibiotic compounds and enamel demineralization. An in vitro study

Area of Science:

• Dental materials science
• Oral medicine
• Biomaterials science

Background:

• Antibiotic administration, particularly oral antibiotics, has been linked to dental issues such as discoloration, pigmentation, and caries-like lesions.
• Understanding the interaction between medicaments and tooth structure is crucial for preventing adverse dental outcomes.

Purpose of the Study:

• To investigate the in vitro effects of commonly used penicillin compounds and tetracycline sodium on human tooth enamel.
• To evaluate the potential for medicament-induced enamel demineralization and microhardness reduction.

Main Methods:

• Exposing polished human enamel surfaces to aqueous solutions and oily suspensions of various antibiotics.
• Utilizing visual inspection, microhardness testing, scanning electron microscopy (SEM), and microradiography for analysis.
• Measuring pH and calcium ion ([Ca2+]) concentrations of the test solutions.

Main Results:

• Aqueous solutions of most antibiotics, particularly effervescent calcium penicillin and tetracycline, caused surface/subsurface enamel lesions and reduced microhardness.
• Enamel specimens exposed to deionized water showed similar changes, suggesting a role for pH.
• Oily suspensions, saliva, and ordinary calcium penicillin solutions did not adversely affect enamel.
• A slight pH decrease was noted in aqueous solutions during the experiment, but calcium ion concentration did not correlate with enamel destruction.

Conclusions:

• Certain oral antibiotics, especially in aqueous and effervescent forms, can induce enamel demineralization and microhardness loss in vitro.
• Tetracycline and effervescent calcium penicillin pose the highest risk for enamel damage.
• Formulation type (aqueous vs. oily) and specific antibiotic agent significantly influence the potential for dental erosion.