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Muñoz Forti K, Weisman GA, Jasmer KJ. Cell type-specific transforming growth factor-β (TGF-β) signaling in the regulation of salivary gland fibrosis and regeneration. J Oral Biol Craniofac Res 2024; 14:257-272. [PMID: 38559587 PMCID: PMC10979288 DOI: 10.1016/j.jobcr.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/13/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
Salivary gland damage and hypofunction result from various disorders, including autoimmune Sjögren's disease (SjD) and IgG4-related disease (IgG4-RD), as well as a side effect of radiotherapy for treating head and neck cancers. There are no therapeutic strategies to prevent the loss of salivary gland function in these disorders nor facilitate functional salivary gland regeneration. However, ongoing aquaporin-1 gene therapy trials to restore saliva flow show promise. To identify and develop novel therapeutic targets, we must better understand the cell-specific signaling processes involved in salivary gland regeneration. Transforming growth factor-β (TGF-β) signaling is essential to tissue fibrosis, a major endpoint in salivary gland degeneration, which develops in the salivary glands of patients with SjD, IgG4-RD, and radiation-induced damage. Though the deposition and remodeling of extracellular matrix proteins are essential to repair salivary gland damage, pathological fibrosis results in tissue hardening and chronic salivary gland dysfunction orchestrated by multiple cell types, including fibroblasts, myofibroblasts, endothelial cells, stromal cells, and lymphocytes, macrophages, and other immune cell populations. This review is focused on the role of TGF-β signaling in the development of salivary gland fibrosis and the potential for targeting TGF-β as a novel therapeutic approach to regenerate functional salivary glands. The studies presented highlight the divergent roles of TGF-β signaling in salivary gland development and dysfunction and illuminate specific cell populations in damaged or diseased salivary glands that mediate the effects of TGF-β. Overall, these studies strongly support the premise that blocking TGF-β signaling holds promise for the regeneration of functional salivary glands.
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Affiliation(s)
- Kevin Muñoz Forti
- Christopher S. Bond Life Sciences Center and Department of Biochemistry, University of Missouri, United States
| | - Gary A. Weisman
- Christopher S. Bond Life Sciences Center and Department of Biochemistry, University of Missouri, United States
| | - Kimberly J. Jasmer
- Christopher S. Bond Life Sciences Center and Department of Biochemistry, University of Missouri, United States
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Spyraki F, Maniewicz S, Mojon P, Müller F. A novel test for hyposalivation using a sugar cube. J Oral Rehabil 2024. [PMID: 38685706 DOI: 10.1111/joor.13715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Hyposalivation is a highly prevalent condition in old persons. OBJECTIVES The aim of this study was to assess a novel tool for the diagnosis of hyposalivation using a sugar cube and to compare its reliability to other validated test methods. METHODS Five tests were performed: unstimulated salivary flow test by draining method (USFT), oral moisture device Mucus® (MCS), sugar cube test (SCT), stimulated salivary flow test by chewing gum (CG) and Saxon test (SX). The sugar cube test consisted in measuring the time needed to disintegrate a standard-sized sugar cube N°4 (5.6 g) placed beneath the tongue. Bivariate correlation analyses were performed. ROC curve analysis and the Youden Index were used to determine the cut-off value. Sensitivity and specificity were calculated according to the determined cut-off point. RESULTS A total of 121 participants were recruited, with an average age of 49.8 ± 18.2 years. The USFT was best correlated with the SCT. No correlation was found between SCT and the stimulated saliva tests (CG, SX) as well as the MCS test. According to the Youden index, 140 s is appropriate to diagnose hyposalivation. Sensitivity of .64 and specificity of .91 were found for SCT using USFT as gold standard. The mean subjective evaluation score of the SCT was 3.1 ± 1, significantly higher than USFT 2.6 ± 1.1 (p < .05). CONCLUSIONS The sugar cube test proved to be a useful method for assessing unstimulated salivation, reducing test execution time and causing less participant discomfort than the gold standard unstimulated salivary flow test.
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Affiliation(s)
- Foteini Spyraki
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Mojon
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Bagavant H, Durslewicz J, Pyclik M, Makuch M, Papinska JA, Deshmukh US. Age-associated B cell infiltration in salivary glands represents a hallmark of Sjögren's-like disease in aging mice. GeroScience 2024:10.1007/s11357-024-01159-3. [PMID: 38656650 DOI: 10.1007/s11357-024-01159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Sjögren's disease (SjD), characterized by circulating autoantibodies and exocrine gland inflammation, is typically diagnosed in women over 50 years of age. However, the contribution of age to SjD pathogenesis is unclear. C57BL/6 female mice at different ages were studied to investigate how aging influences the dynamics of salivary gland inflammation. Salivary glands were characterized for immune cell infiltration, inflammatory gene expression, and saliva production. At 8 months, gene expression of several chemokines involved in immune cell trafficking was significantly elevated. At this age, age-associated B cells (ABCs), a unique subset of B cells expressing the myeloid markers CD11b and/or CD11c, were preferentially enriched in the salivary glands compared to other organs like the spleen or liver. The salivary gland ABCs increased with age and positively correlated with increased CD4 T follicular helper cells. By 14 months, lymphocytic foci of well-organized T and B cells spontaneously developed in the salivary glands. In addition, the mice progressively developed high titers of serum autoantibodies. A subset of aged mice developed salivary gland dysfunction mimicking SjD patients. Our data demonstrates that aging is a significant confounding factor for SjD. Thus, aged female C57BL/6 mice are more appropriate and a valuable preclinical model for investigating SjD pathogenesis and novel therapeutic interventions.
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Affiliation(s)
- Harini Bagavant
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA.
| | - Justyna Durslewicz
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Marcelina Pyclik
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Magdalena Makuch
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Joanna A Papinska
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Umesh S Deshmukh
- Arthritis and Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA.
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Sigurðsson K, Andersen BV, Bendixen KH, Baad-Hansen L. Are orofacial pain and xerostomia associated with differences in diet, sensory perception, appetite and enjoyment of eating?-An explorative study. J Oral Rehabil 2024; 51:703-711. [PMID: 38087996 DOI: 10.1111/joor.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/06/2023] [Accepted: 12/06/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Orofacial function is believed to influence an individual's diet. knowledge on appetite and enjoyment of eating in orofacially impaired individuals is scarce. OBJECTIVE We aimed to explore potential associations between impaired orofacial function, that is, orofacial pain, jaw function limitation and xerostomia, respectively, and diet, appetite, taste perception, as well as the enjoyment of eating. METHODS An online questionnaire was shared among Aarhus University's dental patients and through social media. A convenience sample of 351 individuals responded (97 men, 254 women, aged 18-86 years). Participants were divided into groups with and without orofacial pain or xerostomia based on responses. Questions about food intake, appetite, meal-related well-being and oral/general health were included. Data were analysed using Mann Whitney U tests, Spearman's correlation, Chi-square tests, and t-tests. RESULTS Participants with (n = 123) and without (n = 228) orofacial pain differed significantly regarding age, perceived oral/general health, frequency of consumption of for example cooked vegetables and raw whole fruit, perception of sourness, chewiness, and nausea/pain when eating (p ≤ .031). Participants with (n = 101) and without (n = 250) xerostomia differed significantly regarding perceived oral/general health, intake of prepared fruit, alcohol, ice cream/mousse/pudding, general appetite, intake of breakfast and liquid snacks, nausea/pain when eating, taste and chewiness of food (p ≤ .038). CONCLUSION Diet, appetite, taste and sensory perception, as well as enjoyment of eating of individuals reporting orofacial pain and/or xerostomia differed slightly to that of individuals free of such symptoms. However, due to the explorative nature of this study, the results should be interpreted with caution pending further research on potential long-term effects on nutritional status and well-being.
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Affiliation(s)
- Kristófer Sigurðsson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health Sciences, Aarhus University and Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Barbara Vad Andersen
- Food Quality Perception and Society Team, iSense Lab, Department of Food Science, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
| | - Karina Haugaard Bendixen
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health Sciences, Aarhus University and Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Lene Baad-Hansen
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health Sciences, Aarhus University and Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
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Inanc N, Jousse-Joulin S, Abacar K, Cimşit Ç, Cimşit C, D'Agostino MA, Naredo E, Hocevar A, Finzel S, Pineda C, Keen H, Iagnocco A, Hanova P, Schmidt WA, Mumcu G, Terslev L, Bruyn GA. The Novel OMERACT Ultrasound Scoring System for Salivary Gland Changes in Patients With Sjögren Syndrome Is Associated With MRI and Salivary Flow Rates. J Rheumatol 2024; 51:263-269. [PMID: 37914219 DOI: 10.3899/jrheum.2023-0202] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To assess the construct validity of the novel Outcome Measures in Rheumatology (OMERACT) ultrasound (US) semiquantitative scoring system for morphological lesions in major salivary glands by comparing it with magnetic resonance imaging (MRI) and unstimulated whole salivary flow rates (U-WSFRs) in patients with primary Sjögren syndrome (pSS). METHODS Nine sonographers applied the OMERACT 0-3 grayscale scoring system for parotid (PGs) and submandibular glands (SMGs) in 11 patients with pSS who also had MRIs performed. These were evaluated by 2 radiologists using a semiquantitative 0-3 scoring system for morphological lesions. The agreement between US and MRI and the association between U-WSFRs and imaging structural lesions was determined. A score ≥ 2 for both US and MRI was defined as gland pathology. RESULTS The prevalence of US morphological lesions in 11 patients with a score ≥ 2 was 58% for PGs and 76% for SMGs, and 46% and 41% for PGs and SMGs, respectively, for MRI. The agreement between OMERACT US scores and MRI scores was 73-91% (median 82%) in the right PG and 73-91% (median 91%) in the left PG, 55-91% (median 55%) in the right SMG and 55-82% (median 55%) in the left SMG. When relations between the presence of hyposalivation and an US score ≥ 2 were examined, agreement was 91-100% (median 83%) in both PGs and 55-91% (median 67%) in both SMGs. CONCLUSION There is moderate to strong agreement between the OMERACT US and MRI scores for major salivary glands in patients with pSS. Similar agreement ratios were observed between the higher OMERACT US scores and presence of hyposalivation.
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Affiliation(s)
- Nevsun Inanc
- N. Inanc, MD, K. Abacar, MD, Rheumatology Department, Marmara University School of Medicine, Istanbul, Turkey;
| | - Sandrine Jousse-Joulin
- S. Jousse-Joulin, MD, CHU de Brest, University Brest, Inserm, LBAI, UMR 1227, Brest, France
| | - Kerem Abacar
- N. Inanc, MD, K. Abacar, MD, Rheumatology Department, Marmara University School of Medicine, Istanbul, Turkey
| | - Çagatay Cimşit
- Ç. Cimşit, MD, C. Cimşit, MD, Radiology Department, Marmara University School of Medicine, Istanbul, Turkey
| | - Canan Cimşit
- Ç. Cimşit, MD, C. Cimşit, MD, Radiology Department, Marmara University School of Medicine, Istanbul, Turkey
| | - Maria-Antonietta D'Agostino
- M.A. D'Agostino, MD, PhD, Hôpital Ambroise Paré, Boulogne-Billancourt, Versailles Saint Quentin University, Versailles, France
| | - Esperanza Naredo
- E. Naredo, MD, PhD, Rheumatology Department, Joint and Bone Research Unit. Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Alojzija Hocevar
- A. Hocevar, MD, PhD, Rheumatology Department, University Medical Centre, Ljubljana, Slovenia
| | - Stephanie Finzel
- S. Finzel, MD, Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carlos Pineda
- C. Pineda, MD, PhD, Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Helen Keen
- H. Keen, MD, Medicine and Pharmacology Department, The University of Western Australia, Murdoch, Perth, Australia
| | - Annamaria Iagnocco
- A. Iagnocco, MD, Academic Rheumatology Centre, Università degli Studi di Torino, Turin, Italy
| | - Petra Hanova
- P. Hanova, MUDr, Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Wolfgang A Schmidt
- W.A. Schmidt, MD, Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch, Berlin, Germany
| | - Gonca Mumcu
- G. Mumcu, DDS, PhD, Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Lene Terslev
- L. Terslev, PhD, Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - George A Bruyn
- G.A. Bruyn, MD, PhD Rheumatology, Reumakliniek Lelystad, Lelystad, and Tergooi MC Hospitals, Hilversum, the Netherlands
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Bagavant H, Durslewicz J, Pyclik M, Makuch M, Papinska JA, Deshmukh US. Age-associated B cell infiltration in salivary glands represents a hallmark of Sjögren's-like disease in aging mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.13.580185. [PMID: 38405963 PMCID: PMC10888762 DOI: 10.1101/2024.02.13.580185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Sjögren's disease (SjD), characterized by circulating autoantibodies and exocrine gland inflammation, is typically diagnosed in women over 50 years of age. However, the contribution of age to SjD pathogenesis is unclear. C57BL/6 female mice at different ages were studied to investigate how aging influences the dynamics of salivary gland inflammation. Salivary glands were characterized for immune cell infiltration, inflammatory gene expression, oxidative stress, and saliva production. At 8 months, gene expression of several chemokines involved in immune cell trafficking was significantly elevated. At this age, Age-associated B cells (ABCs), a unique subset of B cells expressing the myeloid markers CD11b and/or CD11c, were preferentially enriched in the salivary glands compared to other organs like the spleen or liver. The salivary gland ABCs increased with age and positively correlated with increased CD4 T follicular helper cells. By 14 months, lymphocytic foci of well-organized T and B cells spontaneously developed in the salivary glands. In addition, the mice progressively developed high titers of serum autoantibodies. A subset of aged mice developed salivary gland dysfunction mimicking SjD patients. Our data demonstrates that aging is a significant confounding factor for SjD. Thus, aged female C57BL/6 mice are more appropriate and a valuable preclinical model for investigating SjD pathogenesis and novel therapeutic interventions.
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Faruque MRJ, Taidouch K, Bikker FJ, Ligtenberg AJM. Exploring the Correlation between Salivary Spinnbarkeit and Caries Scores. Caries Res 2024; 58:115-120. [PMID: 38246142 PMCID: PMC10997273 DOI: 10.1159/000536402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION In this study, the relationship between the spinnbarkeit, i.e., the stretchability of saliva, and dental caries was investigated. METHODS Dentistry students were divided into a group with more than 2 decayed, missed, and filled teeth (DMFT ≥2, n = 30) and caries-free group (DMFT = 0, n = 36). RESULTS Unstimulated saliva flow rate, pH, and spinnbarkeit were determined. Salivary spinnbarkeit was significantly lower in the caries-prone group compared to the caries-free group (5.4 ± 3.9 mm vs. 13.5 ± 7.6 mm, respectively, p < 0.001). CONCLUSION This suggests that saliva with high spinnbarkeit protects better against dental caries.
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Affiliation(s)
- Mouri R J Faruque
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Kawtar Taidouch
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Floris J Bikker
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Antoon J M Ligtenberg
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Kim YJ. Xerostomia: Advances and Challenges in Drug Development. Curr Drug Targets 2024; 25:301-305. [PMID: 38424432 DOI: 10.2174/0113894501293941240228050343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/29/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Yoon-Jung Kim
- Department of Physiology and Neuroscience, Dental Research Institute, Seoul National University School of Dentistry, Seoul 03080, Korea
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Qutob AF. The Approach to Dental Caries Prevention in a Case of Agenesis of the Major Salivary Glands: A Case Report. Cureus 2024; 16:e52923. [PMID: 38274608 PMCID: PMC10810142 DOI: 10.7759/cureus.52923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 01/27/2024] Open
Abstract
Xerostomia leads to great challenges for patients and dentists in managing and maintaining oral health due to the high risk of developing dental caries. We discuss a case of a 10-year-old male patient who presented with complaints of decayed teeth and difficulty chewing and swallowing food. He had bilateral congenital stenosis and stricture of lacrimal ducts and a family history of lacrimal gland agenesis and Hashimoto's disease. The diagnosis reached was agenesis of all major salivary glands confirmed by saliva testing and ultrasound examination of the glands. Comprehensive preventative, restorative, and maintenance protocols based on caries management by risk assessment (CAMBRA) were implemented, including fissure sealants, amalgam and composite resin restorations, professional and home-applied fluoride, chlorhexidine mouthwash, frequent water consumption, and two-monthly recalls. We were able to stabilize the patient's risk of dental caries for over three years. The implementation of stringent restorative, preventive, and maintenance protocols is key to improving and maintaining oral health in severe cases of xerostomia.
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Affiliation(s)
- Akram F Qutob
- Public Health and Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
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Nam K, Dos Santos HT, Maslow F, Small T, Samuel RZ, Lei P, Andreadis ST, Baker OJ. Fibrin hydrogels fortified with FGF-7/10 and laminin-1 peptides promote regeneration of irradiated salivary glands. Acta Biomater 2023; 172:147-158. [PMID: 37844750 PMCID: PMC10908308 DOI: 10.1016/j.actbio.2023.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
Ionizing radiation, commonly used for head and neck cancer treatment, typically damages the salivary glands, resulting in hyposalivation. The development of treatments to restore this lost function is crucial for improving the quality of life for patients suffering from this condition. To address this clinical need, we have developed an innovative hydrogel by chemically conjugating laminin-1 peptides (A99 and YIGSR) and growth factors, FGF-7 and FGF-10, to fibrin hydrogels. Our results demonstrate that FGF-7/10 and laminin-1 peptides fortified fibrin hydrogel [enhanced laminin-1 peptides fibrin hydrogel (Ep-FH)] promotes salivary gland regeneration and functionality by improving epithelial tissue organization, establishing a healthy network of blood vessels and nerves, while reducing fibrosis in a head and neck irradiated mouse model. These results indicate that fibrin hydrogel-based implantable scaffolds containing pro-regenerative signals promote sustained secretory function of irradiated salivary glands, offering a potential alternative treatment for hyposalivation in head and neck cancer patients undergoing radiation treatment. These unique findings emphasize the potential of fibrin hydrogel-based implantable scaffolds enriched with pro-regenerative signals in sustaining the secretory function of irradiated salivary glands and offer a promising alternative treatment for addressing hyposalivation in head and neck cancer patients undergoing radiation therapy. STATEMENT OF SIGNIFICANCE: Radiation therapies used to treat head and neck cancers often result in damaged salivary gland, leading to severe dryness of the oral cavity. In this study, we engineered FGF-7 and FGF-10 and immobilized them into L1p-FH. The resulting hydrogel, Ep-FH, restored irradiated salivary gland functionality by enhancing epithelial tissue organization, promoting the development of a healthy network of blood vessels and nerves as well as reduction of fibrosis.
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Affiliation(s)
- Kihoon Nam
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Harim T Dos Santos
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Frank Maslow
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Travis Small
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Ronel Z Samuel
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Pedro Lei
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Stelios T Andreadis
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States; Department of Biomedical Engineering, School of Engineering and Applied Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States; Center of Bioinformatics and Life Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States; Center of Cell, Gene and Tissue Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Olga J Baker
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States; Department of Biochemistry, University of Missouri, Columbia, MO, United States.
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Faruque M, Nazmi K, van Splunter A, Laine ML, Bikker FJ. Sialagogic Effects Through Olfactory Stimulation with Mastic Resin and α-pinene Volatiles in vivo. Biomed Pharmacother 2023; 168:115699. [PMID: 37865987 DOI: 10.1016/j.biopha.2023.115699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Xerostomia, often associated with decreased saliva quality, poses challenges due to limited treatment efficacy. This study aimed to investigate alternative approaches to enhance saliva secretion through olfactory volatile stimulation with mastic resin and its main compound α-pinene, known for inhibiting acetylcholinesterase in vitro. METHODS The inhibitory effects of freshly prepared mastic resin extract oil and α-pinene oil on acetylcholinesterase (AChE) activity were measured in vitro. Eighty healthy participants were recruited and divided into two groups: exposed to mastic resin volatiles (n = 40) or α-pinene volatiles (n = 40). Saliva samples were collected pre, during and post exposure to analyze saliva flow rate, spinnbarkeit, ion composition and MUC5B levels. RESULTS Mastic resin extract oil and α-pinene oil inhibited AChE activity by 207 % and 22 %, respectively. Olfactory stimulation with these volatiles significantly increased saliva secretion rate without altering spinnbarkeit and ion composition. Salivary MUC5B concentration rose after exposure to mastic resin volatiles. CONCLUSIONS Olfactory stimulation with mastic resin and α-pinene volatiles demonstrated a bona fide in vivo effect on saliva secretion, confirming their sialagogic capability, potentially as a result of local glandular AChE inhibition. These findings highlight the therapeutic potential of both volatile compounds in treating patients with xerostomia and hyposalivation through olfactory exposure.
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Affiliation(s)
- Mouri Faruque
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands; Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Annina van Splunter
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - Floris J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
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Yin Y, Vázquez-Rosado EJ, Wu D, Viswananthan V, Farach A, Farach-Carson MC, Harrington DA. Microfluidic coaxial 3D bioprinting of cell-laden microfibers and microtubes for salivary gland tissue engineering. BIOMATERIALS ADVANCES 2023; 154:213588. [PMID: 37634337 DOI: 10.1016/j.bioadv.2023.213588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/27/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
Replacement therapy for the salivary gland (SG) remains an unmet clinical need. Xerostomia ("dry mouth") due to hyposalivation can result from injury or disease to the SG, such as salivary acinar death caused by radiation therapy (RT) for head and neck squamous cell carcinoma (HNSCC). Currently, only palliative treatments exist for xerostomia, and many patients endure deteriorated oral health and poor quality of life. Tissue engineering could offer a permanent solution for SG replacement by isolating healthy SG tissues prior to RT, expanding its cells in vitro, and recreating a functional salivary neogland for implantation post-RT. 3D bioprinting methods potentiate spatial cell deposition into defined hydrogel-based architectures, mimicking the thin epithelia developed during the complex branching morphogenesis of SG. By leveraging a microfluidics-based bioprinter with coaxial polymer and crosslinker streams, we fabricated thin, biocompatible, and reproducible hydrogel features that recapitulate the thin epithelia characteristics of SG. This flexible platform enabled two modes of printing: we produced solid hydrogel fibers, with diameters <100 μm, that could be rastered to create larger mm-scale structures. By a second method, we generated hollow tubes with wall thicknesses ranging 45-80 μm, total tube diameters spanning 0.6-2.2 mm, and confirmed tube patency. In both cases, SG cells could be printed within the thin hydrogel features, with preserved phenotype and high viability, even at high density (5.0 × 106 cells/mL). Our work demonstrates hydrogel feature control across multiple length scales, and a new paradigm for addressing SG restoration by creating microscale tissue engineered components.
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Affiliation(s)
- Yu Yin
- Department of Bioengineering, Rice University, Houston, TX 77005, USA; Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Ephraim J Vázquez-Rosado
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; Department of Biology, University of Puerto Rico-Mayagüez, Mayagüez 00682, Puerto Rico
| | - Danielle Wu
- Department of Bioengineering, Rice University, Houston, TX 77005, USA; Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Vignesh Viswananthan
- Department of Radiation Oncology - Radiation Therapy, Stanford University, Stanford, CA 94305, USA
| | - Andrew Farach
- Department of Radiation Oncology, Institute for Academic Medicine, Research Institute, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Mary C Farach-Carson
- Department of Bioengineering, Rice University, Houston, TX 77005, USA; Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Daniel A Harrington
- Department of Bioengineering, Rice University, Houston, TX 77005, USA; Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA.
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13
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Ribeiro ASP, Marquezin MCS, Pacheco ERP, Rasera I, Klein MI, de Vasconcellos SP, Landgraf RG, Okamoto D, Calixto LA, Castelo PM. Bypass gastroplasty impacts oral health, salivary inflammatory biomarkers, and microbiota: a controlled study. Clin Oral Investig 2023; 27:4735-4746. [PMID: 37294353 DOI: 10.1007/s00784-023-05101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Knowledge about the impact of gastroplasty on oral health and salivary biomarkers is limited. The aim was to prospectively evaluate oral health status, salivary inflammatory markers, and microbiota in patients undergoing gastroplasty compared with a control group undergoing a dietary program. MATERIALS AND METHODS Forty participants with obesity class II/III were included (20 individuals in each sex-matched group; 23-44 years). Dental status, salivary flow, buffering capacity, inflammatory cytokines, and uric acid were assessed. Salivary microbiological analysis (16S-rRNA sequencing) assessed the abundance of genus, species, and alpha diversity. Cluster analysis and mixed-model ANOVA were applied. RESULTS Oral health status, waist-to-hip ratio, and salivary alpha diversity were associated at baseline. A subtle improvement in food consumption markers was observed, although caries activity increased in both groups, and the gastroplasty group showed worse periodontal status after three months. IFNγ and IL10 levels decreased in the gastroplasty group at 3 months, while a decrease was observed in the control group at 6 months; IL6 decreased in both groups (p < 0.001). Salivary flow and buffering capacity did not change. Significant changes in Prevotella nigrescens and Porphyromonas endodontalis abundance were observed in both groups, while alpha diversity (Sobs, Chao1, Ace, Shannon, and Simpson) increased in the gastroplasty group. CONCLUSIONS Both interventions changed in different degrees the salivary inflammatory biomarkers and microbiota, but did not improve the periodontal status after 6 months. CLINICAL RELEVANCE Although the observed discrete improvement in dietary habits, caries activity increased with no clinical improvement in the periodontal status, emphasizing the need of oral health monitoring during obesity treatment.
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Affiliation(s)
- Aianne Souto Pizzolato Ribeiro
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | - Maria Carolina Salomé Marquezin
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | | | - Irineu Rasera
- Faculdade de Ensino Superior da Amazônia Reunida, Av. Brasil, 1435, Redenção, Brazil
| | - Marlise Inês Klein
- Faculdade de Odontologia de Piracicaba, Universidade de Campinas, Av. Limeira, 901, Piracicaba, Brazil
| | - Suzan Pantaroto de Vasconcellos
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | - Richardt Gama Landgraf
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | - Debora Okamoto
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | - Leandro Augusto Calixto
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil.
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14
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Melo JLDMA, Coelho CPES, Nunes FDPES, Heller D, Grisi DC, Guimarães MDCM, Dame-Teixeira N. A scoping review on hyposalivation associated with systemic conditions: the role of physical stimulation in the treatment approaches. BMC Oral Health 2023; 23:505. [PMID: 37480103 PMCID: PMC10360219 DOI: 10.1186/s12903-023-03192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/30/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Several systemic conditions can result in distinct degrees of salivary gland damage and consequent hypofunction. The development of successful management schemes is highly challenging due to the complexity of saliva. This study aimed to systematically map the literature on the physical stimulation of salivary glands for hyposalivation management and the response of individuals according to different systemic conditions causing salivary impairment. METHODS A systematic search in the literature was performed. Two reviewers independently selected clinical trials, randomized or not, that used physical stimulation to treat hyposalivation caused by systemic conditions. Studies evaluating healthy subjects without hyposalivation were included as controls. Single-arm clinical studies or case series were also included for protocol mapping (PRISMA extension for scoping reviews). RESULTS Out of 24 included studies, 10 evaluated healthy subjects, from which 9 tested transcutaneous electrical nerve stimulation (TENS) and 1 tested acupuncture and electroacupuncture. Fourteen studies evaluated individuals with hyposalivation: 6 applied TENS, 6 applied low-level laser therapy (LLLT), and 2 applied acupuncture, carried out in post-chemotherapy, medication use, postmenopausal women, hemodialysis patients, smokers, diabetics, Sjögren's syndrome (SS). All showed increased salivation after treatment, except for two LLLT studies in individuals with SS. CONCLUSIONS Among the different patient groups, individuals with Sjögren's syndrome (SS) exhibited the poorest responses, while those with medication-induced hyposalivation demonstrated the most favorable treatment outcomes, independently of the management strategy for saliva stimulation. It means that physical stimulation of salivary glands holds promise as an alternative for managing hyposalivation in cases of reversible gland damage. However, to make informed decisions in current practice, it is necessary to conduct new well-designed randomized clinical trials with appropriate methodologies.
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Affiliation(s)
| | | | | | - Debora Heller
- Post Graduate Program in Dentistry, Cruzeiro Do Sul University, São Paulo, Brazil
- Experimental Research, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Periodontology, UT Health San Antonio, San Antonio, TX, USA
| | - Daniela Corrêa Grisi
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília, Brazil.
| | | | - Naile Dame-Teixeira
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasília, Brazil.
- Oral Biology Division, School of Dentistry, University of Leeds, Leeds, UK.
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15
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Müller F, Chebib N, Maniewicz S, Genton L. The Impact of Xerostomia on Food Choices-A Review with Clinical Recommendations. J Clin Med 2023; 12:4592. [PMID: 37510706 PMCID: PMC10380232 DOI: 10.3390/jcm12144592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Xerostomia and hyposalivation are highly prevalent conditions in old age, particularly among multimorbid elders, and are often attributed to the use of multiple medications. These conditions negatively affect oral functions, such as chewing, swallowing, speech, and taste. Additionally, the lack of lubrication of the oral mucosa frequently leads to super-infections with candida. Denture retention and comfort may also be compromised. The risk of dental caries and erosion of natural teeth increases since saliva, which is essential for repairing initial lesions in tooth structures, is insufficient. The dry sensation in the mouth also impacts the emotional and social well-being of elderly individuals. Patients experiencing xerostomia often avoid certain foods that are uncomfortable or difficult to consume. However, some foods may alleviate the symptoms or even stimulate salivation. This review discusses the limited available evidence on nutritional advice for patients with xerostomia and aims to provide insight into the patient's perspective while offering clinical recommendations. Future studies should focus on investigating the nutritional intake of individuals suffering from xerostomia or hyposalivation in order to ensure oral health comfort, prevent malnutrition, and minimize the impact on their quality of life.
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Affiliation(s)
- Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, 1205 Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Najla Chebib
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, 1205 Geneva, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, 1205 Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
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16
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Kim YJ. Xerostomia and Its Cellular Targets. Int J Mol Sci 2023; 24:ijms24065358. [PMID: 36982432 PMCID: PMC10049126 DOI: 10.3390/ijms24065358] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023] Open
Abstract
Xerostomia, the subjective feeling of a dry mouth associated with dysfunction of the salivary glands, is mainly caused by radiation and chemotherapy, various systemic and autoimmune diseases, and drugs. As saliva plays numerous essential roles in oral and systemic health, xerostomia significantly reduces quality of life, but its prevalence is increasing. Salivation mainly depends on parasympathetic and sympathetic nerves, and the salivary glands responsible for this secretion move fluid unidirectionally through structural features such as the polarity of acinar cells. Saliva secretion is initiated by the binding of released neurotransmitters from nerves to specific G-protein-coupled receptors (GPCRs) on acinar cells. This signal induces two intracellular calcium (Ca2+) pathways (Ca2+ release from the endoplasmic reticulum and Ca2+ influx across the plasma membrane), and this increased intracellular Ca2+ concentration ([Ca2+]i) causes the translocation of the water channel aquaporin 5 (AQP5) to the apical membrane. Consequently, the GPCR-mediated increased [Ca2+]i in acinar cells promotes saliva secretion, and this saliva moves into the oral cavity through the ducts. In this review, we seek to elucidate the potential of GPCRs, the inositol 1,4,5-trisphosphate receptor (IP3R), store-operated Ca2+ entry (SOCE), and AQP5, which are essential for salivation, as cellular targets in the etiology of xerostomia.
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Affiliation(s)
- Yoon-Jung Kim
- Department of Physiology and Neuroscience, Dental Research Institute, Seoul National University School of Dentistry, Seoul 03080, Republic of Korea
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17
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Ohshima H, Mishima K. Oral biosciences: The annual review 2022. J Oral Biosci 2023; 65:1-12. [PMID: 36740188 DOI: 10.1016/j.job.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Journal of Oral Biosciences is devoted to advancing and disseminating fundamental knowledge concerning every aspect of oral biosciences. HIGHLIGHT This review features review articles in the fields of "Bone Cell Biology," "Tooth Development & Regeneration," "Tooth Bleaching," "Adipokines," "Milk Thistle," "Epithelial-Mesenchymal Transition," "Periodontitis," "Diagnosis," "Salivary Glands," "Tooth Root," "Exosome," "New Perspectives of Tooth Identification," "Dental Pulp," and "Saliva" in addition to the review articles by the winner of the "Lion Dental Research Award" ("Plastic changes in nociceptive pathways contributing to persistent orofacial pain") presented by the Japanese Association for Oral Biology. CONCLUSION The review articles in the Journal of Oral Biosciences have inspired its readers to broaden their knowledge about various aspects of oral biosciences. The current editorial review introduces these exciting review articles.
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Affiliation(s)
- Hayato Ohshima
- Division of Anatomy and Cell Biology of the Hard Tissue, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
| | - Kenji Mishima
- Division of Pathology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
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18
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de Azevedo BLR, Roni GM, Dettogni RS, Torrelio RMF, Leal LF, da Gama-de-Souza LN. Epidermolysis bullosa in oral health: clinical manifestations and salivary alterations. Clin Oral Investig 2023:10.1007/s00784-023-04917-3. [PMID: 36781477 DOI: 10.1007/s00784-023-04917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023]
Abstract
Epidermolysis bullosa (EB) is an inherited disease characterized by the fragility of the skin and mucous membranes. All types/subtypes of EB can lead to alterations in the mouth and glands. OBJECTIVE To evaluate clinical manifestations of EB on the oral mucosa and alterations in salivary flow. MATERIALS AND METHODS Sociodemographic and clinical data were obtained from EB individuals. The salivary flow analysis was performed in EB and in non-EB patients. Fischer's exact test was applied to the qualitative variables, and the Mann-Whitney test was applied to the quantitative data. RESULTS A total of 11 cases of EB were evaluated, and 3 types of EB were diagnosed (recessive dystrophic-RDEB; junctional-JEB; and simplex-EBS). Only individuals with RDEB or JEB showed the oral manifestation of the disease. The most affected sites were the lips (54%), hard palate (36%), and oral mucosa (27%). Ulcer and ankyloglossia were diagnosed in all RDEB cases. Regarding salivary flow, an intragroup comparison revealed an increase in stimulated versus unstimulated collection in the control sample (p = 0.0064). The EB group showed no difference (p = 0.6086). We also observed no differences in salivary volume between the control and EB groups (p = 0.7117 and p = 0.5557, unstimulated and stimulated flows, respectively). CONCLUSIONS No oral manifestations were observed in EBS subjects. It is unclear whether individuals with EB are predisposed to manifest hyposalivation. CLINICAL RELEVANCE Severe cases of EB show broad alterations in the oral mucosa, whereas the saliva needs to be better evaluated.
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Affiliation(s)
| | - Gabriel Marim Roni
- Medical School, Morphology Department, Health Science Center, Federal University of Espírito Santo, Vitória, Brazil
| | - Raquel Spinassé Dettogni
- Morphology Department, Health Science Center, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | | | - Letícia Nogueira da Gama-de-Souza
- Graduate Program in Dental Science, Morphology Department, Health Science Center, Federal University of Espírito Santo, Avenue Marechal Campos, 1468, Maruípe, 29.040-090, Vitória, ES, Brazil.
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19
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Motamed B, Alaee A, Azizi A, Jahandar H, Fard MJK, Jafari A. Comparison of the 1 and 2% pilocarpine mouthwash in a xerostomic population: a randomized clinical trial. BMC Oral Health 2022; 22:548. [PMID: 36457091 PMCID: PMC9713117 DOI: 10.1186/s12903-022-02576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
AIMS & BACKGROUND Pilocarpine is an accepted treatment for xerostomia, but limited research has been conducted on the oral, topical form. The present study aimed to compare the effects of 1 and 2% pilocarpine mouthwash on xerostomic participants. METHODS In this double-blind clinical trial study, 48 subjects with xerostomia were randomly divided into three groups to measure the effects of 1 and 2% pilocarpine and placebo mouthwashes on saliva levels. The amount of saliva in the 1st and 14th days was measured at 0, 45, 60, and 75 mins, while participants used their mouthwash three times a day for 14 days. On the 1st and 14th days, they filled out the information forms on xerostomia and the medicine's side effects before and after the intervention. RESULTS On the 1st day, the mean salivary flow at 45, 60, and 75 mins in the 2 and 1% pilocarpine mouthwash were significantly higher than in the placebo mouthwash group (p < 0.05). On the 14th day, the mean salivary flow time at 45 mins in the 2% pilocarpine mouthwash group was significantly higher than in the placebo mouthwash group (p = 0.007). Furthermore, the mean salivary flow at 60 and 75 mins in the 2% (p < 0.001) and 1% pilocarpine mouthwash (p = 0.028) was significantly higher than in the placebo group. Moreover, the salivary flow in the 2% pilocarpine mouthwash group was significantly higher than the 1% pilocarpine mouthwash (p < 0.05) during these two times. No side effects were observed in any of the subjects. CONCLUSIONS The study showed that 5 ml of 2 and 1% pilocarpine mouthwash for 2 weeks increased salivary flow in xerostomic participants compared to placebo without any side effects.
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Affiliation(s)
- Babak Motamed
- grid.411463.50000 0001 0706 2472Member of Dental Materials Research Center, School of Dentistry, Islamic Azad University - Tehran Medical Branch, Tehran, Iran
| | - Arezoo Alaee
- grid.411463.50000 0001 0706 2472Department of Oral Medicine, Member of the dental material research center, School of Dentistry, Islamic Azad University - Tehran Medical Branch, No.9, Neyestan 9, Pasdaran St., Tehran, Iran
| | - Arash Azizi
- grid.472338.90000 0004 0494 3030Department of Oral Medicine, School of Dentistry, Islamic Azad University Tehran Medical Branch, Tehran, Iran
| | - Hoda Jahandar
- grid.411463.50000 0001 0706 2472Pharmaceutical Sciences Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohammad Javad Kharazi Fard
- grid.411705.60000 0001 0166 0922Epidemiologist, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aryan Jafari
- grid.411463.50000 0001 0706 2472Member of Dental Materials Research Center, School of Dentistry, Islamic Azad University - Tehran Medical Branch, Tehran, Iran
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20
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Muacevic A, Adler JR, Browning S. Sweet Shop Sialagogues: A Sour Solution to Sialolithiasis. Cureus 2022; 14:e32097. [PMID: 36601206 PMCID: PMC9803858 DOI: 10.7759/cureus.32097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/03/2022] Open
Abstract
Historically, boiled sweets have been recommended by ear, nose, and throat surgeons for their sialagogue effect in patients with sialolithiasis. This study presents an in vivo analysis of boiled sweets and solutions to determine sialagogue superiority. Six high-street boiled sweets (lemon sherbets, rhubarb sweets, mint humbugs, Werther's Original® (August Storck, Germany), Fox's Glacier Fruits® (Fox's Confectionery, Braunstone, Leicester, United Kingdom), and Chupa Chups® lollipops (Perfetti Van Melle, Breda, Netherlands)) and two solutions (malt vinegar and lemon juice) were compared to two controls (no sweet and inert plastic) in two healthy participants. Malt vinegar and lemon juice produced the highest salivary flow. The best-performing boiled sweets were Chupa Chups lollipops and lemon sherbet. Substances with the highest concentrations of citric or lactic acid were the best sialagogues. This pilot study provides a proof of concept for further investigation in this cohort of patients.
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21
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da Silva NDG, de Paiva PRB, Magalhães TVM, Braga AS, Santos PSDS, Henrique-Silva F, Magalhães AC, Buzalaf MAR. Effect of experimental and commercial artificial saliva formulations on the activity and viability of microcosm biofilm and on enamel demineralization for irradiated patients with head and neck cancer (HNC). BIOFOULING 2022; 38:674-686. [PMID: 36154759 DOI: 10.1080/08927014.2022.2111258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/14/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
The effect of different artificial saliva formulations on biofilm activity and viability, and on enamel demineralization for head and neck cancer (HNC) patients was evaluated. Irradiated enamel samples were treated (1 min) with BioXtra® or with experimental formulations containing carboxymethylcellulose plus inorganic constituents alone (AS) or containing 0.1 mg mL-1 CaneCPI-5 (AS + Cane), 1.0 mg mL-1 hemoglobin (AS + Hb) or combination of both (AS + Cane + Hb). Phosphate-buffered-saline and chlorhexidine (0.12%) were negative and positive control, respectively. Biofilm was produced from the saliva of five male HNC patients, under 0.2% sucrose exposure for 5 days, and daily treated with the formulations (1 min). No significant effects were observed for the different experimental treatments. BioXtra® significantly reduced lactobacilli, demonstrating antibacterial potential for this group. Chlorhexidine was an effective treatment to significantly reduce all parameters, being an important antimicrobial and anticaries agent. Future in vitro studies must be performed using a new approach for the design of the experimental formulations.
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Affiliation(s)
- Natara Dias Gomes da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Pedro Renato Bodo de Paiva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Flávio Henrique-Silva
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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22
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The relationship between ocular and oral dryness in a cohort from the 65-year-old population in Norway. Sci Rep 2022; 12:9805. [PMID: 35697848 PMCID: PMC9191758 DOI: 10.1038/s41598-022-13985-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
In the present study, the relationship between dry eyes and dry mouth was explored in 150 65-year-old subjects randomly selected from the general population in Oslo, Norway. The number of drugs, including xerogenic drugs, and current and previous systemic diseases were recorded. Ocular parameters recorded were the McMonnies Dry Eye Questionnaire, the Ocular Surface Disease Index, the Schirmer I Test, tear film break-up time and ocular surface staining. The oral parameters were xerostomia frequency, Summated Xerostomia Inventory, Clinical Oral Dryness Score, and unstimulated and stimulated whole saliva. The participants with current or previous systemic diseases had significantly more ocular and oral symptoms and significantly more oral clinical findings than the participants without a history of disease. Moreover, correlation and factor analyses demonstrated an association between subjective ocular and oral parameters. A significant correlation between the total number of drugs and the presence of ocular and oral symptoms was also noted. When the participants were categorized based on their ocular symptoms, poorer values were found for the oral parameters among the participants more troubled with dry eyes. The results in the present study call for increased awareness and an interdisciplinary approach in matters related to dry eyes and dry mouth.
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23
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Schoppmeier CM, Helpap J, Hagemeier A, Wicht MJ, Barbe AG. Using the modified Schirmer test for dry mouth assessment: A cross-sectional study. Eur J Oral Sci 2022; 130:e12880. [PMID: 35692181 DOI: 10.1111/eos.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
Abstract
This study aimed to establish whether the modified Schirmer test could serve as a diagnostic tool for dry mouth, that is, whether it could reliably measure salivary film at selected locations within the oral cavity, and to identify levels of sensitivity/specificity and determine reference values. Therefore, a cross-sectional study (N = 120, mean age 63.5 [SD 13.9] years) was performed. The test was used at five locations (hard palate; buccal mucosa in molar region at 4 mm above occlusal plane; anterior tongue; lower lip; mouth floor), and results were recorded after 1, 2 and 3 min. A statistically significant discriminatory ability of the Schirmer test for the unstimulated salivary flow rates could be shown for the palate (at 3 min), buccal mucosa (at 1 min), mouth floor (at 1 min), and tongue (at 2 and 3 min) (areas under the curve 0.64-0.68), with individual sensitivity/specificity values depending on test location/time points. Thus, the modified Schirmer test has potential to become a simple and reproducible instrument for the detection of dry mouth based on low unstimulated salivary flow rates in dentistry and especially outreach care. Care must be taken concerning intraoral test location and measurement time.
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Affiliation(s)
- Christoph Matthias Schoppmeier
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Juliane Helpap
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Anna Hagemeier
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Michael Jochen Wicht
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Cologne, Germany
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24
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Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)-A Cross-Sectional Study. J Clin Med 2022; 11:jcm11113249. [PMID: 35683634 PMCID: PMC9181801 DOI: 10.3390/jcm11113249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 non-PTSD periodontal patients (Control group). The study group was further divided into two subgroups of individuals who received psychiatric medications (40 patients) or did not (60 patients). All patients underwent complete dental, oral, and periodontal examinations, including assessing signs of parafunction. Results: All PTSD patients had poor oral hygiene. The plaque index (PI) was higher in the PTSD group compared to the control group (0.72 ± 0.28 vs. 0.45 ± 0.29, respectively, p < 0.001). The decayed, missing, and filled teeth score (DMFt) was higher in the PTSD population than in the controls (19.97 ± 8.07 vs. 13.05 ± 6.23 p < 0.05). Severe periodontal disease was more common among the PTSD subgroup taking medications (med -group) (62.5%) compared to the nonmedicated group (non-med group) (30.0%) and the controls (27.2%) (p = 0.001). Heavy smoking was more prevalent in the medicated PTSD patients than in other groups. Conclusions: The present study shows higher morbidities in combat-induced PTSD patients, including oral, dental, and periodontal manifestations, especially in medicated patients.
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Pärnänen P, Lomu S, Räisänen IT, Tervahartiala T, Sorsa T. Effects of Fermented Lingonberry Juice Mouthwash on Salivary Parameters—A One-Year Prospective Human Intervention Study. Dent J (Basel) 2022; 10:dj10040069. [PMID: 35448063 PMCID: PMC9025424 DOI: 10.3390/dj10040069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 01/25/2023] Open
Abstract
A one-year prospective human intervention study was performed to examine the effects of fermented lingonberry juice (FLJ), used as a mouthwash for six months, on salivary parameters. A total of 25 adult participants used 10 mL of FLJ as mouthwash 30 s daily for 6 months in addition to their normal oral homecare routines. Standard oral examinations and gathering of samples were performed at the beginning of the study and after six months and one year. Resting and stimulated saliva secretion rates, resting saliva pH, and stimulated saliva buffering capacity were determined. A questionnaire of participants’ subjective sensations of mouth dryness was also recorded at each timepoint. Fermented lingonberry juice mouthwash had positive effect to all five salivary parameters and were, according to the omnibus test, statistically significant during the study period. Analysis of the subjective dry mouth sensation questionnaires revealed that symptoms of xerostomia decreased due to the use of FLJ. This study revealed that the once-a-day use of FLJ mouthwash had a beneficial, increasing effect on salivary flow rates, buffering capacity, and salivary pH. FLJ thus can be safely used as an adjunctive and beneficial therapy in oral homecare, protecting teeth and oral mucosa, including periodontium, and also relieving dry mouth symptoms.
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Affiliation(s)
- Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (S.L.); (I.T.R.); (T.T.); (T.S.)
- Correspondence: ; Tel.: +35-84-0543-2566
| | - Sari Lomu
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (S.L.); (I.T.R.); (T.T.); (T.S.)
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (S.L.); (I.T.R.); (T.T.); (T.S.)
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (S.L.); (I.T.R.); (T.T.); (T.S.)
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, P.O. Box 63 (Haartmaninkatu 8), FI-00014 Helsinki, Finland; (S.L.); (I.T.R.); (T.T.); (T.S.)
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, 17177 Huddinge, Sweden
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26
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Chibly AM, Aure MH, Patel VN, Hoffman MP. Salivary Gland Function, Development and Regeneration. Physiol Rev 2022; 102:1495-1552. [PMID: 35343828 DOI: 10.1152/physrev.00015.2021] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Salivary glands produce and secrete saliva, which is essential for maintaining oral health and overall health. Understanding both the unique structure and physiological function of salivary glands, as well as how they are affected by disease and injury will direct the development of therapy to repair and regenerate them. Significant recent advances, particularly in the OMICS field, increase our understanding of how salivary glands develop at the cellular, molecular and genetic levels; the signaling pathways involved, the dynamics of progenitor cell lineages in development, homeostasis and regeneration and the role of the extracellular matrix microenvironment. These provide a template for cell and gene therapies as well as bioengineering approaches to repair or regenerate salivary function.
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Affiliation(s)
- Alejandro Martinez Chibly
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Marit H Aure
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Vaishali N Patel
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Matthew Philip Hoffman
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
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27
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Yüce Sarı S, Yılmaz MT, Elmalı A, Kılıç L, Yüce D, Özyiğit G, Cengiz M, Yazıcı G. Turkish translation and validation of the Xerostomia Inventory. Arch Rheumatol 2022; 37:351-360. [PMID: 36589609 PMCID: PMC9791545 DOI: 10.46497/archrheumatol.2022.8702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives The Xerostomia Inventory (XI) was developed to assess the severity of dryness in patients with xerostomia. It has a long and a short form with three- and five-point Guttman-type response options. In this study, we aimed to translate the XI into Turkish, to assess the validity and reliability of both response options in patients with head & neck cancer (HNC) or Sjögren syndrome (SS), and to select the optimal version for Turkish patients. Patients and methods Between January 2019 and June 2019, the XI was translated into Turkish (XI-T) and applied to patients aged ≥18 years with HNC and SS. All patients were applied two tests including both the three- and five-point options. The internal consistency was assessed by Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Content validity was based on expert opinion and patient reviews. Results A total of 186 patients (109 males, 77 females; median age: 54 years; range, 19 to 78 years) answered the XI-T. The number of patients with HNC and SS was 143 (77%) and 43 (23%), respectively. Median XI-T score was 17 for the three-point, and 24 for the five-point option, respectively. Overall internal consistency was satisfactory for both options (α=0.81 and α=0.89, respectively). Overall test-retest reliability was satisfactory and ICCs ranged between 0.71 and 0.92 for the three-point, and 0.36 and 0.94 for the five-point option, respectively. Assessments based on expert opinions and patient reviews also favored the content validity of the scale. Conclusion The XI-T with both three- and five-point options is a valid and reliable tool to evaluate the presence and severity of dryness in patients with HNC and SS who experience xerostomia. The three-point option is more comprehensible and can be preferred over the five-point option in the Turkish population.
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Affiliation(s)
- Sezin Yüce Sarı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melek Tuğce Yılmaz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Ayşenur Elmalı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gökhan Özyiğit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gözde Yazıcı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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28
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Kapourani A, Kontogiannopoulos KN, Manioudaki AE, Poulopoulos AK, Tsalikis L, Assimopoulou AN, Barmpalexis P. A Review on Xerostomia and Its Various Management Strategies: The Role of Advanced Polymeric Materials in the Treatment Approaches. Polymers (Basel) 2022; 14:polym14050850. [PMID: 35267672 PMCID: PMC8912296 DOI: 10.3390/polym14050850] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/12/2022] [Accepted: 02/18/2022] [Indexed: 02/04/2023] Open
Abstract
The medical term xerostomia refers to the subjective sensation of oral dryness. The etiology seems to be multifactorial with the most frequently reported causes being the use of xerostomic medications, neck and head radiation, and systematic diseases (such as Sjögren’s syndrome). Xerostomia is associated with an increased incidence of dental caries, oral fungal infections, and difficulties in speaking and chewing/swallowing, which ultimately affect the oral health-related quality of life. The development of successful management schemes is regarded as a highly challenging project due to the complexity of saliva. This is why, in spite of the fact that there are therapeutic options aiming to improve salivary function, most management approaches are alleviation-oriented. In any case, polymers are an integral part of the various formulations used in every current treatment approach, especially in the saliva substitutes, due to their function as thickening and lubricating agents or, in the case of mucoadhesive polymers, their ability to prolong the treatment effect. In this context, the present review aims to scrutinize the literature and presents an overview of the role of various polymers (or copolymers) on either already commercially available formulations or novel drug delivery systems currently under research and development.
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Affiliation(s)
- Afroditi Kapourani
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (K.N.K.); (A.-E.M.)
| | - Konstantinos N. Kontogiannopoulos
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (K.N.K.); (A.-E.M.)
| | - Alexandra-Eleftheria Manioudaki
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (K.N.K.); (A.-E.M.)
| | - Athanasios K. Poulopoulos
- Department of Oral Medicine and Maxillofacial Pathology, School of Dentistry, Aristotle University, 54124 Thessaloniki, Greece;
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Andreana N. Assimopoulou
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Natural Products Research Centre of Excellence-AUTH (NatPro-AUTH), Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
| | - Panagiotis Barmpalexis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (K.N.K.); (A.-E.M.)
- Natural Products Research Centre of Excellence-AUTH (NatPro-AUTH), Center for Interdisciplinary Research and Innovation (CIRI-AUTH), 57001 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-2310997629
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29
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Ciudad P, Escandón JM, Manrique OJ, Bustos VP, Chen HC. The use of free colon flap transfer for management of xerostomia in a patient. Microsurgery 2021; 42:199-200. [PMID: 34951058 DOI: 10.1002/micr.30852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/26/2021] [Accepted: 10/22/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Pedro Ciudad
- Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, Peru.,Academic Department of Surgery, Hipolito Unanue School of Medicine, Federico Villarreal National University, Lima, Peru.,Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Joseph M Escandón
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
| | - Oscar J Manrique
- Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA
| | - Valeria P Bustos
- Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Hung-Chi Chen
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
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30
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Tsuchiya H. Characterization and Pathogenic Speculation of Xerostomia Associated with COVID-19: A Narrative Review. Dent J (Basel) 2021; 9:dj9110130. [PMID: 34821594 PMCID: PMC8625834 DOI: 10.3390/dj9110130] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) have become known to present with different oral symptoms. However, xerostomia remains poorly recognized compared with taste dysfunction. For better understanding of COVID-19 symptomatology, xerostomia associated withCOVID-19 was characterized and its possible pathogenesis was speculated by a narrative literature review. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, Google Scholar, medRxiv and bioRxiv from 1 April 2020 with a cutoff date of 30 September 2021. Results of the literature search indicated that xerostomia is one of prevalent and persistent oral symptoms associated with COVID-19. In contrast to taste dysfunction, the prevalence and persistence of xerostomia do not necessarily depend on ethnicity, age, gender and disease severity of patients. COVID-19 xerostomia is pathogenically related to viral cellular entry-relevant protein expression, renin-angiotensin system disturbance, salivary gland inflammation, zinc deficiency, cranial neuropathy, intercurrent taste dysfunction, comorbidities and medications. Despite a close association with COVID-19, xerostomia, dry mouth and hyposalivation tend to be overlooked unlike ageusia, dysgeusia and hypogeusia. Although mouth dryness per se is not life-threating, it has an impact on the oral health-related quality of life. More attention should be paid to xerostomia in COVID-19 patients and survivors.
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31
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Care need and dry mouth as risk indicators for impaired taste and smell. Sci Rep 2021; 11:20419. [PMID: 34650210 PMCID: PMC8516854 DOI: 10.1038/s41598-021-99978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Abstract
To identify whether reduced saliva secretion or xerostomia symptoms are risk indicators for impaired taste and smell, depending on age and care needs. This cross-sectional study evaluated taste and smell in patients categorized into different age groups (<65> years) and different care need, with and without dry mouth. Of the 185 patients included, 119 were classified as “dry mouth” and 66 as “without dry mouth”. Overall, 103 (55.7%) were female and 37 (20%) needed care. There was no difference between “dry mouth” and “without dry mouth” regarding identification of odors or tastes, but a difference in the number of correctly identified odors and tastes in favor of “without care need” patients (p < 0.05). The ability to identify smells and tastes was negatively influenced by age, number of medications, and number of comorbidities, but subjective dry mouth had no impact. According to our results, subjective dry mouth is not a risk factor for an impaired ability to recognize smells and tastes. However, care need representing age, the number of medications taken, and the number of chronic comorbidities is a risk indicator.
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32
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Storbeck T, Qian F, Marek C, Caplan D, Marchini L. Dose-dependent association between xerostomia and number of medications among older adults. SPECIAL CARE IN DENTISTRY 2021; 42:225-231. [PMID: 34644409 DOI: 10.1111/scd.12662] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE/AIM To investigate factors associated with self-reported dry mouth (xerostomia) among older adults seeking dental care at a University clinic. MATERIALS AND METHODS A query was performed in the electronic records database and de-identified data were collected from patients aged 65 + recorded on the date that the initial health history was entered. Among these patients, data about patients' medications, gender, age, BMI, tobacco use, alcohol addiction, diabetes, heart disease, joint replacement, allergies to medications, hypertension, and mental disorders were obtained. Evaluation of potential risk factors for dry mouth was performed using univariate and multivariable logistic regression analyzes (alpha = 0.05). RESULTS A total of 11,061 subjects were included in the analysis, 51.5% of whom were women. The mean age in years was 74.2 ± 7.0, the median number of medications was 7 (IQR = 4-11), and 38.5% of the participants reported dry mouth. The multivariable logistic regression analysis revealed that the odds of xerostomia for subjects who took 11 +, 7-10, or 4-6 medications were 3.34, 2.07, or 1.38 times those of subjects who had took 0-3 medications, respectively. CONCLUSION Number of medications showed a strong and dose-dependent association with xerostomia.
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Affiliation(s)
- Tanner Storbeck
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Fang Qian
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Cindy Marek
- Department of Oral Pathology, Radiology and Medicine, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Daniel Caplan
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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33
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Nam K, Dos Santos HT, Maslow F, Trump BG, Lei P, Andreadis ST, Baker OJ. Laminin-1 Peptides Conjugated to Fibrin Hydrogels Promote Salivary Gland Regeneration in Irradiated Mouse Submandibular Glands. Front Bioeng Biotechnol 2021; 9:729180. [PMID: 34631679 PMCID: PMC8498954 DOI: 10.3389/fbioe.2021.729180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies demonstrated that salivary gland morphogenesis and differentiation are enhanced by modification of fibrin hydrogels chemically conjugated to Laminin-1 peptides. Specifically, Laminin-1 peptides (A99: CGGALRGDN-amide and YIGSR: CGGADPGYIGSRGAA-amide) chemically conjugated to fibrin promoted formation of newly organized salivary epithelium both in vitro (e.g., using organoids) and in vivo (e.g., in a wounded mouse model). While these studies were successful, the model's usefulness for inducing regenerative patterns after radiation therapy remains unknown. Therefore, the goal of the current study was to determine whether transdermal injection with the Laminin-1 peptides A99 and YIGSR chemically conjugated to fibrin hydrogels promotes tissue regeneration in irradiated salivary glands. Results indicate that A99 and YIGSR chemically conjugated to fibrin hydrogels promote formation of functional salivary tissue when transdermally injected to irradiated salivary glands. In contrast, when left untreated, irradiated salivary glands display a loss in structure and functionality. Together, these studies indicate that fibrin hydrogel-based implantable scaffolds containing Laminin-1 peptides promote secretory function of irradiated salivary glands.
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Affiliation(s)
- Kihoon Nam
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Harim T Dos Santos
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Frank Maslow
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Bryan G Trump
- School of Dentistry, University of Utah, Salt Lake City, UT, United States
| | - Pedro Lei
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Stelios T Andreadis
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States.,Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States.,Center of Bioinformatics and Life Sciences, University at Buffalo, The State University of New York, Buffalo, NY, United States.,Center of Cell, Gene and Tissue Engineering, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - Olga J Baker
- Bond Life Sciences Center, University of Missouri, Columbia, MO, United States.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States.,Department of Biochemistry, University of Missouri, Columbia, MO, United States
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34
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Reis VP, Bezerra AR, Maia ABP, Marques LC, Conde DC. An integrative review of oral manifestations in patients with COVID-19: signs directly related to SARS-CoV-2 infection or secondary findings? Int J Dermatol 2021; 61:278-290. [PMID: 34541674 PMCID: PMC8653326 DOI: 10.1111/ijd.15881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/01/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
We conducted an integrative review on oral manifestations in patients with COVID‐19 based on the current available literature evidence. A bibliographic search was carried out on March 11, 2021, among published studies in the years 2019–2021 in the PubMed database and based on the search strategy (“COVID‐19” AND “oral lesions” OR “oral mucositis” OR “oral manifestation”). After applying the inclusion and exclusion criteria, 29 articles were considered suitable for this review. A total of 110 cases of patients with COVID‐19 who had oral manifestations were reported. The presence of ulcerated lesions was the most common finding, having a herpetiform and aphthous clinical pattern observed in most cases. Macules, petechiae, hemorrhagic blisters, pustular enanthem, mucositis, and halitosis were also among the most frequently described oral manifestations. The tongue was the most commonly affected site, followed by the palate and lip. Most of the reported cases were diagnosed only by the clinical aspect of the lesion associated with a positive SARS‐CoV‐2 test or the presence of other COVID‐19 symptoms. Current scientific evidence still could not affirm that most of the oral lesions observed in patients with COVID‐19 are related to the virus's direct or indirect action on the oral mucosa. To confirm this association, prospective and longitudinal studies are further needed, together with a larger number of patients, complemented by histopathological examination of these lesions. Additionally, molecular techniques, such as immunohistochemistry and in situ hybridization, may be necessary to perform the differential diagnosis with other oral lesions.
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Affiliation(s)
- Vanessa Paiva Reis
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Polyclinic of Cascadura (Policlínica da Polícia Militar de Cascadura), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriana Raymundo Bezerra
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Dental Clinic (Odontoclínica Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Adriane Batista Pires Maia
- Oral Maxillofacial Surgery and Traumatology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
| | - Letícia Côgo Marques
- Dentistry Sector, Healthcare and Social Assistance Section of The Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.,Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil.,Oral Maxillofacial Surgery and Traumatology Service and Anatomical Pathology Service, Military Police Central Hospital (Hospital Central da Polícia Militar), Rio de Janeiro State Military Police, Rio de Janeiro, Brazil
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35
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Common Medical and Dental Problems of Older Adults: A Narrative Review. Geriatrics (Basel) 2021; 6:geriatrics6030076. [PMID: 34449647 PMCID: PMC8395714 DOI: 10.3390/geriatrics6030076] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 12/12/2022] Open
Abstract
The advancement of medicine has reduced the rate of mortality and older adult population is increasing. Among the 7,700,000,000 world population in 2019, 1 in 11 people were at the age of 65 or more. The population is expected to increase to 1 in 6 people by 2050. Older adults have degenerative changes that become more severe with age. This study used the World Health Organization’s websites and PubMed and Google Scholar databases to review current global oral and systemic health issues. Studies generally reported that many older adults have no regular dental checkup. Common oral diseases such as dental caries particularly root caries and periodontal disease are highly prevalent among them. These oral diseases are often interrelated with their systemic problems. A meta-analysis reported diabetes increases the incidence and progression of periodontitis by 86%. A decrease in salivary output is common among older adults having polypharmacy. A review reported the caries risk in older adults increases by 60% with low resting pH and low stimulated salivary flow rate. Many older adults suffer from dementia and depression which complicates the delivery of dental treatment. Proper oral hygiene practice and dental care at supine position are often difficult to be carried out if they have rheumatoid arthritis. With the increasing need of elderly dental care, dentists and other dental personnel should understand interlaced oral and general health in order to provide a successful dental care plan for older adults. The aim of this study is to give an overview of the common medical conditions and dental problems and their impacts on older adults.
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Effects of oligonol on the submandibular gland in ovariectomized rats. Biomed Pharmacother 2021; 141:111897. [PMID: 34328116 DOI: 10.1016/j.biopha.2021.111897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to observe the effects of oligonol on submandibular gland dysfunction in ovariectomized rats. We randomly divided female Sprague-Dawley rats into sham-operated, ovariectomized, and oligonol-treated ovariectomized groups. Oligonol was intraperitoneally administered at 30 mg/kg daily for six weeks. Lipogenesis increased after the ovariectomy while fatty acid oxidation increased and intracellular triglyceride levels decreased in response to oligonol treatment. Submandibular gland fibrosis characterized by collagen type I accumulation was observed in the ovariectomized group. However, oligonol markedly reduced fibrosis to a level comparable to that observed in the sham group. Aquaporin 1 and glucose transporter 4 were downregulated in the ovariectomized group. Nevertheless, both factors were significantly upregulated by oligonol treatment. However, aquaporin 5 was significantly downregulated in the oligonol treatment group. Our findings indicate that oligonol protects against damage in postmenopausal rat salivary glands.
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Iacovelli NA, Ingargiola R, Facchinetti N, Franceschini M, Romanello DA, Bossi P, Bergamini C, Alfieri S, Cavalieri S, Baron G, Aldini G, Locati L, Orlandi E. A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Study to Evaluate the Efficacy of Aqualief TM Mucoadhesive Tablets in Head and Neck Cancer Patients Who Developed Radiation-Induced Xerostomia. Cancers (Basel) 2021; 13:cancers13143456. [PMID: 34298670 PMCID: PMC8303446 DOI: 10.3390/cancers13143456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
Xerostomia, the subjective complaint of dry mouth, is caused by therapeutic interventions or diseases. Nowadays, radiotherapy (RT) in patients with head and neck cancer (HNC) stands out as one of the most important causes of xerostomia. Currently available therapies for the treatment of xerostomia are still less than optimal and xerostomia still represents an unmet clinical need. In this article, we present the results of a prospective clinical study with a new product, AqualiefTM, in patients treated with curative RT with or without chemotherapy for HNC. AqualiefTM is based on two main ingredients, carnosine and karkadé, which have acid buffering and antioxidant properties. The study was performed on 30 patients, with 4 of the patients being lost during the study period. Each patient received randomly one of the two treatments, AqualiefTM or placebo, for 8 days. After a 10-day wash-out period, each patient received the other treatment for a further 8 days. The results show that AqualiefTM stimulated salivation in these patients and reduced the pH drop that was observed in an equivalent placebo-treated population of patients. Moreover, no serious, treatment-related adverse events were observed. AqualiefTM has shown positive results, although with limitations due to unsuccessful trial accrual. Therefore, it may be further investigated as a tool for the treatment of RT-related xerostomia.
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Affiliation(s)
- Nicola Alessandro Iacovelli
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
- Correspondence:
| | - Rossana Ingargiola
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Nadia Facchinetti
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Marzia Franceschini
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Domenico Attilio Romanello
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
| | - Paolo Bossi
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Cristiana Bergamini
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Salvatore Alfieri
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Stefano Cavalieri
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Giovanna Baron
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133 Milan, Italy; (G.B.); (G.A.)
| | - Giancarlo Aldini
- Department of Pharmaceutical Sciences (DISFARM), Università degli Studi di Milano, Via Mangiagalli 25, 20133 Milan, Italy; (G.B.); (G.A.)
| | - Laura Locati
- Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (P.B.); (C.B.); (S.A.); (S.C.); (L.L.)
| | - Ester Orlandi
- Radiation Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy; (R.I.); (N.F.); (M.F.); (D.A.R.); (E.O.)
- Radiation Oncology Unit 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133 Milan, Italy
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Hwang BY, Mampre D, Boesch JR, Huang J, Anderson WS. Total Fasting and Dehydration in the Operating Room: How Can Surgeons Survive and Thrive? JOURNAL OF SURGICAL EDUCATION 2021; 78:1295-1304. [PMID: 33419691 DOI: 10.1016/j.jsurg.2020.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/06/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Hydration and nutrition are critical to achieving optimal performance. This study aimed to assess the impact of limited oral intake in the operating room environment on surgical resident health, well-being, and performance. DESIGN Electronic survey was sent to 94 surgical trainees at our institution in 2020. Chi-square analyses were performed to assess for differences in survey responses by sex. SETTING A single tertiary-care institution. PARTICIPANTS Surveys were sent to surgical residents and fellows in general surgery, neurosurgery, and orthopedic surgery. Seventy-nine (80%) of the 94 residents and fellows responded. RESULTS Of the 79 responses, most trainees (79%) experienced dehydration within 6 hours of operating. Forty-four (56%) reported no fluid intake for greater than 6 hours on average, and 39 (49%) reported that they frequently had difficulty rehydrating in between cases. Most of the respondents (70%) frequently experienced symptoms of dehydration, including orthostasis, headache, and constipation. Fifty-six (71%) believed that dehydration frequently affected their performance. Compared to men, women were more likely to feel dehydrated within 4 hours of operating (58% vs. 25%, p = 0.005). Women were also more likely to have difficulty rehydrating in between cases (75% vs. 38%, p = 0.0026), experience symptoms of dehydration (92% vs. 60%, p = 0.0049), and report that dehydration affects surgical performance (88% vs. 64%, p = 0.0318). CONCLUSIONS Prolonged fasting and dehydration are common issues that may negatively impact performance and wellbeing of surgical trainees. Also, dehydration may affect men and women differently.
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Affiliation(s)
- Brian Y Hwang
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - David Mampre
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - John R Boesch
- 160th Special Operations Aviation Regiment (Airborne), U.S. Army Special Operations Command, Fort Campbell, Kentucky
| | - Judy Huang
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - William S Anderson
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland
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Beyond dissolution: Xerostomia rinses affect composition and structure of biomimetic dental mineral in vitro. PLoS One 2021; 16:e0250822. [PMID: 33901259 PMCID: PMC8075190 DOI: 10.1371/journal.pone.0250822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/14/2021] [Indexed: 11/24/2022] Open
Abstract
Xerostomia, known as dry mouth, is caused by decreased salivary flow. Treatment with lubricating oral rinses provides temporary relief of dry mouth discomfort; however, it remains unclear how their composition affects mineralized dental tissues. Therefore, the objective of this study was to analyze the effects of common components in xerostomia oral rinses on biomimetic apatite with varying carbonate contents. Carbonated apatite was synthesized and exposed to one of the following solutions for 72 hours at varying pHs: water-based, phosphorus-containing (PBS), mucin-like containing (MLC), or fluoride-containing (FC) solutions. Post-exposure results indicated that apatite mass decreased irrespective of pH and solution composition, while solution buffering was pH dependent. Raman and X-ray diffraction analysis showed that the addition of phosphorus, mucin-like molecules, and fluoride in solution decreases mineral carbonate levels and changed the lattice spacing and crystallinity of bioapatite, indicative of dissolution/recrystallization processes. The mineral recrystallized into a less-carbonated apatite in the PBS and MLC solutions, and into fluorapatite in FC. Tap water did not affect the apatite lattice structure suggesting formation of a labile carbonate surface layer on apatite. These results reveal that solution composition can have varied and complex effects on dental mineral beyond dissolution, which can have long term consequences on mineral solubility and mechanics. Therefore, clinicians should consider these factors when advising treatments for xerostomia patients.
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Fernandes MS, Castelo PM, Chaves GN, Fernandes JPS, Fonseca FLA, Zanato LE, Gavião MBD. Relationship between polypharmacy, xerostomia, gustatory sensitivity, and swallowing complaints in the elderly: A multidisciplinary approach. J Texture Stud 2020; 52:187-196. [PMID: 33191538 DOI: 10.1111/jtxs.12573] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022]
Abstract
Oral dysfunctions are common in the elderly but the literature lacks a multidisciplinary approach on the relationship between polypharmacy, saliva flow, xerostomia, taste, and swallowing complaints. This cross-sectional study included 204 non-institutionalized elderly (>60 years; 123 women/81 men), free of severe disabilities and non-alcohol/tobacco consumers, from whom specific pharmacological therapies were evaluated, as well xerostomia (Xerostomia Inventory-XI) and swallowing complaints (EAT-10 questionnaire), salivary flow rate and gustatory sensitivity. Statistical analysis included Chi-square, Mann-Whitney, Two-way ANCOVA, and linear multiple regression. Polypharmacy (≥5 drugs daily), hyposalivation, and severe taste dysfunction were found in 18, 46, and 10% of the participants, respectively. Polypharmacy was related with xerostomia (p = .041) and swallowing complaints (p < .001; power = 94%), but not with taste dysfunction. Dry mouth complaint and higher risk of swallowing disorders were found in 50 and 12% of the elderly, respectively, and angiotensin-converting enzyme (ACE) inhibitors users (n = 36) showed higher EAT-10 scores (p = .038). Regression models showed that stimulated salivary flow rate was dependent on gender and diuretic use, while xerostomia scores were dependent on the number of medications and unstimulated saliva flow (p < .001). In conclusion, the results draw attention to the high frequency of oral and maxillofacial dysfunctions found in non-institutionalized elderly, especially polypharmacy, xerostomia and swallowing complaints, and the side effects of drugs that can disturb the oral functions, the acceptance of food, and the adherence to oral therapies.
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Affiliation(s)
- Mariana S Fernandes
- Department of Pediatric Dentistry, University of Campinas, Piracicaba, Brazil
| | - Paula M Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil
| | - Giovanna N Chaves
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil
| | - João P S Fernandes
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil
| | - Fernando L A Fonseca
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil
| | - Luciana E Zanato
- Department of Speech Language Therapy, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria B D Gavião
- Department of Pediatric Dentistry, University of Campinas, Piracicaba, Brazil
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Prevention of irradiation-induced damage to salivary glands by local delivery of adipose-derived stem cells via hyaluronic acid-based hydrogels. J IND ENG CHEM 2020. [DOI: 10.1016/j.jiec.2020.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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da Mata ADSP, Amaral JPDAR, Thomson WM, Barcelos F, Vaz Patto J, Pereira RMN, Marques DNDS. Patient-related outcomes in Sjögren syndrome treated with stimulants of salivary secretion: Randomized clinical trial. Oral Dis 2019; 26:313-324. [PMID: 31814226 DOI: 10.1111/odi.13251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the impact of gustatory stimulants of salivary secretion (GSSS) on Sjögren's syndrome patients' self-perception of xerostomia, oral health-related quality of life (OHRQoL) and salivary secretion. METHODS A total of 110 Sjögren's syndrome patients were randomly allocated to be treated with either a malic acid lozenge or a citric acid mouthwash and then crossed over. Before and after the interventions, the Xerostomia Inventory 5 (SXI-5-PL) and the Oral Health Impact Profile (OHIP-14-PT) questionnaires (both in the Portuguese language) were administered to patients. Unstimulated, mechanical and gustatory-stimulated salivary flows were determined. Repeated measures and between-subject analyses were performed. Statistical significance was set at 5%. RESULTS After the intervention and within each group, both GSSS elicited a reduction in the SXI-5-PL and OHIP-14-PT scores and an increase in salivary output, significant in the malic acid lozenge group. The malic acid treatment resulted in a greater effect size and percentage improvement than citric acid mouthwash. The malic acid lozenge also produced a significant greater salivary output than the citric acid rising solution. CONCLUSIONS In Sjögren's syndrome patients, lozenges containing malic acid increased saliva production and xerostomia relief, resulting in improved quality of life.
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Affiliation(s)
- António Duarte Sola Pereira da Mata
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,New York University, New York, NY, USA.,Clinic Hugo Madeira-Advanced Aesthetics & Implantology, Lisboa, Portugal
| | - João Pedro de Almeida Rato Amaral
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - William Murray Thomson
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | | | | | - Ruben Miguel Nunes Pereira
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Nuno da Silva Marques
- Oral Biology & Biochemistry Research Group, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Implantology Institute, Lisboa, Portugal
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Murakami S, Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Periodontol 2019; 89 Suppl 1:S17-S27. [PMID: 29926958 DOI: 10.1002/jper.17-0095] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/08/2017] [Accepted: 08/19/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This review proposes revisions to the current classification system for gingival diseases and provides a rationale for how it differs from the 1999 classification system. IMPORTANCE Gingival inflammation in response to bacterial plaque accumulation (microbial biofilms) is considered the key risk factor for the onset of periodontitis. Thus, control of gingival inflammation is essential for the primary prevention of periodontitis. FINDINGS The clinical characteristics common to dental plaque-induced inflammatory gingival conditions include: a) clinical signs and symptoms of inflammation that are confined to the gingiva: b) reversibility of the inflammation by removing or disrupting the biofilm; c) the presence of a high bacterial plaque burden to initiate the inflammation; d) systemic modifying factors (e.g., hormones, systemic disorders, drugs) which can alter the severity of the plaque-induced inflammation and; e) stable (i.e., non-changing) attachment levels on a periodontium which may or may not have experienced a loss of attachment or alveolar bone. The simplified taxonomy of gingival conditions includes: 1) introduction of the term "incipient gingivitis;" 2) a description of the extent and severity of gingival inflammation; 3) a description of the extent and severity of gingival enlargement and; 4) a reduction of categories in the dental plaque-induced gingival disease taxonomy. CONCLUSIONS Dental plaque-induced gingival inflammation is modified by various systemic and oral factors. The appropriate intervention is crucial for the prevention of periodontitis.
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Affiliation(s)
- Shinya Murakami
- Osaka University, Graduate School of Dentistry-Department of Periodontology, Osaka, Japan
| | - Brian L Mealey
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Angelo Mariotti
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Iain L C Chapple
- Department of Periodontology, University of Birmingham School of Dentistry, Birmingham, UK
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Rao RS, Akula R, Satyanarayana TSV, Indugu V. Recent Advances of Pacemakers in Treatment of Xerostomia: A Systematic Review. J Int Soc Prev Community Dent 2019; 9:311-315. [PMID: 31516864 PMCID: PMC6714424 DOI: 10.4103/jispcd.jispcd_389_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 05/01/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives: Treatment of dry mouth is the most common clinical challenge in the dental field. Although some remedies have been used to improve the signs and symptoms of xerostomia, none of them are absolutely satisfactory for the patients who have this alteration. In the current years, non-pharmacological treatments based on neuro-electro-stimulation for the treatment of xerostomia were developed. This review aimed at presenting recent developments for the treatment of xerostomia, applying neuro-electro-stimulation by miniaturized intraoral electrostimulators. Materials and Methods: A thorough literature search between 1986 and 2018 was carried out using PubMed Central, Scopus, National Science Library, ProQuest, and Google Scholar databases; the results were reviewed, prioritized, and the findings were compiled. Twenty-two studies were evaluated for the review. Results: This tool increases salivary secretion and improves xerostomia symptoms. Scientific trials have been carried out, which have revealed the wetting effect of the method described in this text. Conclusion: Neuro-electro-stimulation of the salivary gland plays an important role in the stimulation of saliva in patients who need further therapy and have poor quality of life. Intraoral electrostimulator offers a new non-pharmacological method for treating dry mouth.
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Affiliation(s)
- Rayapati Srinivasa Rao
- Department of Prosthodontics, Teerthanker Mahaveer University Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Rajesh Akula
- Dental department, Ex-servicemen contributory health Scheme, Srikakulam, Andhra Pradesh, India
| | - Tammineedi S V Satyanarayana
- Department of Prosthodontics and Crown and Bridge, KLR's Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Venkatagiri Indugu
- Department of Orthodontics and Dentofacial Orthopedics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
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Aframian DJ, Baaton S, Mazor S, Nadler C, Keshet N, Haviv Y, Zadik Y, Schwimmer-Noy R, Shay B, Almoznino G. Improvement of dry mouth following intraductal irrigation of salivary glands. Oral Dis 2019; 25:1735-1743. [PMID: 31278807 DOI: 10.1111/odi.13152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/10/2019] [Accepted: 06/30/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the effect of major salivary gland intraductal irrigations (IGs) to relieve mouth dryness. METHODS We retrospectively analyzed the records of patients with mouth dryness who underwent major salivary gland IG during 2013-2015. Records included demographics, medical background, dry mouth etiologies and symptomatology, and results of sialometry and sialo-cone-beam computerized tomography. Subjective improvement following the IG procedure (yes/no) and sustained subjective improvement (mouth dryness relief for ≥1 month) were recorded. Objective improvement was assessed by comparing the mean unstimulated (USF) and stimulated (SSF) whole salivary flow (WSF) rate before and after the IG. RESULTS Seventy-four patients were included [mean age: 59.08 ± 12.46 years]. Improvement was detected in the USF (p = .027), but not in the SSF (p = .878). Fifty-five (84.6%) noted subjective improvement, while 10 (15.4%) did not. Subjective improvement was positively associated with the USF following IG (p = .037), with salivary gland swelling episodes (p = .033), and with difficulties in swallowing dry foods (p = .014). Of those with subjective improvement, 45 (81.8%) reported sustained improvement, which was positively associated with lack of a gritty eye sensation (p = .042) and abnormal sialo-CBCT findings (p = .001). CONCLUSIONS Major salivary gland IG is a simple and safe procedure that may relieve dry mouth for a relatively extended duration. Further studies are needed to confirm these preliminary findings and assess their underlying mechanisms.
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Affiliation(s)
- Doron J Aframian
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Sagit Baaton
- Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Sigal Mazor
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Chen Nadler
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Naama Keshet
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Yaron Haviv
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Yehuda Zadik
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Rinat Schwimmer-Noy
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Boaz Shay
- Department of Endodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Galit Almoznino
- Sjogren's Syndrome Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Rusthen S, Kristoffersen AK, Young A, Galtung HK, Petrovski BÉ, Palm Ø, Enersen M, Jensen JL. Dysbiotic salivary microbiota in dry mouth and primary Sjögren's syndrome patients. PLoS One 2019; 14:e0218319. [PMID: 31211815 PMCID: PMC6581286 DOI: 10.1371/journal.pone.0218319] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/31/2019] [Indexed: 12/20/2022] Open
Abstract
Objectives Primary Sjögren’s syndrome (pSS) is an autoimmune disease characterized by reduced lacrimal and salivary secretion. Sicca symptoms together with fatigue and musculoskeletal pain can significantly reduce the patients’ quality of life. Furthermore, low salivary secretion may disrupt the oral microbial homeostasis. The aim of this study was to compare the salivary microbiota from pSS patients with patients with sicca symptoms not fulfilling the classification criteria for pSS (non-SS), and with healthy controls without sicca complaints. Methods Pellets from centrifuged chewing-stimulated whole saliva from pSS patients (n = 15), non-SS sicca patients (n = 15) and healthy controls (n = 15) were prepared. DNA was extracted and analyzed by 16S rRNA gene sequencing. The acquired sequencing data were performed using the human oral microbiome database (HOMD). Results We detected 42, 45, and 34 bacterial genera in saliva samples from pSS patients, non-SS sicca patients, and healthy controls, respectively. The most abundant genera in all samples were Prevotella, Veillonella, Streptococcus, and Haemophilus. At species level Streptococcus intermedius, Prevotella intermedia, Fusobacterium nucleatum subsp. vincentii, Porphyromonas endodontalis, Prevotella nancensis, Tannerella spp., and Treponema spp. were detected in the samples from pSS and non-SS only, while Porphyromonas pasteri was mostly found among the healthy controls. Conclusion Our study indicated dysbiosis in the salivary microbiota from pSS and non-SS patients compared to healthy controls. Additionally, the results showed that the salivary microbiome in the pSS group differed significantly from the non-SS group.
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Affiliation(s)
- S. Rusthen
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - A. K. Kristoffersen
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - A. Young
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - H. K. Galtung
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - B. É. Petrovski
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ø. Palm
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - M. Enersen
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - J. L. Jensen
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
- * E-mail:
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Karthikeyan V, Chander NG, Anitha KV. A salivary sensor for the management of xerostomia in edentulous patients. J Prosthet Dent 2019; 121:384-386. [DOI: 10.1016/j.prosdent.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/07/2018] [Accepted: 07/09/2018] [Indexed: 11/25/2022]
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Chávez EM, Wong LM, Subar P, Young DA, Wong A. Dental Care for Geriatric and Special Needs Populations. Dent Clin North Am 2019; 62:245-267. [PMID: 29478456 DOI: 10.1016/j.cden.2017.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article reviews considerations for oral health care associated with the most common causes of mortality and morbidity in older adults. Many of these diseases result in functional or cognitive impairments that must be considered in treatment planning to ensure appropriate, safe, and effective care for patients. Many of these considerations parallel those of adults who have lived with developmental disabilities over a lifetime and similar principles can be applied. Systemic diseases, conditions, and their treatments can pose significant risks to oral health, which requires prevention, treatment, and advocacy for oral health care as integral to chronic disease management.
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Affiliation(s)
- Elisa M Chávez
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA.
| | - Lynne M Wong
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
| | - Paul Subar
- Special Care Clinic, Hospital Dentistry Program, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA; Department of Family and Community Medicine, UCSF School of Medicine, San Francisco, CA, USA
| | - Douglas A Young
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
| | - Allen Wong
- AEGD Program, Hospital Dentistry Program, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
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Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management. Drugs Aging 2018; 35:877-885. [PMID: 30187289 DOI: 10.1007/s40266-018-0588-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Medication-induced xerostomia and hyposalivation will increasingly become oral health issues for older and geriatric patients because of the likely high prevalence of medication intake and polypharmacy, with a complex negative impact on other symptoms such as dysphagia, caries incidence, malnutrition, and quality of life. All healthcare professionals are encouraged to investigate dry mouth symptoms among their patients, since diagnosis can easily be performed within daily clinical practice. This practical article also provides a review of available treatment options, which include medication changes towards products with fewer xerogenic side effects or dose reductions, if possible, as well as multidisciplinary, preventive care-oriented approaches that consider all influencing factors and treatment of the oral symptoms. In addition, several topical agents and saliva substitutes are discussed that may provide symptomatic relief but need to be carefully adapted to each patient's situation in terms of usability and practicability and in the knowledge that therapeutic success varies with each individual. Innovative methods such as intraoral electrostimulation or topical application of anticholinesterase on the oral mucosa are also discussed. The most commonly prescribed pharmaceutical treatment options for dry mouth are pilocarpine (a parasympathomimetic agent with potent muscarinic, cholinergic salivation-stimulating properties) and cevimeline (a quinuclidine analogue with therapeutic and side effects similar to those of pilocarpine). These pharmaceutic treatment options are described in the context of older patients, where the highly prevalent cholinergic side effects, which include nausea, emesis, bronchoconstriction, among others, need to be thoroughly supervised by the healthcare professionals involved. Providing these therapeutic options to patients with medication-induced dry mouth will help improve their oral health and therefore maintain a better quality of life, general health, and well-being.
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50
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Barbe AG, Schmidt P, Bussmann M, Kunter H, Noack MJ, Röhrig G. Xerostomia and hyposalivation in orthogeriatric patients with fall history and impact on oral health-related quality of life. Clin Interv Aging 2018; 13:1971-1979. [PMID: 30349216 PMCID: PMC6188197 DOI: 10.2147/cia.s178370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose Falls are a common cause of morbidity and mortality in older people, and identification of risk indicators and risk factors to prevent falling is essential. Dry mouth (xerostomia and hyposalivation) can exacerbate conditions known to be fall risk indicators, such as nutritional status and sarcopenia. But there is little evidence regarding whether it is an independent risk factor for falling. We explored xerostomia prevalence and intensity and objective salivation rates in hospitalized geriatric patients to determine whether they were associated with an increased risk of falling. Patients and methods Hospitalized geriatric patients with and without a fall history were compared. We investigated several oral health issues including xerostomia, stimulated and unstimulated salivation rates, total number of teeth and prosthetics, periodontal status, and oral health-related quality of life. Results Forty patients were included, 28 in the fall history group and 12 in the control group. All patients had oral health issues that impacted on their oral health-related quality of life. However, there were no significant differences between the groups, including xerostomia and hyposalivation, apart from increased dysphagia and less flavor in food in patients with a fall history. Conclusion Dry mouth does not appear to be an independent risk factor for falling in this population, but oral health was impaired. Thus, it is important that dentists and geriatricians are aware of and investigate these conditions in their patients and that appropriate action is taken to reduce the consequences of impaired oral health, including a potential reduction in falls.
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Affiliation(s)
- Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Köln, Germany,
| | - Pia Schmidt
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Köln, Germany,
| | - Michael Bussmann
- Department of Orthogeriatrics, Evangelisches Krankenhaus Köln Kalk, Cologne, Germany
| | - Henning Kunter
- Department of Orthogeriatrics, Evangelisches Krankenhaus Köln Kalk, Cologne, Germany
| | - Michael Johannes Noack
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Cologne, Köln, Germany,
| | - Gabriele Röhrig
- Geriatric Diagnostic Center, MVZ Medicum Köln Ost, Cologne, Germany
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