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Piboonratanakit P, Ferreira JN, Pravinvongvuthi K, Maison K, Urkasemsin G, Boonroung T, Prayongrat A, Lertbutsayanukul C, Sucharitakul J, Vacharaksa A. Trehalose versus carboxymethylcellulose oral spray for relieving radiation-induced xerostomia in head and neck cancer patients: a randomized controlled trial. BMC Oral Health 2023; 23:288. [PMID: 37179287 PMCID: PMC10182540 DOI: 10.1186/s12903-023-02966-4] [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: 11/17/2022] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of trehalose oral spray to relieve radiation-induced xerostomia on a randomized controlled trial (RCT). METHODS Prior to RCT, the effect of trehalose (5-20%) on the epithelial growth of fetal mouse salivary gland (SG) explants was evaluated to confirm if 10% trehalose exerted the best epithelial outcomes. Participants who completed radiotherapy for head and neck cancer (HNC) treatment were enrolled in a double-blind RCT, according to inclusion and exclusion criteria as per the CONSORT statement. The experimental group (n = 35) received 10% trehalose spray, while the control group (n = 35) received carboxymethylcellulose (CMC) spray to apply intra-orally 4 times/day for 14 days. Salivary pH and unstimulated salivary flow rate were recorded pre- and post-interventions. The Xerostomia-related Quality of Life scale (XeQoLs) was filled, and scores assessed post-interventions. RESULTS In the SG explant model, pro-acinar epithelial growth and mitosis was supported by 10% topical trehalose. As for RCT outcomes, salivary pH and unstimulated salivary flow rate were significantly improved after use of 10% trehalose spray when compared to CMC (p < 0.05). Participants reported an improvement of XeQoLs dimension scores after using trehalose or CMC oral sprays in terms of physical, pain/discomfort, and psychological dimensions (p < 0.05), but not social (p > 0.05). When comparing between CMC and trehalose sprays, XeQoLs total scores were not statistically different (p > 0.05). CONCLUSIONS The 10% trehalose spray improved salivary pH, unstimulated salivary flow rate, and the quality-of-life dimensions linked with physical, pain/discomfort, and psychological signs. The clinical efficacy of 10% trehalose spray was equivalent with CMC-based saliva substitutes for relieving radiation-induced xerostomia; therefore, trehalose may be suggested in alternative to CMC-based oral spray.(Thai Clinical Trials Registry; https://www.thaiclinicaltrials.org/ TCTR20190817004).
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Affiliation(s)
- Pornpan Piboonratanakit
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Research Unit in Oral Diseases, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Joao N Ferreira
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Department of Research Affairs, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Kulpriya Pravinvongvuthi
- Geriatric and Special Patients (International) Program, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
| | - Khwanchanok Maison
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Department of Research Affairs, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Preclinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Bangkok, Thailand
| | - Ganokon Urkasemsin
- Department of Preclinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Bangkok, Thailand
| | - Thirayu Boonroung
- Dental Department, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Anussara Prayongrat
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chawalit Lertbutsayanukul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jeerus Sucharitakul
- Department of Biochemistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Anjalee Vacharaksa
- Geriatric and Special Patients (International) Program, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand.
- Department of Microbiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
- Excellent Center on Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Rai AV, Naik BD. The effect of saliva substitute on the color stability of three different nanocomposite restorative materials after 1 month: An in vitro study. J Conserv Dent 2021; 24:50-56. [PMID: 34475680 PMCID: PMC8378500 DOI: 10.4103/jcd.jcd_444_20] [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: 08/31/2020] [Revised: 10/21/2020] [Accepted: 01/29/2021] [Indexed: 11/19/2022] Open
Abstract
Context (Background): The color stability of an esthetic material like composite resin may be hampered, due to the constant presence of oral microflora, saliva, and the frequent intake of food. However, as the oral cavity has a dynamic environment, the color stability of these restorative materials has been a challenge to dentistry. Aim: The aim of this study was to evaluate the effect of a saliva substitute (SS) on the color stability of three different nanocomposite restorative materials. Materials and Methods: A total of 66 disc-shaped samples of test materials were prepared using a polycarbonate mold measuring 15 mm diameter and 2 mm height and were randomly assigned to three groups of 22 samples each based on the test material used: Group I – Estelite Sigma Quick, Group II – Solare sculpt, and Group III – Beautifil II LS. They were further divided into two subgroups A and B with 11 samples each based on the immersion solutions, namely distilled water (DW) and saliva substitute (SS), respectively. The samples were immersed for 30 days. Baseline and post immersion color analysis were done with a spectrophotometer. The CIE L*a*b* values were measured and CIE ΔE values obtained were tabulated. Data were analyzed using the two-way-ANOVA test and Tukey's multiple post hoc test. Results: The mean color difference (ΔE) among the three different nanocomposite restorative materials ranged from 4.0 ± 0.26 to 10.62 ± 1.92. Group I showed the lowest color change (7.80 ± 0.55 and 4.00 ± 0.26), followed by Group III (8.59 ± 0.29 and 6.24 ± 0.66) and Group II (10.62 ± 1.92 and 6.85 ± 0.46) when immersed in SS and DW, respectively. Conclusion: All the specimens when immersed in SS showed greater discoloration than compared to the specimens immersed in DW. Group I showed greater resistance to color change compared to other groups.
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Affiliation(s)
- Amulya Vittal Rai
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, A Constituent College of Sri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
| | - Balaram Damodar Naik
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, A Constituent College of Sri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
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Lam OLT, Bandara HMHN, Samaranayake LP, McGrath C, Li LSW. Oral health promotion interventions on oral yeast in hospitalised and medically compromised patients: a systematic review. Mycoses 2011; 55:123-42. [PMID: 21749481 DOI: 10.1111/j.1439-0507.2011.02062.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Yeast are major aetiological agents of localised oral mucosal lesions, and are also leading causes of nosocomial bloodstream infections. The purpose of this systematic review was to examine the effectiveness of oral health promotion interventions on the prevalence and incidence of these opportunistic oral pathogens in hospitalised and medically compromised patients. The PubMed, ISI Web of Science and Cochrane Library databases were searched for clinical trials assessing the effect of oral health promotion interventions on oral yeast. Chlorhexidine delivered in a variety of oral hygiene products appeared to have some effect on oral yeast, although some studies found equivocal effects. Although a wide array of other compounds have also been investigated, their clinical effectiveness remains to be substantiated. Likewise, the utility of mechanical oral hygiene interventions and other oral health promotion measures such as topical application of salivary substitute, remains unsettled. Although many chemical agents contained in oral hygiene products have proven in vitro activity against oral yeast, their clinical effectiveness and potential role as adjuncts or alternative therapies to conventional treatment remains to be confirmed by further high-quality randomised controlled trials. This is pertinent, given the recent emergence of yeast resistance to conventional antifungal agents.
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Affiliation(s)
- Otto L T Lam
- Oral Rehabilitation, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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A comparison of salivary substitutes versus a natural sialogogue (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. ACTA ACUST UNITED AC 2011; 112:e15-20. [DOI: 10.1016/j.tripleo.2011.01.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Revised: 01/22/2011] [Accepted: 01/27/2011] [Indexed: 11/18/2022]
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Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 2011; 39:430-7. [DOI: 10.1016/j.jdent.2011.03.008] [Citation(s) in RCA: 229] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 03/14/2011] [Accepted: 03/30/2011] [Indexed: 11/16/2022] Open
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Hahnel S, Behr M, Handel G, Bürgers R. Saliva substitutes for the treatment of radiation-induced xerostomia--a review. Support Care Cancer 2009; 17:1331-43. [PMID: 19495809 DOI: 10.1007/s00520-009-0671-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Accepted: 05/21/2009] [Indexed: 11/28/2022]
Abstract
GOAL The aim of this review is to summarize the in vitro and in vivo evidence on the performance of contemporary saliva substitutes in the treatment of xerostomia and hyposalivation caused by radiation therapy for head and neck malignancies. METHODS A literature search was conducted during July to September 2008 in PubMed, using the query terms "saliva substitute", "saliva substitute and xerostomia", "artificial saliva", and "artificial saliva and xerostomia"; for clinical studies, only studies in patients suffering from radiation-induced xerostomia have been included in the review. RESULTS AND CONCLUSION Fifty-two studies met the inclusion criteria and were allotted either to the in vitro topics "viscosity", "lubrication", "wetting properties", "antimicrobial effects", and "enamel and dentin de- and remineralization", or to the in vivo topics "clinical acceptance" or "influence on plaque formation and oral mucosa and microflora". The findings suggest that there are significant differences in the performance of various saliva substitutes concerning the review parameters, yet indicate that further in vitro and in vivo studies on the properties of saliva substitutes are necessary.
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Affiliation(s)
- Sebastian Hahnel
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany.
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Tschoppe P, Meyer-Lueckel H, Kielbassa A. Effect of carboxymethylcellulose-based saliva substitutes on predemineralised dentin evaluated by microradiography. Arch Oral Biol 2008; 53:250-6. [DOI: 10.1016/j.archoralbio.2007.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Revised: 10/04/2007] [Accepted: 10/09/2007] [Indexed: 11/26/2022]
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Meyer-Lueckel H, Chatzidakis AJ, Kielbassa AM. Effect of various calcium/phosphates ratios of carboxymethylcellulose-based saliva substitutes on mineral loss of bovine enamel in vitro. J Dent 2007; 35:851-7. [PMID: 17913327 DOI: 10.1016/j.jdent.2007.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 08/13/2007] [Accepted: 08/13/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The present study evaluated the effects of various calcium and phosphate concentrations and ratios of carboxymethylcellulose (CMC)-based solutions on the mineral loss of predemineralised bovine enamel in vitro. METHODS Bovine enamel specimens were prepared, polished and partly covered with nail varnish, thus serving as control of sound enamel. After demineralisation (37 degrees C; pH 5.0; 14 days) the specimens were exposed to CMC-based solutions (20g/l) with various saturations with respect to apatites containing 0.1mM NaF, CaCl2 (0-32 mM) and KH2PO4 (0-52 mM) at two different pH values (5.5 or 6.5). A fluoride-free solution served as control, and four commercially available products were tested as well. The differences in mineral loss (DeltaDeltaZ) between the values prior to (DeltaZ Demin) and after storage (DeltaZ Effect) in the various solutions were evaluated from microradiographs of thin sections (100microm). RESULTS The general linear model revealed a significant dependency for DeltaDeltaZ on 'calcium' (p<0.001), 'phosphate' (p=0.023), 'fluoride' (p=0.002) and 'pH' (p<0.001). With increasing calcium and phosphate concentrations an increase in DeltaDeltaZ could be observed up to the solution containing the third highest saturation with respect to octacalciumphosphate (3.2), showing a significant remineralisation (p<0.05; t-test). The commercially available products as well as the control groups revealed significantly reduced DeltaDeltaZ values compared to this group (p<0.01; Bonferroni). CONCLUSIONS A saturation with respect to octacalciumphosphate of 3.2 and a pH of 6.5 enables CMC-based solutions to remineralise bovine enamel in vitro.
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Affiliation(s)
- Hendrik Meyer-Lueckel
- Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Germany
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