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Sánchez Garrido I, Ramírez L, Muñoz Corcuera M, Garrido E, Sánchez L, Martínez Acitores ML, Hernández G, López-Pintor RM. Xerostomia and Salivary Dysfunction in Patients With Diabetes Mellitus. A Cross-Sectional Study. J Oral Pathol Med 2024. [PMID: 39343735 DOI: 10.1111/jop.13583] [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: 03/11/2024] [Revised: 09/06/2024] [Accepted: 09/16/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Diabetes mellitus (DM) has been associated with salivary disorders such as xerostomia and hyposalivation. The aim of this study was to determine the prevalence of these disorders and their risk factors in DM patients. METHODS DM patients from two health centers were included. Epidemiological and DM control-related variables were collected. Xerostomia Inventory was filled out by the patients and unstimulated whole salivary flow was collected. Logistic regression tests were performed. RESULTS A total of 168 patients were included (46.4% men, 53.6% women, mean age 72.54 [SD 11.03 years]). Thirteen patients had Type 1 DM and 155 had Type 2 DM. 52.4% experienced xerostomia and 41.1% had unstimulated whole salivary flow hyposalivation. Women were more likely to suffer hyposalivation than men (OR 2.5, 95% CI 1.32-4.73; p = 0.005). Patients with T2DM were less likely to suffer UWS hyposalivation than T1DM patients (OR 0.28, 95% CI 0.08-0.95; p = 0.04). Glycemic control was not significantly worse in patients with xerostomia and hyposalivation. The drugs for the treatment of DM were not associated with salivary disorders. However, some drugs to treat other comorbidities such hypertension and neurological diseases were associated with xerostomia and hyposalivation. CONCLUSIONS The prevalence of xerostomia and unstimulated whole salivary flow hyposalivation in patients with DM is high. Female sex, T1DM, and the use of certain non-antidiabetic drugs increased the risk of suffering these disorders. The possible association between DM, xerostomia, and/or hyposalivation is complex and may be influenced by multiple factors. Therefore, further studies are needed to evaluate whether DM influences these salivary disorders.
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Affiliation(s)
- Isabel Sánchez Garrido
- ORALMED Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University, Madrid, Spain
| | - Lucía Ramírez
- ORALMED Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University, Madrid, Spain
| | - Marta Muñoz Corcuera
- Department of Clinical Dentistry, School of Biomedical Science, European University of Madrid, Madrid, Spain
| | | | - Lorenzo Sánchez
- Internal Medicine Service, University Hospital of Guadalajara, Guadalajara, Spain
| | | | - Gonzalo Hernández
- ORALMED Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University, Madrid, Spain
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Campelo RC, Benatti BB, de Sousa JAB, Nascimento GC, Azulay RSS, Faria MDS, Magalhães M, Rodrigues VP. Clinical factors associated with salivary flow rate in adults with acromegaly. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00431-0. [PMID: 39277444 DOI: 10.1016/j.oooo.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/29/2024] [Accepted: 08/11/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVE To investigate the stimulated salivary flow (SSF) and unstimulated salivary flow (USF) in adults with acromegaly and to identify possible clinical factors associated with salivary flow. STUDY DESIGN A case-control study was conducted with a group composed of adults diagnosed with acromegaly (n = 29, mean age = 50.2 years) and a control group (n = 29, mean age = 54.3 years). Variables for socio-demographic characterization, lifestyle habits, and diabetes diagnosis, body mass index (BMI), cervical circumference (CC) and abdominal circumference (AC) were collected. USF and SSF variables were analyzed as outcomes. Unpaired t-test, Pearson's correlation, and multivariate regression models were used for statistical analysis. RESULTS Both groups were 44.8% male and 55.2% female. Diabetes was present in 55.2% of the acromegaly group and in 51.7% of the controls (P = .792). The acromegaly group had a higher USF than the control group (0.50 mL/min versus 0.22 mL/min). SSF showed a direct correlation with CC (r = 0.470, P = .010). Acromegaly was associated with higher USF (standardized coefficient = 0.780, P = .039), and age was inversely related to USF (standardized coefficient = -0.333, P = .013). CONCLUSIONS The findings suggest that adults with acromegaly have an increased USF and that being older is associated with a decrease in USF.
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Affiliation(s)
- Renata C Campelo
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Bruno B Benatti
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | | | - Gilvan C Nascimento
- Research Group in Clinical and Molecular Endocrinology and Metabology, University Hospital of the Federal University of Maranhão, São Luís, Brazil; Department of Medicine, Federal University of Maranhão, São Luís, Brazil
| | - Rossana S S Azulay
- Research Group in Clinical and Molecular Endocrinology and Metabology, University Hospital of the Federal University of Maranhão, São Luís, Brazil; Department of Medicine, Federal University of Maranhão, São Luís, Brazil
| | - Manuel Dos S Faria
- Research Group in Clinical and Molecular Endocrinology and Metabology, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Marcelo Magalhães
- Research Group in Clinical and Molecular Endocrinology and Metabology, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Vandilson P Rodrigues
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil; Research Group in Clinical and Molecular Endocrinology and Metabology, University Hospital of the Federal University of Maranhão, São Luís, Brazil.
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Liu G, Qiu X, Tan X, Miao R, Tian W, Jing W. Efficacy of a 1% malic acid spray for xerostomia treatment: A systematic review and meta-analysis. Oral Dis 2023; 29:862-872. [PMID: 34954846 DOI: 10.1111/odi.14116] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/11/2021] [Accepted: 12/18/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To assess the efficacy of topical sialogogue spray containing malic acid 1% for treating xerostomia. METHODS We searched PubMed, Cochrane Library, Embase, ClinicalTrials.gov and Web of Science databases. Literature search, screening, study selection, data collection, data extraction and assessment of bias risk were independently conducted by two reviewers. The study appraisal was performed by Cochrane Collaboration's tool for assessing bias risk. The systematic review registration number was PROSPERO-CRD42021241322. All statistical analyses were performed using Review Manager version 5.4. RESULTS Five original articles involving 244 patients with xerostomia who received topical sialogogue spray (malic acid 1%) or placebo for two weeks were included in this review. Based on the questionnaire survey, the topical sialogogue spray (malic acid 1%) improved the symptoms of dry mouth significantly better than the placebo, which was reflected in the Dry Mouth Questionnaire (DMQ), Xerostomia Inventory (XI) and Visual Analogue Scale (VAS) scores. Regarding the increase in unstimulated and stimulated saliva flow rates, the intervention group was also better than the placebo group after a two-week course of treatment. CONCLUSIONS Although the included studies are limited, our results show that topical sialogogue spray (malic acid 1%) is an effective method for the treatment of xerostomia. Additional randomised controlled trials in the future are needed to provide high-quality evidence of this therapy and to improve clinical practice guidelines.
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Affiliation(s)
- Gang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoning Qiu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinzhi Tan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong Miao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Ramírez L, Sánchez I, Muñoz M, Martínez-Acitores ML, Garrido E, Hernández G, López-Pintor RM. Risk factors associated with xerostomia and reduced salivary flow in hypertensive patients. Oral Dis 2023; 29:1299-1311. [PMID: 34839577 DOI: 10.1111/odi.14090] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the risk factors associated with xerostomia and hyposalivation in a group of hypertensive patients. SUBJECTS AND METHODS A cross-sectional study was conducted. Hypertensive patients belonged to two healthcare centers were included. Xerostomia was assessed by asking a question and using the Xerostomia Inventory. Unstimulated salivary flow was collected. Different epidemiological variables were analyzed such as age, sex, habits, diseases, drugs, and blood pressure. RESULTS 221 individuals were included. Xerostomia was reported in 51.13% of patients. Patients with xerostomia suffered more from osteoarthritis and diaphragmatic hernia. These patients took more anticoagulants (acenocoumarol), antiarrhythmics (amiodarone), analgesics (paracetamol) and epilepsy drugs (pregabalin) and less platelet aggregation inhibitors and angiotensin II receptor blockers (losartan). Unstimulated flow was reduced in 37.56% of patients. Patients suffering hyposalivation presented more diseases such as anxiety, infectious or parasitic diseases, hepatitis C, diaphragmatic hernia, and osteoarthritis. These patients took more repaglinide, thiazides, anti-inflammatories, anti-rheumatics, glucosamine, diazepam, and selective beta-2-adrenoreceptor agonists and less combinations of candesartan and diuretics. CONCLUSIONS Xerostomia and hyposalivation are frequent in hypertensive patients. It is advisable to take into consideration the comorbidities and the drugs they receive, since they can increase the risk of these salivary disorders.
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Affiliation(s)
- Lucía Ramírez
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Isabel Sánchez
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Marta Muñoz
- Department of Clinical Dentistry, School of Biomedical Science, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | | | - Gonzalo Hernández
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Sangalli L, Eldomiaty W, Miller CS. Xerogenic medications may contribute to decreased unstimulated salivary flow in patients with oral burning and/or gastro-esophageal reflux disease. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2023.1047235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BackgroundPatients who complain of mucosal burning sensations (i.e., glossodynia and gastro-esophageal reflux disease, GERD) often take multiple medications. However, the relationship between xerogenic medication intake and salivary flow in these patients has not been thoroughly examined.MethodsA retrospective study of 192 consecutive patients diagnosed with glossodynia (ICD-10-CM) at a regional center over a six-year period was performed. Data from electronic health records were extracted and relationships between medication intake, unstimulated whole salivary flow rate (UWSFR), xerostomia and GERD were determined by chi-square, t-test, and correlation analysis.ResultsOf 134 records that met inclusion criteria, 87.1% of patients reported daily intake of one or more xerogenic medications. Two or more xerogenic medications were taken significantly more often by patients with glossodynia reporting GERD than those with glossodynia without GERD (p = .02). UWSFR was negatively correlated with number of medications [r(103) = −.277, p = .005] and xerogenic medications [r(103) = −.195, p = .049]. The lowest UWSFR was observed with use of trazodone and cyclobenzaprine.ConclusionsDaily xerogenic medication intake, hyposalivation, and xerostomia were commonly present and potentially interrelated in patients who suffer from glossodynia and/or GERD.Practical implicationsClinicians should be aware of the consequences of prescribing multiple and certain xerogenic medications in reducing UWSFR, especially in patients physiologically at risk of hyposalivation such as those suffering from GERD and/or glossodynia.
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Evaluation of Salivary Mucin, Amylase, Protein Profile, and Periodontal Parameters among Hypertensive and Diabetic Patients. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic and localized oral disease instigates alterations in salivary composition and content. The objective of the study was to evaluate the levels of salivary amylase, mucin, total protein levels, and periodontal inflammatory parameters in Type 2 Diabetes mellitus (T2DM), hypertensive (HTN) patients, and healthy controls. The study sample was divided into three groups: healthy, T2DM, and HTN. Salivary samples were collected from the included participants and salivary flow rate (SFR) and pH were measured. The salivary levels of amylase, mucin, and total protein concentration were analyzed using an enzyme-linked immunosorbent assay. The effect of anti-hypertensive and hypoglycemic drugs on the salivary flow rate, salivary pH, mucin, amylase, and total protein concentrations was evaluated. The results were analyzed with Chi-squared and analysis of variance to compare the means and standard deviations of variables among the study groups. SFR was significantly (p < 0.01) lower among diabetics (0.78 ± 0.45 mL/min) in comparison to healthy (1.52 ± 0.62 mL/min) and hypertensive (1.07 ± 0.7 mL/min) subjects. PISA values were significantly higher in T2DM (1029 ± 234.6 mm2) and HTN (799.4 ± 155.05 mm2) subjects when compared to controls, indicating a high inflammatory burden of oral cavity caused by these conditions, and showed statistically significant difference between the groups (p-value < 0.001). Mucin levels were significantly higher (p-value < 0.05) in hypertensive patients (4.6 ± 1.17 units) compared to diabetics (3.59 ± 1.03 unit/mL) and healthy (2.26 ± 1.09 units/mL) subjects. Amylase levels were significantly higher among healthy subjects (1.76 ± 0.75 mg/mL) compared to both hypertensive (1.33 ± 1.0 mg/mL) and diabetic (0.88 ± 0.57 mg/mL) patients. Total protein concentration was significantly raised (p-value < 0.001) in diabetics (37.67 ± 3.12 mg/mL) compared to healthy (29.3 ± 3.22 mg/mL) subjects. Significant differences in BOP, CAL, and PPD was observed (p-value < 0.001). Use of antihypertensive and hypoglycemic drugs showed a significant influence on salivary flow rate, protein, mucin, and amylase levels. T2DM and HTN induced irregularities in salivary flow rate, pH, amylase, and mucin levels and showed an increased incidence of moderate to severe periodontitis in patients. UWS levels of SFR, mucin, amylase, and total protein can be used as diagnostic and therapeutic biomarkers in patients with T2DM and HTN with oral disease.
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Marques RCR, da Silva JR, Vieira Lima CP, Stefani CM, Damé-Teixeira N. Salivary parameters of adults with diabetes mellitus: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:176-189. [PMID: 35725961 DOI: 10.1016/j.oooo.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Among the oral manifestations of diabetes mellitus (DM), salivary alterations stand out when considering that they can be linked to environmental changes that prompt other oral diseases. This study aimed to compare whether salivary parameters such as salivary flow, ionic composition, pH, and buffer capacity are altered in adults with DM. STUDY DESIGN A literature search was performed in 8 databases and the gray literature. Observational and clinical studies with populations >30 years old were included. The methodological quality of individual studies was assessed, 7 meta-analyses were performed, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach (protocol registered at PROSPERO-CRD42021214632). RESULTS Of the 5,816 titles retrieved, 22 observational studies were included, representing a total of 1,202 individuals with DM and 946 normoglycemic control subjects. Individuals with DM had significantly lower unstimulated (mean difference [Md] = 0.13 mL/min; CI = 0.06-0.2; P = .0005) and stimulated (Md = 0.44 mL/min; CI = 0.13-0.75; P = .005) salivary flow rates, a lower pH when evaluated with electrodes (Md = 0.45; CI = 0.19-0.71; P = .0007), and a higher salivary urea (standard Md = 1.52; CI = 0.19-2.85; P = .03). No significant differences were found in the other parameters. CONCLUSIONS Although the certainty of evidence was low because of the type of studies included, this review indicated salivary alterations in individuals with DM, such as hyposalivation, pH, and urea concentration.
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Affiliation(s)
| | | | | | - Cristine Miron Stefani
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Naile Damé-Teixeira
- Department of Dentistry, School of Health Sciences, University of Brasilia, Brasilia, Brazil.
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Piperi E, Georgaki M, Andreou A, Pettas E, Tziveleka S, Nikitakis NG. Cheilitis Glandularis: A clinicopathologic study with emphasis on etiopathogenesis. Oral Dis 2022; 29:1579-1587. [PMID: 35113467 DOI: 10.1111/odi.14144] [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: 11/23/2021] [Revised: 01/06/2022] [Accepted: 01/25/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Cheilitis Glandularis (CG) is an uncommon entity of obscure etiology. A cases series is presented with emphasis on etiopathogenesis. MATERIALS AND METHODS Fourteen CG cases were analyzed according to their demographic and clinicopathologic characteristics. RESULTS The mean age of the patients with CG was 68.1 years, while a male-to-female ratio of 1.8:1 was observed. One or more potential causative factors were identified for each patient, including long-term smoking (9 cases), xerostomia (4 cases), cosmetic filler injections (2 cases), and actinic cheilitis (1 case). The lesions were located on the lips, buccal mucosa, or both in 7, 2, and 5 cases, respectively. Multiple submucosal nodules with dilated ductal orifices and mucous or purulent discharge were observed in all cases. Histopathologically, ductal ectasia with metaplasia, intraductal mucin, and chronic or mixed inflammation were noted, as well as pools of hyaluronic acid in 2 cases with a history of cosmetic filler injections. CONCLUSIONS CG etiopathogenesis is probably multifactorial. Reduced salivary flow rate and increased viscosity of saliva, potentially caused by long-term smoking, diabetes mellitus, and drug-induced xerostomia, may participate in the initial pathogenesis, while local irritants, for example, poor oral hygiene and local trauma, may further contribute to the development and aggravation of the condition.
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Affiliation(s)
- Evangelia Piperi
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Maria Georgaki
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Anastasia Andreou
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Efstathios Pettas
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Styliani Tziveleka
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Nikolaos G Nikitakis
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
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Wang X, Martinez PS, Terpstra JH, Shaalan A, Proctor GB, Spijkervet FKL, Vissink A, Bootsma H, Kroese FGM, Coppes RP, Pringle S. β-Adrenergic signaling induces Notch-mediated salivary gland progenitor cell control. Stem Cell Reports 2021; 16:2813-2824. [PMID: 34678204 PMCID: PMC8581054 DOI: 10.1016/j.stemcr.2021.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/06/2022] Open
Abstract
β-Adrenergic signaling blockade is a mainstay of hypertension management. One percent of patients taking β-blockers develop reduced salivary gland (SG) function. Here we investigate the role of SG progenitor cells in β-blocker-induced hyposalivation, using human SG organoid cultures (SGOs). Compared with control SGs, initial low SG progenitor cell yield from patients taking β-blockers was observed. When passaged, these SGOs recovered self-renewal and upregulated Notch pathway expression. Notch signaling was downregulated in situ in β-adrenergic receptor-expressing luminal intercalated duct (ID) cells of patients taking β-blockers. Control SGOs treated with β-adrenergic agonist isoproterenol demonstrated increased proportion of luminal ID SGO cells with active Notch signaling. Control SGOs exposed to isoproterenol differentiated into more mature SGOs (mSGOs) expressing markers of acinar cells. We propose that β-blocker-induced Notch signaling reduction in luminal ID cells hampers their ability to proliferate and differentiate into acinar cells, inducing a persistent hyposalivation in some patients taking β-blocking medication. SG organoids from patients taking β-adrenergic blockers show low yield Notch signaling in parotid SG luminal ID cells decreases with β-blocker use β-Adrenergic stimulation induces proliferation of parotid SG luminal ID cells β-Adrenergic-induced Notch activity stimulates SGO differentiation into mSGOs
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Affiliation(s)
- X Wang
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - P Serrano Martinez
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J H Terpstra
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A Shaalan
- Centre for Host and Microbiome Interactions, King's College London, London, UK
| | - G B Proctor
- Centre for Host and Microbiome Interactions, King's College London, London, UK
| | - F K L Spijkervet
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H Bootsma
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F G M Kroese
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R P Coppes
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S Pringle
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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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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12
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Oz FD, Meral E, Ergİn E, Gurgan S. One-year evaluation of a new restorative glass ionomer cement for the restoration of non-carious cervical lesions in patients with systemic diseases: a randomized, clinical trial. J Appl Oral Sci 2020; 28:e20200311. [PMID: 33111883 PMCID: PMC9648967 DOI: 10.1590/1678-7757-2020-0311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/11/2020] [Accepted: 07/02/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This randomized and clinical trial aimed to evaluate the performance of a new restorative Glass Ionomer Cement (GIC) for the restoration of non-carious cervical lesions (NCCLs) of patients with systemic diseases compared with a posterior resin composite after 12 months. METHODOLOGY 134 restorations were placed at 30 patients presenting systemic diseases by a single clinician. NCCLs were allocated to two groups according to restorative system used: a conventional restorative GIC [Fuji Bulk (GC, Tokyo Japan) (FB)] and a posterior resin composite [G-ænial Posterior (GC, Tokyo Japan) (GP)] used with a universal adhesive using etch&rinse mode. All restorative procedures were conducted according to manufacturer's instructions. Restorations were scored regarding retention, marginal discoloration, marginal adaptation, secondary caries, surface texture, and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after 1 week (baseline), 6, and 12 months. Descriptive statistics were performed using chi-square tests. Cochran Q and Mc Nemar's tests were used to detect differences over time. RESULTS After 12 months, recall rate was 93% and the rates of cumulative retention failure for FB and GP were 4.9% and 1.6% respectively. Both groups presented similar alpha rates for marginal adaptation (FB 86.2%, GP 95.5%) and marginal discoloration (FB 93.8%, GP 97%) at 6-month recall, but FB restorations showed higher bravo scores than GP restorations for marginal adaptation and marginal discoloration after 12 months (p<0.05). Regarding surface texture, 2 FB restorations (3.1%) were scored as bravo after 6 months. All restorations were scored as alpha for secondary caries and postoperative sensitivity after 12 months. CONCLUSION Although the posterior resin composite demonstrated clinically higher alpha scores than the conventional GIC for marginal adaptation and discoloration, both materials successfully restored NCCLs at patients with systematic disease after a year. CLINICAL RELEVANCE Due to its acceptable clinical results, the tested conventional restorative GIC can be used for the restoration of NCCLs of patients with systemic diseases.
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Affiliation(s)
- Fatma Dilsad Oz
- Hacettepe University , School of Dentistry , Department of Restorative Dentistry , Sihhiye , Ankara , Turkey
| | - Ece Meral
- Hacettepe University , School of Dentistry , Department of Restorative Dentistry , Sihhiye , Ankara , Turkey
| | - Esra Ergİn
- Hacettepe University , School of Dentistry , Department of Restorative Dentistry , Sihhiye , Ankara , Turkey
| | - Sevil Gurgan
- Hacettepe University , School of Dentistry , Department of Restorative Dentistry , Sihhiye , Ankara , Turkey
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Mizuhashi F, Morita T, Toya S, Sato R, Watarai Y, Koide K. Protein Ingredient in Saliva on Oral Dryness Patients Caused by Calcium Blocker. Geriatrics (Basel) 2020; 5:geriatrics5040070. [PMID: 33036340 PMCID: PMC7709676 DOI: 10.3390/geriatrics5040070] [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: 08/25/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 12/02/2022] Open
Abstract
Oral dryness as a side effect of certain drugs is increasing. The aim of this study was to examine the change of the protein ingredient in saliva of oral dryness patients caused by calcium blocker. Six patients taking calcium blocker and six healthy elderly were enrolled. Unstimulated salivary flow rate, protein concentration, and flow rate of protein were measured and compared between the patients taking calcium blocker and healthy elderly. iTRAQ (Isobaric Tag for Relative and Absolute Quantitation) proteomic analysis was performed to extract the salivary protein changed in patient taking calcium blocker, and the intensities of Western blotting products were quantified (unpaired t-test). Unstimulated salivary flow rate was significantly lower on patients taking calcium blocker (p < 0.01). Protein concentration tended to be higher and the flow rate of protein tended to be lower on patients. As the result of iTRAQ proteomic analysis, calmodulin-like protein 3, glutathione S-transferase P, and keratin type I cytoskeletal 13 increased characteristically in patient taking calcium blocker, and the expression in calmodulin-like protein 3 was significantly larger (p < 0.01). The results of this study indicated that calmodulin-like protein 3 increased in patients taking calcium blocker and could be a salivary biomarker for oral dryness caused by calcium blocker.
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Affiliation(s)
- Fumi Mizuhashi
- Department of Removable Prosthodontics, the Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan; (Y.W.); (K.K.)
- Correspondence: ; Tel.: +81-25-267-1500
| | - Takao Morita
- Department of Biochemistry, the Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan; (T.M.); (R.S.)
| | - Shuji Toya
- Dry Mouth Clinic, Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, Niigata 951-8580, Japan;
| | - Ritsuko Sato
- Department of Biochemistry, the Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan; (T.M.); (R.S.)
| | - Yuko Watarai
- Department of Removable Prosthodontics, the Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan; (Y.W.); (K.K.)
| | - Kaoru Koide
- Department of Removable Prosthodontics, the Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan; (Y.W.); (K.K.)
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Ramírez Martínez-Acitores L, Hernández Ruiz de Azcárate F, Casañas E, Serrano J, Hernández G, López-Pintor RM. Xerostomia and Aalivary Flow in Patients Taking Antihypertensive Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2478. [PMID: 32260482 PMCID: PMC7177425 DOI: 10.3390/ijerph17072478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 02/05/2023]
Abstract
The aims of this systematic review are (1) to compare the prevalence of xerostomia and hyposalivation between patients taking antihypertensive drugs with a control group (CG), (2) to compare salivary flow rate between patients treated with a CG, and (3) to identify which antihypertensives produce xerostomia. This systematic review was carried out according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. To evaluate methodological quality of the eligible studies Cochrane Collaboration tool for assessing the risk of bias for clinical trials and the modified Newcastle-Ottawa scale case-control studies were used. The databases were searched for studies up to November 19th 2019. The search strategy yielded 6201 results and 13 publications were finally included (five clinical trials and eight case-control studies). The results of the included studies did not provide evidence to state that patients taking antihypertensives suffer more xerostomia or hyposalivation than patients not taking them. With regard to salivary flow, only two clinical studies showed a significant decrease in salivary flow and even one showed a significant increase after treatment. The case-control studies showed great variability in salivary flow, but in this case most studies showed how salivary flow is lower in patients medicated with antihypertensive drugs. The great variability of antihypertensive drugs included, the types of studies and the outcomes collected made it impossible to study which antihypertensive drug produces more salivary alterations. The quality assessment showed how each of the studies was of low methodological quality. Therefore, future studies about this topic are necessary to confirm whether antihypertensive drugs produce salivary alterations.
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Affiliation(s)
| | | | | | | | | | - Rosa María López-Pintor
- Department of Dental Clinical Specialities. ORALMED Research Group. School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain; (L.R.M.-A.); (F.H.R.d.A.); (E.C.); (J.S.); (G.H.)
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Varellis MLZ, Gonçalves MLL, Pavesi VCS, Horliana ACRT, de Fátima Teixeira da Silva D, Motta LJ, Barbosa Filho VF, Bezerra CDS, da Silva FG, Bussadori SK, Deana AM. Evaluation of photobiomodulation in salivary production of patients with xerostomy induced by anti-hypertensive drugs: Study protocol clinical trial (SPIRIT compliant). Medicine (Baltimore) 2020; 99:e19583. [PMID: 32311925 PMCID: PMC7220222 DOI: 10.1097/md.0000000000019583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Hypertension (systemic arterial hypertension [SAH]) is a systemic condition that affects about 30% of the world population, according to data from the World Health Organization (WHO). Drugs used to control this disease have the potential to induce xerostomia, an oral condition in which the decrease of the salivary flow is observed and whose presence leads to the increase of the index of caries, periodontal disease, loss of the teeth, dysgeusia, difficulty of mastication, dysphagia, bad breath and oral burning and impairment of prothesis installed in the buccal cavity, including retention of removable and total dentures. METHODS This is a randomized, placebo-controlled, blind clinical protocol that aims to analyze the impact of phobiomodulation (PBM) on salivary glands of patients with antihypertensive drug induced xerostomia. Patients will be divided into 2 groups: G1: older adults with xerostomia induced by antihypertensive drugs and treatment with PBM (n = 30); G2: placebo PBM (n = 30). The irradiation will be made using a diode laser emitting at 808 nm with 100 mW and 40 seconds of exposure per site at the salivary glands. Twenty sites will be irradiated weekly for 4 weeks. Non-stimulated and stimulated salivary flow will be analyzed before and after the treatment. RESULTS This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. CONCLUSION This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs. TRIAL REGISTRATION Clinicaltrials.gov - NCT03632096.
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Bernardi L, Souza BCD, Sonda NC, Visioli F, Rados PV, Lamers ML. Effects of Diabetes and Hypertension on Oral Mucosa and TGFβ1 Salivary Levels. Braz Dent J 2018; 29:309-315. [PMID: 29972459 DOI: 10.1590/0103-644020181868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/27/2018] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate salivary levels of TGFβ1 and proliferation/ maturation of epithelial mucosa cells in diabetic and hypertensive patients. DESIGN in this cross-sectional study, whole stimulated saliva and oral mucosa exfoliative cytology specimens were collected from 39 patients that were healthy (control, n=10) or presented history of arterial hypertension (HAS, n=9), diabetes mellitus (DM, n=10) or both (DM+HAS, n=10). Salivary flow rate (SFR), TGFβ1 level in saliva, AgNORs and the epithelial maturation were evaluated. Non-parametric Kruskal-Wallis test, followed by Dunn's multiple comparison post-test and the Spearman test correlation analysis were used. SFR showed a significant decreased in DM and DM+HAS (0.47±0.11 and 0.64±0.43 mL/min) when compared to control (1.4±0.38 mL/min). DM+HAS presented the highest value of TGFβ1 concentration (24.72±5.89 pg/mL). It was observed a positive correlation between TGFβ1 and glycaemia (R=0.6371; p<0.001) and a negative correlation between TGFβ1 and saliva (R=-0.6162; p<0.001) and glycaemia and SFR (R=-0.5654; P=0.001). AgNORs number and status of maturation of mucosa cells were similar for all conditions. DM and DM+HAS presented the lowest SFR, which correlated with increased TGFβ1 levels. Despite the higher TGFβ1 secretion it was not observed changes in the morphology or proliferation of epithelial cells when diabetes or hypertension was present.
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Affiliation(s)
- Lisiane Bernardi
- Basic Research Center, Dentistry School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bárbara Capitanio de Souza
- Basic Research Center, Dentistry School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nicole Canalli Sonda
- Basic Research Center, Dentistry School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernanda Visioli
- Department of Oral Pathology, Dentistry School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Pantelis Varvaki Rados
- Department of Oral Pathology, Dentistry School, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Gawron-Skarbek A, Prymont-Przymińska A, Sobczak A, Guligowska A, Kostka T, Nowak D, Szatko F. A comparison of native and non-urate Total Antioxidant Capacity of fasting plasma and saliva among middle-aged and older subjects. Redox Rep 2017; 23:57-62. [PMID: 29088986 PMCID: PMC6748680 DOI: 10.1080/13510002.2017.1392714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES As plasma and salivary total antioxidant capacity (TAC) is mainly contributed by uric acid (UA), the present study measures non-urate TAC (Nu-TAC). The aim of the study was to correlate plasma native TAC, Nu-TAC and UA with their salivary analogues, and compare the UA contribution in both body fluids using two different methods. METHODS The study involved 55 middle-aged and older subjects (66.7 ± 4.5 years). TAC was determined simultaneously with two methods (ferric reducing ability of plasma - FRAP, 2.2-diphenyl-1-picryl-hydrazyl - DPPH and countertypes for saliva - FRAS and DPPHS test), with and without UA (native TAC and Nu-TAC, respectively). Plasma UA and salivary UA (SUA) were assessed. RESULTS Subjects with increased FRAP, DPPH and UA had higher FRAS, DPPHS and SUA, respectively (P < 0.05). Plasma Nu-TAC indices did not correlate with salivary Nu-TAC. The contribution of UA to the plasma and salivary DPPH tests was similar: 75.7 ± 10.3% and 75.2 ± 14.0%, respectively. However, the contribution of UA to FRAS was higher than that for FRAP (71.6 ± 13.9% vs. 64.0 ± 8.1%; P < 0.001). DISCUSSION Our findings suggest that saliva is a good predictor for native plasma TAC but not for Nu-TAC. UA level is comparably dominant in saliva and in plasma according to DPPH, but lower in plasma according to FRAP.
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Affiliation(s)
- Anna Gawron-Skarbek
- a Department of Hygiene and Health Promotion , Medical University of Lodz , Lodz , Poland
| | | | - Agnieszka Sobczak
- c Faculty of Medical Laboratory , Medical University of Lodz , Lodz , Poland
| | | | - Tomasz Kostka
- d Department of Geriatrics , Medical University of Lodz , Lodz , Poland
| | - Dariusz Nowak
- e Department of Clinical Physiology , Medical University of Lodz , Lodz , Poland
| | - Franciszek Szatko
- a Department of Hygiene and Health Promotion , Medical University of Lodz , Lodz , Poland
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Pereira LJ, Foureaux RC, Pereira CV, Alves MC, Campos CH, Rodrigues Garcia RCM, Andrade EF, Gonçalves TMSV. Oral physiology, nutrition and quality of life in diabetic patients associated or not with hypertension and beta-blockers therapy. J Oral Rehabil 2016; 43:511-8. [PMID: 27043215 DOI: 10.1111/joor.12398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/16/2022]
Abstract
The relationship between type 2 diabetes oral physiology, nutritional intake and quality of life has not been fully elucidated. We assessed the impact of type 2 diabetes - exclusive or associated with hypertension with beta-blockers treatment - on oral physiology, mastication, nutrition and quality of life. This cross-sectional study was performed with 78 complete dentate subjects (15 natural teeth and six masticatory units minimum; without removable or fixed prostheses), divided into three groups: diabetics (DM) (n = 20; 45·4 ± 9·5 years), diabetics with hypertension and receiving beta-blockers treatment (DMH) (n = 19; 41·1 ± 5·1 years) and controls (n = 39; 44·5 ± 11·7 years) matched for gender, age and socioeconomic status. Blood glucose, masticatory performance, swallowing threshold, taste, food intake, stimulated and unstimulated salivary flow, pH and buffering capacity of saliva were assessed. Glycemia was higher in DM than in controls (P < 0·01). No differences were observed between DM and controls for nutrition and quality of life. Both stimulated and unstimulated salivary flow rate were lower in DMH (P < 0·01), which also presented the lowest number of teeth and masticatory units (P < 0·0001), and reduction in the number of chewing cycles (P < 0·01). Controls showed lower Decayed Missing Filled Teeth index (DMFT) scores in comparison with DMH (P = 0·021). Masticatory performance and saliva buffering capacity were similar among groups. Exclusive type 2 diabetes did not alter oral physiology, nutrition or quality of life. However, when hypertension and beta-blockers treatment were associated with diabetes, the salivary flow rate, chewing cycles and number of teeth decreased.
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Affiliation(s)
- L J Pereira
- Department of Health Sciences, Federal University of Lavras, Lavras, Brazil
| | - R C Foureaux
- Department of Health Sciences, Federal University of Lavras, Lavras, Brazil
| | - C V Pereira
- Department of Dentistry, Lavras University Center, Lavras, Brazil
| | - M C Alves
- Department of Statistics, University of São Paulo - ESALQ, Piracicaba, Brazil
| | - C H Campos
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - R C M Rodrigues Garcia
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - E F Andrade
- Department of Veterinary Sciences, Federal University of Lavras, Lavras, Brazil
| | - T M S V Gonçalves
- Department of Odontology, Federal University of Santa Catarina, Florianópolis, Brazil
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Salivary and Urinary Total Antioxidant Capacity as Biomarkers of Oxidative Stress in Humans. PATHOLOGY RESEARCH INTERNATIONAL 2016; 2016:5480267. [PMID: 26966611 PMCID: PMC4761395 DOI: 10.1155/2016/5480267] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/10/2016] [Indexed: 12/20/2022]
Abstract
Total Antioxidant Capacity (TAC) is a biomarker often used in order to investigate oxidative stress in many pathological conditions. Saliva and urine can be collected noninvasively and represent attractive diagnostic fluids for detecting biomarkers of various pathological conditions. The reviewed case-control and intervention studies that measured salivary or urinary TAC revealed that diseases, antioxidant foods, or supplements and age, gender, and lifestyle factors influenced salivary or urinary TAC. Salivary and urinary TAC were particularly affected by oral or renal status, respectively, as well as by infection; therefore these factors must be taken into account in both case-control and intervention studies. Furthermore, some considerations on sample collection and normalization strategies could be made. In particular, unstimulated saliva could be the better approach to measure salivary TAC, whereas 24 h or spontaneous urine collection should be chosen on the basis of the study outcome and of the creatinine clearance. Finally, the uric acid-independent TAC could be the better approach to evaluate red-ox status of body, in particular after nutritional interventions and in diseases associated with hyperuricaemia.
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Herrmann G, Müller K, Behr M, Hahnel S. Xerostomie und ihr Einfluss auf die mundgesundheitsbezogene Lebensqualität. Z Gerontol Geriatr 2015; 50:145-150. [DOI: 10.1007/s00391-015-0968-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/01/2015] [Indexed: 11/27/2022]
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