Nitric Oxide Concentration and Other Salivary Changes after Insertion of New Complete Dentures in Edentulous Subjects

Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment

BACKGROUND

Taking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective.

METHODS

This was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month).

RESULTS

In the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166).

CONCLUSIONS

The results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD. Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.

Evaluation of Psychological Stress Marker in Partially Edentulous Indian Adults Restored with Fixed Dental Prosthesis - A Prospective Cohort Study

Background

Clinical studies have established mastication as a stress relaxation behavior in humans. Absence of teeth compromises mastication, increasing psychologic stress in individuals depicted by many physiologic changes in body. Quantitative level of psychologic stress bio-markers serve as indicators of underlying physical ailment. Lesser literatures are available in determining the role of alpha amylase stress bio marker in partially edentulous clinical situations.

Aim

The purpose of this clinical study was to evaluate the levels of salivary alpha-amylase (sAA) stress biomarker in partially edentulous subjects before and after restoration with fixed dental prosthesis.

Material and Methods

Forty partially edentulous patients with missing mandibular first molar were selected for this study. Two questionnaires, state trait anxiety inventory (STAI) and perceived stress scale (PSS) was used to evaluate stress and anxiety levels of participants. The recruited participants were treated with metal ceramic fixed dental prosthesis (FDP). A visual analog scale (VAS) was used to determine the patient satisfaction .Unstimulated salivary samples were collected preoperative, 3rd and 6th month post FDP placement. Level of sAA was estimated. Data obtained in the form of mean ± SD was subjected to statistical analysis using paired sample t-test (α=.05).

Results

The salivary alpha amylase level was highest with mean of 36.73 μM/min/mg ptn before restoration with FDP. In the third month after prosthesis placement, the enzyme values decreased to16.62 μM/min/mg ptn and least value of 8.58 μM/min/mg ptn was detected in sixth month (P < 0.05).

Conclusion

The salivary alpha amylase stress biomarker decreased after tooth replacement with FDP.

Effectiveness of a simplified method for final impression in complete denture treatment: A pragmatic clinical trial

PURPOSE

This study aimed to compare two methods for final impression during the fabrication of complete dentures: a traditional method using custom trays (T-group) and a simplified method using the trial denture baseplate (S-group).

METHODS

A pragmatic clinical trial was conducted among edentulous individuals referred for conventional denture treatment. A consecutive sample of edentulous patients was assigned to two groups by cluster randomisation according to the final impression strategy, 30 in the T-group and 38 in the S-group. In the T-group, an auto-polymerising acrylic resin custom tray was used for impression; in the S-group, the final impression was performed using the try-in dentures. For both groups, zinc oxide eugenol paste was used as the impression material. The quality of the dentures was assessed using two rating scales (Functional Assessment of the Dentures and Kapur method). Moreover, clinical time for denture fabrication, number of post-insertion appointments for adjustments, patient satisfaction and post-treatment oral health-related quality of life impacts were also assessed.

RESULTS

There were no significant differences between groups regarding prosthodontic and patient-reported outcomes. The S-group demanded less clinical time (P = 0.002), with a 23.3% mean reduction in clinical time (P = 0.002) and lower number of appointments until the delivery of the dentures (S-group = 4.18 vs T-group = 5.0; P = 0.001).

CONCLUSIONS

This study showed that the alternative method for final impression is less time-consuming and has similar clinical outcomes when compared to the traditional final impression method. Findings suggest that this alternative may be considered when efficiency is a critical issue in healthcare services.

Comparison of Oxidative Effects of Two Different Administration Form of Oxybutynin in the Potential Target Tissues

Oxybutynin is an important anticholinergic agent that prevents uncontrolled contractions in the treatment of overactive bladder (OAB). However, drugs containing oxybutynin have significant side effects such as dry eyes, dry mouth, increased heart rate, constipation, blurred vision, and confusion. In recent years, new delivery methods for this agent are being searched. One of them is vaginal delivery. In this study, we aimed to compare the effects of oxybutynin on oxidative parameters in the potential target tissues of the oral and vaginal delivery. Female New Zealand white rabbits (n=12) were divided into two groups: oral delivery and vaginal delivery. The animals were sacrificed 48 h after administration and nitric oxide (NOx), thiobarbituric acid-reactive substances (TBARs), and glutathione (GSH) levels were determined spectrophotometrically in the aorta, salivary gland, and small intestine tissue samples. Vaginal delivery significantly decreased NOx levels in all tissue samples as compared to oral delivery (p < 0.05). Moreover, it reduced TBARs levels in salivary gland and aorta tissue samples (p < 0.05). In the light on these findings, it can be said that vaginal delivery may decrease the oxidant-induced side effects of oxybutynin as compared to oral delivery.