A clinical study to compare between resting and stimulated whole salivary flow rate and pH before and after complete denture placement in different age groups

Influence of denture-bearing conditions on masticatory function and patient-reported outcomes measures

PURPOSE

To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers.

METHODS

Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann-Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test.

RESULTS

Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05).

CONCLUSIONS

The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.

Estimation of alpha amylase, cortisol, and pH level in saliva of patients wearing conventional and Biofunctional Prosthetic System complete dentures: A parallel randomized clinical trial

STATEMENT OF PROBLEM

Biofunctional Prosthetic System (BPS) complete dentures have been reported to maintain a harmonious relationship with the surrounding oral structures and provide improved adaptation compared with conventional complete dentures. However, an evaluation of salivary changes and its constituents between BPS and conventional dentures is lacking.

PURPOSE

The purpose of this parallel randomized clinical trial was to evaluate the alpha amylase, cortisol, and pH levels in saliva in participants provided with conventional and BPS complete dentures.

MATERIAL AND METHODS

Sixteen completely edentulous participants were recruited for providing with conventional and BPS dentures (n=8). The levels of alpha amylase, cortisol, and pH in their saliva were evaluated by using an enzyme-linked immunosorbent assay (ELISA), colorimetric, and pH meter before insertion and 1 week and 1 month after denture insertion. The data were analyzed with repeated measure ANOVA and the Student t test (α=.05).

RESULTS

The mean ±standard deviation for pH was 6.94 ±0.22 in conventional complete dentures and 7.04 ±0.12 in BPS dentures; for alpha amylase, it was 206.75 ±14.64 and 210.88 ±15.72 IU/mL; and for cortisol, it was 0.29 ±0.05 and 31 ±0.04 nmol/L before insertion and 1 week and 1 month after denture insertion. From the repeated measures ANOVA, the mean pH and salivary cortisol were not statistically different (P>.05), but salivary amylase was statistically different (P<.05). The Student t test showed no significant difference in pH (P>.05), but a statistically significant difference in alpha amylase and salivary cortisol levels was found between the 2 groups (P<.05).

CONCLUSIONS

No significant difference in salivary pH was found in completely edentulous patients provided with conventional or BPS dentures, but significant differences were found in levels of alpha amylase and salivary cortisol.

Surface hardness and wear resistance of prefabricated and CAD-CAM milled artificial teeth: A cross-over clinical study

PURPOSE

To clinically evaluate the surface roughness and wear resistance of prefabricated and CAD-CAM milled acrylic resin teeth for complete dentures.

MATERIALS AND METHODS

In a cross-over study design, 10 completely edentulous patients were randomly included in this study and given two complete dentures. The first complete denture was made using prefabricated teeth, while the second was constructed using CAD-CAM milled teeth. Following insertion (T0), 3 months (T3), and 6 months (T6), the complete dentures were scanned. Utilizing 3D surface super-imposition techniques, the vertical (2D wear), and volumetric (3D wear) material loss were measured. The hardness of the teeth was evaluated at the time of denture insertion (T0) and then after 6 months (T6) of denture insertion by digital Vickers hardness tester. Statistical analysis was done using SPSS software. Paired groups were compared by paired t-test. Also, a repeated measure test was used. The significant difference was considered if p ≤ 0.05.

RESULTS

The time of denture function was linearly correlated with the wear of the prefabricated and CAD-CAM milled denture tooth. Prefabricated acrylic teeth had significantly more vertical and volumetric wear after 3 and 6 months, compared to CAD-CAM milled denture teeth where p-values were 0.01, 0.009, 0.003, and 0.024, respectively. Additionally, CAD-CAM milled teeth displayed significantly higher hardness values than prefabricated teeth both before and after 6 months of use where p-values were 0.001. After 6 months, all studied teeth showed a decrease in their hardness.

CONCLUSIONS

In terms of wear resistance and surface hardness, CAD-CAM milled acrylic resin teeth were superior to prefabricated acrylic resin artificial teeth once the complete denture functions.

Saliva sampling method influences oral microbiome composition and taxa distribution associated with oral diseases

Saliva is a readily accessible and inexpensive biological specimen that enables investigation of the oral microbiome, which can serve as a biomarker of oral and systemic health. There are two routine approaches to collect saliva, stimulated and unstimulated; however, there is no consensus on how sampling method influences oral microbiome metrics. In this study, we analyzed paired saliva samples (unstimulated and stimulated) from 88 individuals, aged 7-18 years. Using 16S rRNA gene sequencing, we investigated the differences in bacterial microbiome composition between sample types and determined how sampling method affects the distribution of taxa associated with untreated dental caries and gingivitis. Our analyses indicated significant differences in microbiome composition between the sample types. Both sampling methods were able to detect significant differences in microbiome composition between healthy subjects and subjects with untreated caries. However, only stimulated saliva revealed a significant association between microbiome diversity and composition in individuals with diagnosed gingivitis. Furthermore, taxa previously associated with dental caries and gingivitis were preferentially enriched in individuals with each respective disease only in stimulated saliva. Our study suggests that stimulated saliva provides a more nuanced readout of microbiome composition and taxa distribution associated with untreated dental caries and gingivitis compared to unstimulated saliva.

Effects of tongue lesions and palatal coverage on oral sensory functions

STATEMENT OF PROBLEM

Oral stereognosis (OS) plays a significant role in the oral rehabilitation of patients with edentulism, as it influences their adaptation to new prostheses. Because of the essentially tactile characteristic of oral sensory perception, the tongue and palate appear to have a crucial function in OS. However, little is known about the influence of tongue lesions on OS and sensorial function. In addition, controversies remain regarding the role of the palate.

PURPOSE

The purpose of this clinical study was to evaluate whether tongue lesions and palatal coverage are disruptive to OS and gustatory function.

MATERIAL AND METHODS

Seventy participants (mean age=30.7 ±6.7 years) were divided into a tongue lesion group (experimental; n=35) and a control group (n=35). The tongue lesion group included participants with geographic, fissured, or hairy tongue. OS was evaluated with the oral stereognosis ability (OSA) test. Gustatory function was assessed with exposure to flavored solutions. After completing the above tests, the participants received a palate covering device, and then OS and gustatory function were immediately reevaluated. Data were analyzed with the Mann-Whitney and Wilcoxon tests (α=.05).

RESULTS

OSA and gustatory function scores did not differ among the tongue lesion and control groups with and without palatal coverage (all P>.05). After palatal coverage, the tongue lesion group took more time to perform the OSA test than the control group (P<.05).

CONCLUSIONS

Neither the presence of tongue lesions nor palatal coverage influenced OS or gustatory function. The OSA test response times were longer for the tongue lesion group after they had received palatal coverage.

Saliva as Blood Alternative in Therapeutic Monitoring of Teriflunomide-Development and Validation of the Novel Analytical Method

Therapeutic drug monitoring (TDM) is extremely helpful in individualizing dosage regimen of drugs with narrow therapeutic ranges. It may also be beneficial in the case of drugs characterized by serious side effects and marked interpatient pharmacokinetic variability observed with leflunomide and its biologically active metabolite, teriflunomide. One of the most popular matrices used for TDM is blood. A more readily accessible body fluid is saliva, which can be collected in a much safer way comparing to blood. This makes it especially advantageous alternative to blood during life-threatening SARS-CoV-2 pandemic. However, drug’s saliva concentration is not always a good representation of its blood concentration. The aim of this study was to verify whether saliva can be used in TDM of teriflunomide. We also developed and validated the first reliable and robust LC-MS/MS method for quantification of teriflunomide in saliva. Additionally, the effect of salivary flow and swab absorptive material from the collector device on teriflunomide concentration in saliva was evaluated. Good linear correlation was obtained between the concentration of teriflunomide in plasma and resting saliva (p < 0.000016, r = 0.88), and even better between plasma and the stimulated saliva concentrations (p < 0.000001, r = 0.95) confirming the effectiveness of this non-invasive method of teriflunomide’s TDM. The analyzed validation criteria were fulfilled. No significant influence of salivary flow (p = 0.198) or type of swab in the Salivette device on saliva’s teriflunomide concentration was detected. However, to reduce variability the use of stimulated saliva and synthetic swabs is advised.

An Updated Review of Salivary pH Effects on Polymethyl Methacrylate (PMMA)-Based Removable Dental Prostheses

Salivary pH is a neglected factor that may affect the performance of removable dental prostheses (RDP). This study aimed to review literature in reference to the role of salivary pH on the performance of RDP and materials used for their fabrication. From January 1990 until December 2021, a search was done on PubMed, Scopus, and Web of Science databases using removable dental prostheses, salivary pH, PMMA, Denture base, and physical properties as keywords. Articles that met the inclusion criteria (full-length articles have investigated the effect of salivary pH on RDP materials in vitro and in vivo) were included. Out of 433 articles, 8 articles that met the inclusion criteria were included. All studies used artificial saliva with different salivary pH ranging between 3 and 14. Two articles investigated the role of salivary pH on the cytotoxicity of denture base resins and soft liner. One article studied the durability and retention of attachments, one article analyzed the performance of PEEK materials, one article researched the fatigue resistance of a denture base, one article investigated the corrosion of RPD framework cast and milled Co–Cr, one article studied the strength and clasp retention and deformation of acetal and PEEK materials, and one evaluated changes in mass and surface morphology of CAD–CAM fiber-reinforced composites for the prosthetic framework. Different salivary pH affected all included materials in this review except PEEK materials. The most adverse effect was reported with alkaline and acidic; however, the acidic showed the most deterioration effect. Salivary pH has a role in the selection of material used for RDP fabrication.

Assessing physical and chemical properties of saliva among tuberculosis patients on anti-tuberculosis treatment - An observational study

Background

Tuberculosis (TB) is one of the major systemic conditions which is a preventable and curable infection but remains a significant cause of death. The WHO, in its global plan to stop TB reports, that poor treatment has resulted in the evolution of Mycobacterium tuberculosis strains that do not respond to treatment with the standard first-line combination of anti- tuberculosis medicines, resulting in the emergence of multidrug-resistant tuberculosis in almost every country of the world.The present study was aimed to assess the physical and chemical property of stimulated and unstimulated saliva and identify if any association exist with alterations in taste perception in patients with antituberculosis medications.

Methods

A total of 30 patients on anti-tuberculosis drugs were considered as cases and 30 healthy volunteers were considered as controls and included in the study. All study subjects were assessed for their physical property like flow rate, viscosity, pH and chemical property like sodium, potassium, calcium, phosphorous of stimulated and unstimulated saliva. All the subjects on Anti-tuberculosis drugs were assessed for change in taste perceptions using the standard questionnaire.

Results

There is a significant decrease in the flow rate (0.34 ± 0.06) and pH (5.89 ± 0.37) of unstimulated saliva of patients and the flow rate (0.38 ± 0.07) and viscosity (1.34 ± 0.28) of stimulated saliva among the case group compare to the control group. All the electrolytes' concentrations such as sodium, potassium, calcium, and phosphorous values were significantly altered in stimulated and unstimulated saliva of the case group compared to the control group in which p-value < 0.05 was considered.

Conclusion

There are significant changes in physical and chemical properties of both stimulated and unstimulated saliva which has an effect on taste perception inpatient with anti-tuberculosis medications. Hence, salivary flow rate, pH, viscosity, and salivary electrolytes of tuberculosis patients should be considered as important parameters in guiding the diet, so that there will be an improvement in their taste perception and medication protocol, thus maintaining their nutritional status which leads to improving their health.

Role of mucoadhesive polymers in retention of toothpaste in the oral cavity

Retention of active ingredients of toothpastes in the mouth following brushing determines the efficiency of these oral care formulations. In this study, new in vitro methodologies for the observation and measurement of toothpaste retention in the oral cavity were developed and used to evaluate the efficiency of formulations containing different mucoadhesive hydrophilic polymers. The findings suggest that using Carbopol ETD 2020 and Carbopol Ultrez 10 as binders in toothpaste prolongs the retention time of these formulations in the oral cavity. The in vitro methodologies tested, coupled with texture analysis, were able to accurately characterise the behaviour of the toothpaste and produce detailed images showing how it is retained in the oral cavity. This study has not only produced a new method for studying the behaviour of toothpaste and other formulations in the oral cavity but is also the first to investigate how different types of mucoadhesive binders can be used to improve toothpaste retention.

Estimation of Blood Loss in Oral and Maxillofacial Surgery by Measurements of Low Haemoglobin Levels in Mixtures of Blood, Saliva and Saline: a Laboratory Study

Objectives

Estimating blood loss is an important factor in several surgical procedures. The accuracy of blood loss measurements in situations where blood is mixed with saliva and saline is however uncertain. The purpose of this laboratory study was to ascertain if blood loss measurements in mixtures of blood, saline, and saliva are reliable and could be applicable in a clinical setting.

Material and Methods

Venous blood and resting saliva were collected from six volunteers. Saliva, saline, and combinations thereof were mixed with blood to obtain different concentrations. A portable spectrophotometer was first used to measure the haemoglobin concentration in undiluted venous blood followed by measurements of the haemoglobin concentration after each dilution. To examine the strength of linear relationships, linear regression and Pearson correlations were used.

Results

The measurements of haemoglobin concentrations in mixtures of blood, saline, and saliva were proven to be accurate for haemoglobin measurements > 0.3 g/dl (correlation = 0.986 to 1). For haemoglobin measurements < 0.3 g/dl, a small increase in haemoglobin values were reported, which was directly associated to the saliva concentration in the solution (correlation = 0.983 to 1). This interference of saliva was significantly eliminated by diluting the samples with saline, mimicking the clinical situation.

Conclusions

The results suggest that a portable spectrophotometer can be used clinically to preoperatively measure the haemoglobin value of a venous blood sample and postoperatively measure the haemoglobin value of the collected liquids, including shed blood, thereby achieving a highly accurate method of measuring blood loss during oral and maxillofacial surgery.

Single implant overdenture reinforced with a metallic framework: A 2-year clinical follow-up

INTRODUCTION

To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits.

OBJECTIVE

To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users.

MATERIAL AND METHODS

Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p < 0.05) were applied.

RESULTS

Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p < 0.01) after 12 months. MP did not change between evaluations (p > 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p < 0.05).

CONCLUSIONS

Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.

Evaluation of salivary gamma-glutamyl transpeptidase as a biomarker in oral squamous cell carcinoma and precancerous lesions

Background:

Oral cancer is such a common malignancy, but its manifestations are usually asymptomatic, and by the time the lesion is diagnosed its invasion is deep. This makes the survival rate poor and also the treatment rendered during such stages is extensive and debilitating. In this regard, a novel approach has been advocated in the estimation of biomarkers in the body fluids. Gamma-glutamyl transpeptidase (GGT)/gamma-glutamyl transferase is an enzyme that is essential for the absorption of amino acids, especially in the degradation of glutathione. Its activity is increased in oral cancer and precancerous lesions.

Aims and Objectives:

The purpose of this study was to assess the activity and concentration of GGT in precancerous and cancerous patients in comparison with normal patients and also to assess its efficacy as an effective tumor marker.

Materials and Methods:

The study population comprised a total of 75 patients who were categorized into three groups as normal patients (25 cases in Group A), patients with precancerous lesions (25 patients in Group B) and patients with oral squamous cell carcinoma (25 cases in Group C). 5 ml of whole unstimulated saliva collection was done, it was centrifuged at 3000 rpm for 15 min and the supernatant thus obtained was used for the estimation of GGT levels. The detection was done by photometric method reading the absorbance at 405 nm.

Results:

Group A patients had values of GGT ranging from 4 to 30U/L with a mean of 16.7 ± 1.94U/L. Group B had activity of GGT ranging from 39 to 65 U/L with a mean of 50.4 ± 1.67U/L. In group C, the evaluated GGT activity was between 53 and 86 U/L and the mean was 70 ± 2.37 U/L. Statistical analysis using Chi-square test was conducted. Correlations between Group A and Group B and between Groups A and C showed a statistically significant relation (P < 0.005).

Conclusion:

Salivary gamma-glutamyl transferase activity can be used effectively as a tumor marker, and further studies with a larger sample size can be done to correlate this finding.

Evaluation of oral stereognosis, masticatory efficiency, and salivary flow rate in complete denture wearers

AIM

The aim of the present study was to evaluate the improvement in oral stereognostic ability, masticatory efficiency, and difference in salivary flow rate in nonexperienced denture wearers, before, after, and 6 months after rehabilitation with complete dentures.

SETTINGS AND DESIGN

Invivo - Observational study.

MATERIALS AND METHODS

Seventy edentulous subjects were selected who came for rehabilitation with complete dentures for the first time. The study was conducted in three stages-before denture insertion, after denture insertion, and 6 months after denture insertion. Oral stereognostic ability was evaluated by asking the subjects to identify six heat cured acrylic resin samples by oral manipulation without seeing it. The unstimulated salivary flow rate was estimated by measuring the time taken to collect 5 ml of the whole saliva. Masticatory efficiency of the subjects was assessed with the help of preweighed chewing gums. The chewing gums were desiccated after the chewing strokes and weighed again.

STATISTICAL ANALYSES USED

Data were tabulated and analyzed statistically using pairedt-test, one-way ANOVA test, and the post hoc test.

RESULTS

Oral stereognostic ability increased immediately on insertion of complete dentures and was still higher 6 months post insertion of dentures. Comparison of the means of masticatory efficiency after denture insertion and 6 months after denture usage gave highly significant values (p< 0.001). The salivary flow which increased immediately following denture insertion returned to almost normal 6 months after denture insertion.

CONCLUSION

The study support the hypothesis that the presence of dentures improve oral sterognostic ability and masticatory efficiency.

Mastication and oral sensory function in frail edentulous elderly: a case-control study

OBJECTIVE

To evaluate the maximum bite force (MBF), masticatory performance and oral sensory function (OSF) of frail edentulous elderly. The correlation of MBF with maximum grip strength (MGS) was also assessed.

METHODS

Twenty edentulous elderly [10 with and 10 without the frailty phenotype (FP)] were selected to participate in this case-control study. The FP was diagnosed using the criteria of Fried et al., which consider weight loss, exhaustion, physical activity level, weakness and slowness to the evaluation. All volunteers received new complete dentures (CDs) to standardise the occlusal status, and after 2 months of use with no complaint, all variables were assessed. MBF was measured by pressure sensors positioned bilaterally on the first artificial molars. Masticatory performance was assessed using the sieving method and was expressed as the median particle size (X50 ) of Optocal after 40 masticatory cycles. OSF was evaluated using the oral stereognosis test, and MGS was measured using a dynamometer. Groups were compared using one-way analysis of variance. The Pearson coefficient of correlation between MBF and MGS was calculated.

RESULTS

Frail elderly people showed reduced MBF (P = 0.0431) and larger X50 values (P = 0.0053) than did non-frail elders, while OSF did not differ between the groups. MBF had a moderate positive correlation with MGS (r = 0.690, P = 0.003).

CONCLUSIONS

Frail elderly had reduced MBF and impaired mastication. On the other hand, OSF does not seem to be affected by frailty. MBF was moderately correlated with MGS.

Human saliva and model saliva at bulk to adsorbed phases - similarities and differences

Human saliva, a seemingly simple aqueous fluid, is, in fact, an extraordinarily complex biocolloid that is not fully understood, despite many decades of study. Salivary lubrication is widely believed to be a signature of good oral health and is also crucial for speech, food oral processing and swallowing. However, saliva has been often neglected in food colloid research, primarily due to its high intra- to inter-individual variability and altering material properties upon collection and storage, when used as an ex vivo research material. In the last few decades, colloid scientists have attempted designing model (i.e. 'saliva mimicking fluid') salivary formulations to understand saliva-food colloid interactions in an in vitro set up and its contribution on microstructural aspects, lubrication properties and sensory perception. In this Review, we critically examine the current state of knowledge on bulk and interfacial properties of model saliva in comparison to real human saliva and highlight how far such model salivary formulations can match the properties of real human saliva. Many, if not most, of these model saliva formulations share similarities with real human saliva in terms of biochemical compositions, including electrolytes, pH and concentrations of salivary proteins, such as α-amylase and highly glycosylated mucins. This, together with similarities between model and real saliva in terms of surface charge, has led to significant advancement in decoding various colloidal interactions (bridging, depletion) of charged emulsion droplets and associated sensory perception in the oral phase. However, model saliva represents significant dissimilarity to real saliva in terms of lubricating properties. Based on in-depth examination of properties of mucins derived from animal sources (e.g. pig gastric mucins (PGM) or bovine submaxillary mucin (BSM)), we can recommend that BSM is currently the most optimal commercially available mucin source when attempting to replicate saliva based on surface adsorption and lubrication properties. Even though purification via dialysis or chromatographic techniques may influence various physicochemical properties of BSM, such as structure and surface adsorption, the lubricating properties of model saliva formulations based on BSM are generally superior and more reliable than the PGM counterpart at orally relevant pH. Comparison of mucin-containing model saliva with ex vivo human salivary conditioning films suggests that mucin alone cannot replicate the lubricity of real human salivary pellicle. Mucin-based multi-layers containing mucin and oppositely charged polyelectrolytes may offer promising avenues in the future for engineering biomimetic salivary pellicle, however, this has not been explored in oral tribology experiments to date. Hence, there is a strong need for systematic studies with employment of model saliva formulations containing mucins with and without polycationic additives before a consensus on a standardized model salivary formulation can be achieved. Overall, this review provides the first comprehensive framework on simulating saliva for a particular bulk or surface property when doing food oral processing experiments.

Effect of ingesting yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 on influenza virus-bound salivary IgA in elderly residents of nursing homes: a randomized controlled trial

Objective: The purpose of this study was to clarify the influence of consuming yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 (1073R-1-yogurt) on influenza virus-bound salivary immunoglobulin A (IgA) levels, in the elderly residents of nursing homes. Methods: A double-blind, parallel-group, randomized controlled trial was conducted with 96 elderly volunteers residing in 2 nursing homes. During the trial, participants consumed 100 g of 1073R-1-yogurt every morning for 12 weeks, whereas the control participants consumed yogurt fermented with a different Lactobacillus strain (control yogurt). Saliva was collected before the trial and after 4, 8 and 12 weeks of yogurt ingestion. Results: Our data indicated that consumption of 1073R-1-yogurt affected influenza A virus subtype H3N2-bound IgA levels in saliva (p = .001). In addition, saliva flow rate and total IgA levels increased in response to the yogurt intake period in both the 1073R-1 and control yogurt groups (p = .04). Conclusions: Our study suggests that continuous daily ingestion of 1073R-1-yogurt may help prevent infection with influenza A virus subtype H3N2 in elderly subjects with weakened immunity, by increasing the production of influenza A virus subtype of H3N2-bound salivary IgA.

Evaluation of salivary alkaline phosphatase levels in tobacco users to determine its role as a biomarker in oral potentially malignant disorders

Background

Elevated salivary alkaline phosphatase (S-ALP) levels have been observed in oral squamous cell carcinoma, but its status in tobacco users and in individuals with oral potentially malignant disorders (OPMDs) is less explored.

Aims and Objectives

The aims and objectives were to estimate and compare the levels of S-ALP among tobacco users, nonusers and in individuals with OPMD.

Materials and Methods

The study population comprised 42 individuals, categorized into four groups with/without tobacco usage habit and with/without lesion. 5 ml of unstimulated saliva sample was collected, centrifuged at 3000 rpm for 15 min and supernatant separated. S-ALP was estimated in the supernatant by using kinetic photometric method in an automatic analyzer.

Results

Data obtained were subjected to statistical analysis. The mean S-ALP was 18.00 IU/L for normal individuals without tobacco usage, 4.60 IU/L for smokers without lesion, 7.50 IU/L for tobacco chewers without any lesion and 64.90 IU/L for individuals with OPMD. The mean difference between the groups was statistically significant (P < 0.001) using Kruskal-Wallis' ANOVA. No statistically significant difference (P > 0.05) was obtained in the S-ALP levels between tobacco users and nonusers and between smokers and tobacco chewers, using Mann-Whitney U-test. S-ALP levels in individuals with OPMD were statistically significantly higher (P < 0.001) than those without lesions, with or without tobacco usage habit, using Mann-Whitney U-test.

Conclusion

We conclude that S-ALP could be used as a reliable noninvasive biomarker in monitoring OPMD.

Influence of lower complete denture use on masseter muscles and masticatory function: A longitudinal study

BACKGROUND

Edentulism can reduce mastication, leading to changes in food pattern, with possible consequences to masticatory muscle thickness.

OBJECTIVES

This study verified masticatory function and oral perception in subjects who did not use lower CDs, and whether the insertion of new upper and lower CDs would improve such variables.

METHODS

Fifteen edentulous elderly who wore only the upper CD were selected and received new upper and lower CD. Volunteers were evaluated at baseline and after 1, 3 and 6 months of new prosthesis use. Masticatory performance (MP) was assessed by the sieving method (X₅₀ values). Masseter thickness (MT) was evaluated by ultrasonography. Oral sensorial ability (OSA) was assessed by oral stereognosis test and maximum tongue pressure (MTP) was verified by pressure sensors. Data were submitted to repeated measures ANOVA and Tukey-Kramer posthoc tests (α = 0.05). Correlation between OSA and MTP was verified by Person's correlation.

RESULTS

X₅₀ and MTP decreased (P < 0.05) after 1 month and remained stable (P > 0.05) for next assessments. After 3 months, MT in rest position was increased (P < 0.05), while during maximum voluntary contraction 1 month was enough to increase MT (P < 0.05). There were no differences for OSA (P > 0.05) and no correlation between OSA and MTP.

CONCLUSION

Masticatory performance and masseter thickness of elderly who did not use the lower dentures were improved after 2 months using new upper and lower CDs. However, new CDs in both dental arch decreased MTP. Brazilian Registry of Clinical Trials (ReBEC #RBR-37gdst).

Oral health status of hospitalized amyotrophic lateral sclerosis patients: a single-centre observational study

OBJECTIVE

To assess the intraoral conditions and oral function of patients with amyotrophic lateral sclerosis (ALS).

MATERIAL AND METHODS

This single-centre, cross-sectional observational study included 50 ALS patients, who were treated with tracheostomy positive-pressure ventilation (TPPV) while hospitalized. The disease duration, TPPV duration, current number of teeth, number of occlusal units, number of decayed/missing/filled teeth, community periodontal index, bleeding on probing, dental calculus, maximum mouth opening, salivation rate, tongue anomalies (atrophy or hypertrophy) and tongue coating were determined for each patient. Differences in intraoral conditions according to disease duration or TPPV duration were statistically analysed.

RESULTS

The maximum mouth opening was low in the included patients, with a mean distance of 13.7 ± 7.4 mm. Furthermore, the maximum mouth opening showed a significant negative correlation with both disease duration and TPPV duration. No statistically significant differences were found between any other intraoral parameters and disease duration or TPPV duration.

CONCLUSIONS

Severe dental disease is uncommon among hospitalized ALS patients who receive oral care by nurses; however, mouth opening is very restricted in these patients. Early intervention for restricted mouth opening, directed by a dentist or dental hygienist, is essential in this population.

A comparative analysis of salivary factors and maxillary denture retention in different arch forms: An in vivo study

Aims

This study aims to find the effect of change in different salivary factors before and after complete denture insertion and to measure the maxillary denture retention in different arch forms.

Materials and Methods

Thirty completely edentulous individuals (10 each of square, tapered, and ovoid arch form of maxilla) belonging to the age group of 40-70 years were selected. Salivary factors (flow, density, pH, viscosity, and total protein) were evaluated before and after denture insertion. Retention of maxillary denture was measured in all the different arch forms.

Statistical Analysis

Student's independent sample's t-test was applied. The correlation was analyzed by Pearson's correlation analysis.

Results

While mean flow rate and pH of saliva increased, mean viscosity, total protein, and density of saliva decreased after maxillary complete denture insertion. A positive correlation was found between retention and total maxillary basal surface area. Retention value was found to be greatest in square type and least in tapered type.

Conclusions

Complete denture acts as a mechanical stimulant thus increasing flow rate and pH immediately after complete denture insertion. Density, total protein, and viscosity of saliva decreased after complete denture insertion which may be due to increase in water content of saliva. The retention of maxillary complete denture does not seem to depend on the rate of change of the salivary factors, before and after complete denture insertion. Total basal surface area and maxillary denture retention values were highest in square arch form and least in tapered arch form.

Comparative evaluation of effect of complete denture wears on the flow rate of saliva in both medicated and apparently healthy patients

Aim and Objectives:

In the denture wearing people, saliva is necessary to create adhesion, cohesion, and surface tension that ultimately leads to the increased retention of the denture. Medications have some influence on the flow rate of saliva and denture retention. The present study evaluates the effect of complete denture wear on the flow rate of saliva in both medicated and apparently healthy patients.

Materials and Methods:

The participants were 42 edentulous individuals aged 35–70 years requiring complete denture prostheses. The participants were divided into two groups of medicated and unmedicated. Unstimulated whole saliva was collected at 24 h and 3 months after the insertion of new complete dentures in both the groups. The data obtained were analyzed using Student's paired t-test and unpaired t-test. Intergroup changes were compared with unpaired t-test. Intragroup changes were compared with paired t-test using the Statistical Package for Social Sciences, version 22.0.

Results:

In the unmedicated group, the mean salivary flow rate was high at 24 h after denture insertion when compared to before denture insertion (P = 0.001 VHS). In the medicated group, the observation was highly significant (P = 0.007 HS) 24 h after denture insertion and after 3 months (P = 0.02 S) when compared to before denture insertion.

Conclusion:

No significant difference in the salivary flow rate was found 3 months after denture insertion when compared to before denture insertion for both the medicated and unmedicated groups.