Total antioxidant capacity of saliva and dental caries

Characterization of Prototype Gummy Formulations Provides Insight into Setting Quality Standards

Gummy formulations are considered suitable alternatives to traditional oral dosage forms like tablets and capsules due to their merits that include chewability, softness/flexibility, improved drug release, administration without water, appealing organoleptic properties, better patient compliance, easy preparation and usefulness for persons of different ages (e.g. children). Though there is increasing interest in gummy formulations containing drugs, measurable parameters, and specification limits for evaluating their quality are scarce. Quality check forms an essential part of the pharmaceutical development process because drug products must be distributed as consistently stable, safe, and therapeutically effective entities. Consequently, some quality parameters that could contribute to the overall performance of typical gummy formulations were investigated employing six brands of non-medicinal gummies as specimens. Accordingly, key physicochemical and micromechanical characteristics namely adhesiveness (0.009 - 0.028 mJ), adhesive force (0.009 - 0.055 N), chewiness (2.780 - 6.753 N), cohesiveness (0.910 - 0.990), hardness (2.984 - 7.453 N), springiness (0.960 - 1.000), and resilience (0.388 - 0.572), matrix firmness - compression load (2.653 - 6.753 N) and work done (3.288 - 6.829 mJ), rupture (5.315 - 29.016 N), moisture content (< 5%), weight uniformity (< 2.5 g; < 7.5% deviation), and intraoral dissolution pH (≥ 3.5 ≤ 6.8) were quantified to identify measures that may potentially function as specification limits and serve as prospective reference points for evaluating the quality of gummy formulations. Findings from this work contribute to ongoing efforts to standardize the quality control strategies for gummy formulations, particularly those intended for oral drug delivery.

Prevalence of dental caries among coronavirus disease 2019-recovered patients and correlation with salivary total antioxidant capacity in Kalaburagi region of Indian subpopulation

Background

Coronavirus disease 2019 (COVID-19) has vastly affected mankind worldwide, and its long-term effect on oral health needs to be studied.

Aims

The aim of the study was to evaluate the prevalence of dental caries and its correlation with salivary total antioxidant capacity (TAC) in Kalaburagi region of the Indian subpopulation.

Methods

About 80 subjects (16-55 years) were included in the study based on selection criteria and were divided into two groups (n = 40). Group 1: no history of COVID-19 infection and Group 2: COVID-19-recovered subjects. Each group was subdivided into two subgroups (n = 20) A and B with and without dental caries. Dental caries was assessed using the decay, missing, filled, treatment (DMFT) index by the World Health Organization. About 5 ml of unstimulated saliva samples was collected and centrifuged at 2000 rpm for 10 min, and the supernatants were collected. Salivary TAC was estimated using 2,2'-azino-bis-[3-ethylbenzothiazoline-6-sulfonic] acid assay and observed under spectrophotometer (734 nm).

Statistical Analysis

Data were analyzed using the Shapiro-Wilk test for normality distribution followed by one-way analysis of variance and post hoc Tukey test (P < 0.05).

Results

COVID-19-recovered subjects showed a higher prevalence of dental caries and lower TAC levels than non-COVID-19 subjects.

Conclusion

Higher prevalence of dental caries with lower levels of salivary TAC was found in COVID-19-recovered individuals.

Comparison of oral cavity protein abundance among caries-free and caries-affected individuals-a systematic review and meta-analysis

Objective

Some salivary proteins seem to be differently abundant among caries-free (CF) and caries-affected (CA) individuals, but previous results are contradictory precluding that definitive conclusion be drawn. A pooled analysis of the available evidence may provide more robust data on identifying oral cavity protein patterns among CF and CA individuals. This systematic review and meta-analysis (PROSPERO CRD42021269079) aimed to compare the oral cavity protein abundance among caries-free and caries-affected individuals.

Methods

This study was conducted following PRISMA guidelines. PubMed, Embase, and Web of Science databases were systematically assessed (up to February 2023) to retrieve clinical studies written in English, German, or in Latin-based languages that compared the oral cavity protein abundance among CF and CA individuals. Data extraction and methodological quality assessment (NIH guidelines) were independently performed by two investigators. Qualitative synthesis was performed from all included studies and meta-analysis was performed using a random-effects model with inverse variance for studies that reported the concentration of proteins or enzymatic activity. Standardized mean difference (SMD) with respective 95% confidence interval (CI) were calculated for each outcome.

Results

A total of 90 studies (two cohort and 88 cross-sectional designs) of more than 6,000 participants were selected for data extraction, being the quality of evidence graded as "fair" for most of them. The oral cavity of CF individuals presented lower total protein concentration [SMD = 0.37 (95% CI: 0.07-0.68; 18 studies)], lower total antioxidant capacity [SMD = 1.29 (95% CI: 0.74-1.85); 17 studies], and lower carbonic anhydrase activity [SMD = 0.83 (95% CI: 0.58-1.09); three studies], whereas CA individuals presented lower carbonic anhydrase concentration [SMD = -0.66 (95% CI: -1.00 to -0.32); three studies], urease [SMD = -0.95 (IC 95%: -1.72 to -0.17); four studies], and arginine deiminase system [SMD = -2.07 (95% CI: -3.53 to -0.62); three studies] activities. Antimicrobial peptides, secretory immunoglobulin-A concentrations and alpha-amylase activity were similar among individuals.

Conclusion

Differences on oral cavity protein abundance were observed among CF and CA individuals. These data indicate some protein patterns for the oral health and dental caries conditions. Even when statistically significant, some of the results were not very consistent. Cohort studies need to be conducted to validate these results.

The Impact of Passive Smoking on Salivary Glutathione Peroxidase and Selenium in Relation to Dental Caries Severity among Five Years Old Children

Background

It had been found that passive smoking may have the same harmful effect as tobacco cigarettes smoking. Aims: This study was conducted to determine the effect of passive smoking on salivary glutathione peroxidase and selenium in relation to dental caries severity.

Settings and Design

The sample consisted of 120 children aged 5 years old, classified into four groups according to the number of cigarettes smoked by their fathers daily: Passive smoking children of 5-10 cigarettes, those of 10-15 cigarettes daily, those of 15-20 cigarettes daily and non-passive smoking children of no smokers indoor (the control group). The sample was further classified according to dental caries severity into three groups: mild (DMFS values <4), moderate (DMFS values from 4 to 8) and severe (DMFS values >8).

Methods and Material

Stimulated saliva was collected, and salivary glutathione peroxidase and selenium were chemically analysed.

Results and Conclusions

Glutathione peroxidase and selenium were higher among non-passive smoking children than passive smoking children and they were higher among children with mild caries severity than in children with moderate or severe caries severity (p < 0.01). Passive smoking had significant effect in both salivary glutathione peroxidase and selenium (p < 0.01), while dental caries had non-significant effect on them (p > 0.05). In conclusion, passive smoking had deleterious effect in salivary glutathione peroxidase and selenium, while dental caries did not have effect on these two variables. There is no interaction between both passive smoking and dental caries in neither glutathione peroxidase nor selenium, so the effect of passive smoking on these two variables can exceed the effect of dental caries on them.

Determination and correlation of matrix metalloproteases profile and total antioxidant capacity in severe early childhood caries children - A randomized clinical trial

Background and Objective

Matrix metalloproteinases (MMPs) are a multigene family that belongs to the metalloproteinase class of endopeptides, responsible for the remodeling and degeneration of extracellular matrix molecules. MMPs are collectively called Matrixins are known to participate in tooth development and dentin-caries progression. Total antioxidant capacity (TAC) is the measure of the amount of free radicals scavenged by a test solution, being used to evaluate the antioxidant capacity of biological samples. Oxidative stress can affect the initiation and progression of many inflammatory and infectious diseases such as dental caries. Early childhood caries (ECC) is a serious public health problem that adversely affects children's physical and mental health.

Aim

The study aims to investigate and correlate the presence of MMPs and TAC in saliva of children with ECC.

Materials and Methods

The present study was done on 50 children aged 3-6 years with severe ECC. Unstimulated, whole saliva samples were collected and stored and all 50 samples were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis to determine MMPs and were subjected to spectrometry to assess the TAC of saliva. The samples with the presence of MMPs and increased TAC values were subjected to liquid chromatography-mass spectrometry to check the correlation of MMPs and TAC in ECC.

Results

TAC was 0.81 ± 0.14 mmol/l in the caries-active group and 0.15 ± 0.05 mmol/l in the caries-free group and was statistically significant at P < 0.001. MMP level in the caries-active group was 715.75 ± 102.42 μg/ml, whereas, in the caries-free group, it was 250.89 ± 86.51 μg/ml and was statistically significant at P < 0.001. The salivary MMP and TAC levels showed a significant positive moderate correlation with caries scores in the caries-active group and the finding was statistically significant at P < 0.001.

Conclusion

From our results, it can be concluded that the both MMPs and TAC levels were high in caries active group than in the caries-free group. The salivary MMPs showed a moderate positive correlation with TAC in the ECC group. In age-wise comparison, the mean MMP levels in the caries active group were higher in children between 3 and 4 years than in 5-6 years. In the caries-free group, the mean MMP level was similar in both the age groups.

Applications of Antioxidants in Dental Procedures

As people are paying more and more attention to dental health, various dental treatment procedures have emerged, such as tooth bleaching, dental implants, and dental restorations. However, a large number of free radicals are typically produced during the dental procedures. When the imbalance in distribution of reactive oxygen species (ROS) is induced, oxidative stress coupled with oxidative damage occurs. Oral inflammations such as those in periodontitis and pulpitis are also unavoidable. Therefore, the applications of exogenous antioxidants in oral environment have been proposed. In this article, the origin of ROS during dental procedures, the types of antioxidants, and their working mechanisms are reviewed. Additionally, antioxidants delivery in the complicated dental procedures and their feasibility for clinical applications are also covered. Finally, the importance of safety assessment of these materials and future work to take the challenge in antioxidants development are proposed for perspective.

Are Dental Caries Associated with Oxidative Stress in Saliva in Children and Adolescents? A Systematic Review

Background: This systematic review aimed to assess whether dental caries is associated with oxidative salivary stress. Methods: The searches were carried out in electronic databases, including PubMed, Scopus, Web of Science, the Cochrane Library, LILACS, OpenGrey, and Google Scholar, without restrictions on the date of publication and language. The acronym PECO was used, in which the participants (P) were children and adolescents exposed (E) to dental caries compared (C) to those without dental caries, with the outcome (O) of modulation of oxidative biochemical parameters. After the search retrieval, the duplicates were removed, and the articles were evaluated by title and abstract, following the inclusion and exclusion criteria. Then, the papers were read and thoroughly assessed. After selection, the risk of bias assessment and qualitative synthesis were performed using the Newcastle-Ottawa Scale (NOS) for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the level of evidence. Results: A total of 5790 studies were found, and 30 articles were considered eligible and were included for the qualitative synthesis and the level of evidence assessment. The studies showed an imbalance of the antioxidant and pro-oxidant parameters in individuals with dental caries, with primarily increases in both total antioxidant capacity and lipid peroxidation. Most articles showed a low risk of bias, having comparability as the main issue. When exploring through GRADE, a very low level of evidence was found. Conclusions: It was possible to observe an association between oxidative stress and dental caries, showing a disbalance of antioxidants and pro-oxidants, but the evidence level was still very low.

Salivary Redox Homeostasis in Human Health and Disease

Homeostasis is a self-regulatory dynamic process that maintains a stable internal environment in the human body. These regulations are essential for the optimal functioning of enzymes necessary for human health. Homeostasis elucidates disrupted mechanisms leading to the development of various pathological conditions caused by oxidative stress. In our work, we discuss redox homeostasis and salivary antioxidant activity during healthy periods and in periods of disease: dental carries, oral cavity cancer, periodontal diseases, cardiovascular diseases, diabetes mellitus, systemic sclerosis, and pancreatitis. The composition of saliva reflects dynamic changes in the organism, which makes it an excellent tool for determining clinically valuable biomarkers. The oral cavity and saliva may form the first line of defense against oxidative stress. Analysis of salivary antioxidants may be helpful as a diagnostic, prognostic, and therapeutic marker of not only oral, but also systemic health.

Salivary biomarkers of oxidative stress in children with dental caries: Systematic review and meta-analysis

OBJECTIVE

To assess the relationship between salivary biomarkers of oxidative stress and dental caries in children.

METHODS

Studies conducted in children up to 12 years old comparing salivary biomarkers of oxidative stress such as malondialdehyde (MDA), superoxide dismutase (SOD), uric acid, and total antioxidant capacity (TAC), considering children with dental caries lesions and caries-free ones were selected. In addition, salivary parameters such as salivary flow, pH, buffering capacity, calcium and total protein levels were evaluated. A systematic literature review was carried out in 8 databases. The standardized mean difference (SMD) was measured using inverse variance as a statistical method and random effects as an analysis model, corresponding to a 95% confidence interval (CI).

RESULTS

The TAC levels were higher in children affected by dental caries compared to caries-free ones (control group), regardless of age (SMD 2.66, CI 1.33, 3.98), or gender (SMD 0.98, CI 0.56, 1.39). When adjusted for normalized protein, MDA levels were lower in the dental caries group than in the control group (SMD -16.51, CI -29.02, -4.00), and SOD levels were higher in the dental caries group (SMD 5.09, CI 0.01.10.18). The total protein concentration in saliva of children with dental caries was higher than in the control group, regardless of age (SMD 0.98, CI 0.27, 1.69), or gender (SMD 0.77, CI 0.45, 1.10). The salivary parameters assessed had lower levels in children affected by dental caries (p < 0.05).

CONCLUSIONS

The levels of oxidative stress biomarkers and salivary parameters are altered in saliva of children with dental caries.

Salivary Antioxidant Capacity and Oral Health Status in Children with Visual Impairments—A Cross-Sectional Study

Background Children with visual impairment are at a higher risk for developing dental disease, and imbalances in the antioxidant levels may play an important role in the development and management of oral diseases.

Aim Our aim was to evaluate and compare the oral health status and salivary total antioxidant capacity (TAC) in children with and without visual impairment.

Methods Oral health was evaluated among 6 to 11 years old children with and without visual impairment (50 each) using World Health Organization oral health assessment form for caries prevalence, gingival health, and oral hygiene levels. Unstimulated saliva was collected and assayed for TAC using the phosphomolybdic method.

Statistical Analysis The data collected were tabulated, and the results, thus, obtained were subjected to statistical analysis using EZR software—version 1.37. The variables between the two groups were compared using the Mann–Whitney U test and Fisher's exact test. A correlation test was done using Spearman's correlation test.

Results The mean TAC levels among children with and without visual impairment were 49.17 (±25.702) and 156.67 (±56.031) µg/mL, respectively, which was statistically significant (p < 0.001). The children with visual impairment showed a significantly higher number of carious lesions compared with the control group (p < 0.001). Oral hygiene status and gingival health status were significantly poorer in children with visual impairments than the children in the control group (p < 0.001).

Conclusions Oral health was significantly poorer, and salivary TAC levels were significantly lower in children with visual impairment. There may be an inverse correlation between salivary TAC and oral health status. Clinical Significance: Since these children have been shown to have poorer oral health status, a baseline assessment of their salivary antioxidant capacity may indicate the need to reinforce oral care efforts and supplement them using an antioxidant-rich diet.

Salivary Oxidative Stress Markers' Relation to Oral Diseases in Children and Adolescents

Current evidence suggests that salivary markers of oxidative stress are indicative of clinical disease indices such as the papillary bleeding index (PBI) and the caries index (CI). The aim of this study was to assess the relation of oxidative stress markers with oral dental caries and periodontal problems in a pediatric population. In our case-control study, unstimulated whole saliva was collected from individuals aged 3–18 years (n = 177); 14 individuals were excluded. Study subjects were divided into those with caries (CI = 2, n = 78) and those who were caries-free (n = 85). These groups were then divided into another subset consisting of children (mean age 7.3 years, n = 121) and adolescents (mean age 16.1 years, n = 42). The PBI was determined in all groups. We then assessed salivary levels of oxidative stress markers. Our results showed that, the total antioxidant capacity (TAC) level increased in patients with more gingival bleeding (p < 0.05) in the study group aged 3–18 years. In addition, TAC showed a significant decrease in samples with caries when compared to the caries-free group in adolescents (p = 0.008). In conclusion, TAC levels may be a marker of both gingival bleeding and dental caries in young adult populations. We hope that in the near future, prophylaxis, control, follow up and even possible therapeutic use of oxidative stress markers in a chairside way will become possible as antioxidants have been shown to be effective against oral diseases.

Nitric Oxide, Oxidative Stress and Streptococcus mutans and Lactobacillus Bacterial Loads in Saliva during the Different Stages of Pregnancy: A Longitudinal Study

Hormonal changes associated with pregnancy promote oral bacterial growth, which may affect salivary nitric oxide (NO) levels, oxidative stress (OS), and antioxidant capacity (AC). We hypothesized that caries-related bacterial load, NO level, and OS in the saliva change with advancing gestation. The aim of this study was to investigate longitudinal changes in salivary NO, OS, and AC during pregnancy and correlate them with Streptococcus mutans (SM) and Lactobacillus (LB) colonization at different stages of pregnancy. We assessed NO level by Griess method, OS by measuring malondialdehyde (MDA), AC by ABTS radicals and bacterial load by culturing SM and LB in the saliva of pregnant women (n = 96) and compared with non-pregnant women (n = 50) as well as between different stages of pregnancy. Compared with non-pregnant women, NO was 77% higher (4.73 ± 2.87 vs. 2.67 ± 1.55 µM; p < 0.001), MDA was 13% higher (0.96 ± 0.27 vs. 0.85 ± 0.22 nM; p = 0.0055), and AC was 34% lower (60.35 ± 14.33 vs. 80.82 ± 11.60%; p < 0.001) in the late third trimester. NO increased with advancing gestation, but AC and OS did not change significantly during pregnancy. SM were more abundant in pregnant women compared with non-pregnant (p = 0.0012). Pregnancy appears to have an adverse impact on oral health emphasizing the importance optimal oral healthcare during pregnancy.

Salivary melatonin is depleted in patients with dental caries due to the elevated oxidative stress

Objectives

To determine salivary melatonin and malondialdehyde levels in individuals with and without dental caries.

Materials and methods

Saliva samples were collected in a fasting state from patients with active dental caries (n ​= ​16) and patients without dental caries (n ​= ​16). Melatonin was measured in the samples using a commercially available ELISA kit and malondialdehyde was assayed using a standardized spectrophotometric method.

Results

The salivary melatonin levels were significantly lower (p ​< ​0.01) in patients with active dental caries than patients without dental caries, while the salivary malondialdehyde values were significantly higher (p ​< ​0.01) in patients with active dental caries than patients without dental caries. The binary logistic regression analysis revealed a negative correlation (-0.513) between the salivary melatonin and malondialdehyde levels which was statistically significant (p ​< ​0.042) in the patient group with active dental caries, while no such relationship could be demonstrated in the patient group without dental caries.

Conclusion

Melatonin depletion and augmented malondialdehyde levels potentially indicate that the endogenous melatonin has been utilized to counter the oxidative stress-induced during the initiation and progression of dental caries. Further research could explore the potential use of exogenous melatonin supplementation as a preventive and therapeutic measure for dental caries.

Paradoxical sleep deprivation induces oxidative stress in the submandibular glands of Wistar rats

OBJECTIVES

Paradoxical sleep deprivation has been associated with impaired salivary secretion in rats. However, the mechanism that underlies this is not known. Therefore, this study assessed salivary and serum oxidative stress levels following paradoxical sleep deprivation in rats.

METHODS

Twenty-one male Wistar rats randomly divided into three groups of seven rats each as; Control (C); partial sleep-deprived (PSD); and total sleep-deprived (TSD) were used. Malondialdehyde (MDA) concentration, Superoxide dismutase (SOD), and catalase activities were evaluated in saliva, serum, and submandibular glands after seven days of sleep deprivation. Data were expressed as mean ± standard error of the mean and analyzed using one-way ANOVA, Tukey HSD post hoc, and Pearson's correlation tests.

RESULTS

Serum MDA levels were significantly higher in both the TSD and PSD groups compared to the control group whereas only the TSD group showed higher submandibular MDA levels compared to the PSD group and the control group. Submandibular SOD activity was significantly lower in both the TSD and PSD groups compared to the control group. Serum catalase activity was significantly lower in the TSD group only compared to the control group.

CONCLUSIONS

These results have demonstrated for the first time that paradoxical sleep deprivation was associated with changes in the oxidant/antioxidant defense system in the submandibular salivary glands of male Wistar rats which may contribute to impairment in salivary secretion.

Salivary Redox Biomarkers in the Course of Caries and Periodontal Disease

Caries are a pathological process of extracorporeal nature, characterized by demineralization of inorganic substances as well as proteolysis triggered by acids produced by bacteria present in dental plaque, as a result of metabolism of sugars of both external and internal origin. Periodontal disease, on the other hand, is a multifactorial degenerative disease associated with inflammation, involving a group of tissues that surround the dental cervix and root of the tooth. It is believed that one of the mechanisms in the etiopathogenesis of caries and periodontitis are disorders of local and/or general oxidative stress (OS) parameters. Numerous clinical studies have confirmed the relationship between oxidative stress markers and oral diseases. In most analyzed studies, technical and biological variability was so high that none of the markers so far has proven suitable for routine clinical use. The aim of systematic reviews of the literature is to present the existing studies on OS parameters, mainly concerning the activity of antioxidant enzymes in saliva of patients with caries and periodontitis.

Oxidative stress levels and oral bacterial milieu in the saliva from pregnant vs. non-pregnant women

Background

Saliva plays a significant role in maintaining oral health and oral bacterial milieu. Difference in oxidative stress (OS) levels in saliva in conjunction with bacterial load between pregnant and non-pregnant women has not been studied previously. We hypothesized that the physiological changes in pregnancy alter oral bacterial milieu by promoting growth of Streptococcus mutans (SM) and Lactobacillus (LB), and increase OS in saliva. The aim of this study was to measure and compare the oral bacterial milieu, OS and total anti-oxidative capacity (TAC) in the saliva of pregnant and non-pregnant women.

Method

In this cross-sectional study, we assessed oral bacterial milieu by culturing the SM and LB by using commercial kits, TAC by measuring 2, 2′-Azino-Bis-3-Ethylbenzothiazoline-6-Sulfonic Acid (ABTS) free radical scavenging activity spectrophotometrically and OS levels by measuring malondialdehyde (MDA) levels with commercial kits in the saliva of pregnant women (n = 38) at 18–20 weeks of gestation, who were compared with age-matching healthy non-pregnant women (n = 50).

Results

Streptococcus mutans were found to be more abundant in the saliva of pregnant women compared with non-pregnant women (p = 0.003) but the difference was not significant for the LB (p = 0.267). TAC was found to be 46% lower in pregnant women’s saliva compared to non-pregnant women [optical density (OD) measured at 731 nm as 0.118 ± 0.01 vs. 0.063 ± 0.02; p < 0.001]. OS, expressed as saliva MDA levels, was found to be 16% higher in pregnant women compared to non-pregnant women (1.07 nM MDA vs. 0.92 nM MDA; p = 0.023).

Conclusion

Pregnancy has an adverse impact on oral bacterial milieu as demonstrated by increased colonization with Streptococcus mutans together with higher OS levels and decreased TAC levels in saliva. This emphasizes the importance of improved oral hygiene and provision of oral healthcare services during pregnancy care.

Saliva proteomics from children with caries at different severity stages

OBJECTIVE

To perform a comparative analysis of saliva protein profile of patients with early childhood caries at different levels of severity and caries-free individuals.

MATERIALS AND METHODS

Stimulated saliva samples were collected from 126 children (2-6 years old), classified according to the ICDAS II, and divided into 3 groups (n = 42): caries-free (CF), enamel caries (EC), and dentine caries (DC). Samples were digested and analyzed by nanoUPLC coupled with a mass spectrometry. Data analyses were conducted with Progenesis QI for Proteomics Software v2.0. Gene Ontology (GO) terms and protein-protein interaction analysis were obtained.

RESULTS

A total of 306 proteins (≈6 peptides) were identified. Among them, 122 were differentially expressed in comparisons among children with different caries status. Out of the 122 proteins, the proteins E2AK4 and SH3L2 were exclusively present in groups CF and EC, respectively, and 8 proteins (HAUS4, CAH1, IL36A, IL36G, AIMP1, KLHL8, KLH13, and SAA1) were considered caries-related proteins when compared to caries-free children; they were up-regulated proteins in the caries groups (EC and DC).

CONCLUSION

The identification of exclusive proteins for caries-free or carious-related conditions may help in understanding the mechanisms of caries and predicting risk as well as advancing in caries control or anti-caries approaches.

Caries Activity and Ph Level Changes after Fluoride Varnish and Casein Phosphopeptides-Amorphous Calcium Phosphate Application on Children's Saliva

Background

Caries is a disease affecting the hard tissue of the tooth wherein the demineralization process caused by Streptococcus mutans decreases saliva pH faster than the remineralization process can maintain it. Topical fluoridation, such as fluoride varnish and casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) is the most common preventive therapy for the disease.

Aims

The aim of this study is to assess the difference between fluoride varnish and CPP-ACP in reducing saliva pH and caries activity.

Materials and Methods

This is an experimental study with a sample population of 60 children (aged 8-9 years old), divided into two groups of 30. Group 1 was treated with fluoride varnish, Group 2 with CPP-ACP. A t-test was used to measure the effects of the different treatments.

Results

The result showed that the average difference in saliva pH before and after application was -0.12933 in Group 1 and -0.14033 in Group 2 (P = 0.256). The average difference in caries activity before and after application was 3.189 log colony-forming units (CFUs)/mL in Group 1 and 2.237 log CFUs/mL in Group 2 (P = 0.275).

Conclusion

The most effective treatment for increasing saliva pH and reducing caries activity can be achieved by using the varnish for 1 month. However, there is no difference between fluoride varnish and CPP-ACP with regard to altering saliva pH and reducing caries activity statistically. Future study is needed to explore this result.

Oxidative Stress Markers Differ in Two Placental Dysfunction Pathologies: Pregnancy-Induced Hypertension and Intrauterine Growth Restriction

Aim

Pregnancy-induced hypertension (PIH) and intrauterine growth restriction (IUGR) are both multisystemic disorders of pregnancy that cause perinatal morbidity and mortality. Recently, researchers focused on the role of oxidative stress (OS) as a pathophysiological mechanism in the development of these pathologies. The aim of this study was to compare OS in placental-related pathologies (PIH and IUGR) and uncomplicated pregnancies. We also investigated which salivary OS markers reflect systemic oxidative status and which only reflect the state of the oral cavity. Material and Methods. A total of 104 pregnant women (n = 104; 27 with PIH, 30 with IUGR, and 47 controls) were evaluated. Malondialdehyde (MDA), total antioxidant capacity (ORAC), aldehyde dehydrogenase (ALDH), and activity of glutathione peroxidase (GPx) and glutathione transferase (GST) in plasma/whole blood and/or saliva were analysed. Dietary nutrient intake was calculated using a Semiquantitative Food Frequency Questionnaire (SFFQ). Oral health was assessed to eliminate patients with bleeding, severe periodontitis, and other dental pathologies.

Results

In the IUGR group, increased concentration of ORAC was observed both in saliva and plasma. Also, lower plasma levels of MDA in IUGR compared to the control group was detected. No sign of oxidative stress was confirmed in the PIH group. The examined groups did not differ regarding diet and markers of inflammation. ORAC in saliva was correlated with its level in plasma. No such correlations for MDA were observed. In the IUGR group, there were no differences in OS markers in plasma, but there was a lower ALDH level in the blood compared to the control group. It confirms OS occurrence in IUGR. In IUGR, a higher activity of salivary ALDH was probably due to worse oral health.

Conclusion

Oxidative stress differs between IUGR and PIH groups: the presence of oxidative stress was confirmed only in the IUGR group. Salivary ORAC can be used to estimate ORAC in plasma. The activity of salivary ALDH reflects the state of the oral cavity.

Salivary Antioxidant and Oxidative Stress Marker Levels in HIV-Positive Individuals

BACKGROUND

HIV infections are a worldwide health problem. HIV infection reduces CD4+ cell counts. Oxidative stress might play an important role in the stimulation of virus replication and immunodeficiency. Saliva might be the first line of defense against oxidative stress.

OBJECTIVE

The aim of this study was to evaluate the oxidative stress marker and antioxidant levels of saliva in HIV-infected patients by measuring total antioxidant capacity and malondialdehyde level.

METHODS

A total of 49 HIV-positive patients and 49 healthy HIV-negative individuals were randomly selected. All the patients were clinically examined. Five mL of unstimulated whole saliva was collected and evaluated by spectrophotometric assay. Data were analyzed with STATA 11.

RESULTS

Mean ages of the case and control groups were 28 and 33 years, respectively. Salivary malondialdehyde levels were significantly higher in the HIV-positive group (3.68±2.26) compared to the healthy control group (2.79±1.91). Levels of salivary total antioxidant capacity were significantly lower in the HIV-positive group (0.20± 0.09) compared to the control group (0.27±0.10).

CONCLUSION

The antioxidant defense system in HIV-positive individuals was low and oxidative stress was high in this population. Saliva might be used as a diagnostic tool for antioxidant changes in HIV-positive patients in the future. There were changes in salivary antioxidant defense system and oxidative stress in HIV-positive individuals. Antioxidant supplements might help local salivary and general health statuses.

Comparative evaluation of salivary malondialdehyde levels as a marker of lipid peroxidation in early childhood caries

Objective

The aim of this study was to evaluate the association between lipid peroxidation and dental caries in children with ECC by estimating the levels of MDA in saliva of children.

Materials and Methods

A total of 150 children were selected; 75 children with ECC and 75 children without caries (non-ECC). Saliva samples were collected and centrifuged at 12,000 rpm for 24 min at 4°C to obtain a supernatant. MDA levels were estimated by Buege and Aust method by using thiobarbituric acid. The data obtained were analyzed by Student's t-test to compare MDA levels between the groups.

Results

MDA levels were higher in children with ECC. There was no statistically significant difference between children with ECC and without ECC (non-ECC).

Conclusion

MDA levels were slightly higher in children with ECC, indicating the role of lipid peroxidation in the carious process.

Salivary and plasma native and non-urate total antioxidant capacity versus oral health status in older non-smoking adults

OBJECTIVE

The aim of this study was to evaluate the salivary C-reactive protein and native and non-urate total antioxidant capacity (TAC) of saliva and plasma in relation to various oral health status indexes in older non-smoking adults.

DESIGN

Oral health status indices involved the Decayed, Missing, Filled Teeth index, the number of decayed teeth, Approximal Plaque Index, Plaque Index and Community Periodontal Index with Treatment Needs. Sixty older patients (67.0 ± 4.5 years) with different levels of oral health were examined. Salivary C-reactive protein was assessed. The Ferric Reducing Ability of Saliva/Plasma (FRAS/FRAP) and 2.2-diphenyl-1-picryl-hydrazyl test of saliva/plasma (DPPHS/DPPH) were used to assess the native and non-urate salivary (FRAS, non-urate FRAS, DPPHS, non-urate DPPHS, and plasma TAC (FRAP, non-urate FRAP, DPPH, non-urate DPPH).

RESULTS

Salivary C-reactive protein, native TAC and non-urate TAC did not correspond to any oral health status index. No relation was found for plasma native and non-urate TAC either. In multivariate analyses, age was the only independent predictor of DPPHS and salivary uric acid (p < 0.05) while non-urate DPPH was only negatively predicted by Body Mass Index (p < 0.001). None of oral health status indices was selected as an independent predictor of salivary and plasma TAC or C-reactive protein of saliva.

CONCLUSION

Oral health status indexes did not appear to influence the native or the non-urate local antioxidant status of saliva, or the systemic antioxidant status of plasma; they had no local effect related to salivary C-reactive protein. However, lower plasma non-urate antioxidant potential was related to overweight/obesity.

Salivary 1,5-Anhydroglucitol and Vitamin Levels in Relation to Caries Risk in Children

The objective of this study was to evaluate the association between salivary 1,5-anhydroglucitol (AG), vitamins A (VA), C (VC), and E (VE), and caries risk in children. 100 healthy children aged between 6 and 13 years were divided into two equal groups of caries-free (DMFS/dmfs=0) and caries active (DMFS/dmfs>3). Unstimulated midmorning saliva was collected from all the children and the levels of salivary AG and vitamins A, C, and E were measured. Caries risk assessment was done using American Academy of Pediatric Dentistry Caries Assessment Tool. Analysis of salivary AG and vitamins was performed using a commercially available ELISA kit. Low levels of AG were present in caries active and high caries risk groups compared to caries-free and low/medium caries risk groups. This difference is statistically significant (p < 0.05). A strong negative correlation between AG and caries activity was observed in the caries active group. VA was not related to caries activity, while VC and VE displayed a statistically significant correlation (p < 0.05). Similarly, a strong negative correlation was observed between the levels of AG and high caries risk group. Salivary AG, VC, and VE together are related to caries risk in caries active children. These salivary parameters can act as indicator of caries status in children.

In vitro selection and in vivo confirmation of the antioxidant ability of Lactobacillus brevis MG000874

AIMS

This study aimed at isolating a probiotic strain from a collection of lactic acid bacteria (LAB) with the high antioxidant property and confirms its potential in d-gal-induced oxidative stress (OS) murine model.

METHODS AND RESULTS

The in vitro antioxidant ability of 16 LAB strains was determined in the cell-free supernatant of 3- to 5-day-old culture, intact cells and cell lysates using three different methods for determining the reactive oxygen species scavenging activity and inhibition of lipid peroxidation. The strain, An28, presented the best antioxidant activity and was identified as Lactobacillus brevis MG000874 on the basis of 16 sRNA gene sequencing. The antioxidant potential of L. brevis MG000874 was confirmed in an OS murine model. Albino mice were exposed to d-galactose at a dose of 150 mg kg^-1 BW and fed with L. brevis MG000874 (0·2 ml of 10¹⁰ CFU per ml cell suspension per animal per day). Antioxidant enzymes were quantified spectrophotometrically in the liver, kidney and serum. Subcutaneous administration of d-gal resulted in decrease in superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) and increase in glutathione-S-transferase (GST) levels in animals. The L. brevis MG000874-treated animals displayed improvement in SOD, CAT and GST in all tissues and GSH in the liver and serum. The safety assessment of L. brevis MG000874 was performed by comparing liver and renal function tests. None of the selected indicators was significantly different from the negative control group.

CONCLUSIONS

The antioxidant potential of 16 strains was noticed to be strain specific and in vivo performance of L. brevis MG000874 was found satisfactory in a d-gal murine model.

SIGNIFICANCE AND IMPACT OF THE STUDY

Lactobacillus brevis MG000874 was identified for its admirable antioxidant property. This strain or/and its metabolites could be further investigated for possible applications in humans and veterinary fields.

MUC7 Level As A New Saliva Risk Factor For Dental Caries In Adult Patients

Purpose: Data currently available indicate the significance of salivary mucins MUC5B and MUC7 in the protection of teeth against caries. Our study aimed to determine the relationship between dental caries in adults and levels of MUC5B and MUC7. Methods: The studies were conducted on 45 adult subjects selected on the basis of dental examination and calculation of the DMFT (Decayed, Missing, and Filled Teeth) index. Among these patients, two research groups were distinguished: group 1 included 19 caries-free subjects (DMFT = 0); and group 2 included 26 patients with severe caries (DMFT > 13.9). Samples of whole unstimulated saliva were collected and centrifuged. MUC5B and MUC7 content in saliva supernatant were estimated using an enzyme-linked immunosorbent sandwich assay (ELISA). Analysis of the obtained data receiver operating characteristic (ROC) curves was employed to define relationships between the contents of the studied mucins and the detected dental caries. Results: In subjects from group 1, the mean level of MUC5B amounted to 0.63 ± 0.35 ng/ml and this was significantly higher than the concentration of mucin in patients of group 2, which amounted to 0.38 ± 0.32 ng/ml (p = 0.023). The mean level of MUC7 amounted to 5.47 ± 1.18 ng/ml and this was significantly higher than the level of the mucin in group 2, which was 1.39 ± 0.86 ng/ml (p< 0.0001). In parallel, a relationship was detected between levels of the examined mucins and manifestation of dental caries. For MUC7, the optimal cut-off value was obtained (i.e. corresponding to 100% sensitivity and specificity), amounting to 2.5 ng/ml for the detection of dental caries risk. Conclusions: Development of dental caries is linked to reduced concentrations of MUC5B and MUC7. The level of MUC7 may represent a significant parameter clinically suitable for evaluation of disease risk.

Evaluation of Salivary Lipid Peroxidation End Product Level in Dental Caries

BACKGROUND

Tissue destruction can be measured by the level of lipid peroxidation (LP) end products. Since free radicals are very reactive with low survival time, the level of free radicals and oxidative stress activity are measured indirectly by tissue damage end product assessment, i.e. Malondialdehyde (MDA) that is a final end product of LP.

OBJECTIVE

The aim of this study was to evaluate salivary MDA level as an indicator of oxidative stress; in caries-active and caries-free students.

METHODS

A total of 100 male and female students, 15-17 years of age, participated in this casecontrol study. Five mL of whole saliva was obtained. Salivary MDA level was measured spectrophotometrically. Statistical comparisons were performed with Student's t-test, using SPSS 13.

RESULTS

Salivary MDA level was significantly higher in the caries-active group compared to the control caries-free group. MDA was also slightly lower in males.

CONCLUSION

Higher MDA level might indicate caries-induced oxidative stress. In this study there was a relationship between salivary MDA level and dental caries. Therefore oxidative stress suppression might prevent caries initiation and progression.

The effects of cigarette smoking and exercise on total salivary antioxidant activity

Objectives

This study was conducted to determine the effects of both cigarette smoking and exercise on total salivary antioxidants and their impact on periodontal health status.

Material & methods

the study group consisted of 120 males, 20–25 years old selected from patients at the College of Dentistry/University of Baghdad. The sample was classified into four groups: cigarettes smokers who exercised, cigarettes smokers who did not exercise, non-smokers who exercised, and non-smokers who did not exercise. The smokers smoked 5–15 Oriental tobacco cigarettes daily for 3–5 years and did not use other types of tobacco. Physical exercises were performed for a half-hour to an hour daily either at home or the gym. Stimulated saliva was collected under standardised conditions and chemically analysed to determine the total salivary antioxidants concentration using a Total Antioxidant Capacity Assay Kit. The periodontal component of the Periodontal Disease Index (PDI) was applied to diagnose and record periodontal health status. Data were analysed using SPSS version 19.

Results

The total salivary antioxidant concentrations were significantly higher among the non-smokers than the smokers and were significantly higher among those who exercised compared to those who did not exercised (P < 0.01). The mean of the periodontal index was significantly higher in the group of smokers than the group of non-smokers and significantly higher among those who did not exercise compared to those who exercised (P < 0.01). Smoking and physical exercises recorded a significant effect on total salivary antioxidants and the mean of the periodontal index (p < 0.01), but there was no significant interaction between these two variables for total salivary antioxidants or the mean of the periodontal index (P > 0.05). Person's correlation coefficient indicated significant negative correlations between the mean of the periodontal index and the total salivary antioxidant concentrations among the four studied groups.

Conclusion

Cigarette smoking and physical exercise may alter total salivary antioxidants activity and the periodontal health status. However, there is no interaction between cigarette smoking and physical exercise regarding total salivary antioxidants and the periodontal health status. Total salivary antioxidants correlated inversely with the periodontal health status and this correlation was not affected by cigarette smoking or physical exercise.

Salivary antioxidant capacity of children with severe early childhood caries before and after complete dental rehabilitation

OBJECTIVE

There is a need to determine whether total antioxidant capacity (TAC) in severe early childhood caries (S-ECC) is an indicator of inflammatory response to the lesion or a marker of the disease. This study compared TAC levels in children with ECC before and after dental treatment and compared the results with those of caries-free children.

DESIGN

Prospective study.

SETTING

A teaching hospital.

PATIENT SELECTION

Salivary samples were obtained from 20 children aged 5 years and diagnosed with S-ECC, and 20 age- and sex-matched controls.

INTERVENTION DETAILS

Complete dental rehabilitation under general anesthesia was performed on the children with S-ECC, and follow-up salivary samples were obtained one week and three months postoperatively. TAC was measured using a commercially available Oxygen Radical Absorbance Antioxidant Assay measurement kit (Zen-Bio ORAC™, AMS Biotechnology, Abington, UK).

OUTCOME MEASURES

Differences between children with and without dental caries were tested using the Mann-Whitney U test; differences before and after dental treatment were analyzed using Friedman test followed by Wilcoxon sign-rank test with Bonferroni correction to compensate for multiple comparisons.

RESULTS

Median TAC (1.54 mcg/L, CI 1.15-1.92) of the control group was significantly lower than that of the treated group prior to treatment (p = 0.003). Treatment of the dental lesions significantly reduced TAC of the treated group, and no significant differences were observed between the test and control groups at either one week (p = 0.076) recall or three-month recall (p = 0.096). TAC in children posttreatment was significantly reduced compared to their pretreatment values (p < 0.001).

CONCLUSION

Total antioxidant capacity in the saliva of children with severe early childhood caries undergoes significant reduction following treatment of the carious lesions.

Urokinase-plasminogen activator protects periodontal ligament fibroblast from oxidative induced-apoptosis and DNA damage

BACKGROUND AND OBJECTIVE

Urokinase-plasminogen activator (uPA) is a serine protease expressed at high basal level in normal gingival cervical fluid. Despite its known pathologic role in tissue proteolysis in periodontitis, little is known concerning uPA physiological function in oral tissue. Recent evidence in cancer cells has implicated the uPA system in DNA repair and anti-apoptotic pathways. This study is aimed to evaluate the protective function of urokinase against oxidative DNA damage in periodontal ligament (PDL) fibroblast, and to propose a new biological role for uPA in oral cavity.

MATERIAL AND METHODS

PDL cells were isolated from human wisdom teeth obtained from healthy donors. An oxidative stress model was created in which PDL cells were incubated with 20, 30, 40 and 60 μmol/L hydrogen peroxide. Twenty-four hours before and after peroxide treatment, cells were treated with uPA and amiloride. Cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5diphenyltetrazolium bromide assay, apoptosis by DAPI-staining and annexin V/propidium iodide assay, and DNA breaks by alkaline comet assay. For estimating DNA damage level, γ-H2AX expression was studied using flow cytometry and immunostaining.

RESULTS

The incubation of the peroxide-treated cells with uPA significantly increased cell viability and decreased apoptosis. A significant decrease in the number of γ-H2AX foci was seen at 30 μmol/L hydrogen peroxide in uPA-treated cells. uPA inhibition as a result of amiloride treatment, in turn, induced a reduction in cell viability. In addition, there was a significant decrease in the levels of DNA damage in uPA-treated groups as measured by the comet assay.

CONCLUSION

The present study brings support to the theory that uPA may have a protective role for periodontal tissue and could protect PDL fibroblasts from oxidative DNA damage and apoptosis.

The Dental Needs and Treatment of Patients with Down Syndrome

Down syndrome is a common disorder with many oral conditions and systemic manifestations. Dentists need to take a holistic approach including behavioral, oral, and systemic issues. This review of the literature focuses on oral anomalies, systemic interaction, management, and recommendations.

Salivary and Serum Antioxidant and Oxidative Stress Markers in Dental Caries

Dental caries is the most common, chronic, noncommunicable, preventable oral disease worldwide. Oxidation may play an important role in dental caries initiation and progression. Antioxidants in body fluids protect cells. The aim of this study was to evaluate salivary and serum total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in dental caries. A total of 118 healthy caries-free and caries-active male and female students participated. Caries was detected clinically. Unstimulated whole-saliva samples and blood samples were obtained. Sialochemical analysis was carried out by spectrophotometric assay. Data were analyzed with the Student t test using STATA 11. Salivary and serum TAC levels in the case and control groups did not show any significant differences. Mean salivary MDA levels in the case and control groups were 0.71 ± 0.1 and 0.35 ± 0.06 nmol/mL, respectively. The results showed significantly higher levels of salivary and serum MDA in the case group compared to the healthy control group. The oxidative stress marker was significantly higher in the caries group compared to the healthy control group. Antioxidants were not significantly different between the two groups. MDA can be produced by dental caries, resulting in a decrease in antioxidant levels, causing disease progression. Further studies are necessary to determine whether MDA is the cause or effect of the disease.

Oxidative stress in the oral cavity is driven by individual-specific bacterial communities

The term "bacterial dysbiosis" is being used quite extensively in metagenomic studies, however, the identification of harmful bacteria often fails due to large overlap between the bacterial species found in healthy volunteers and patients. We hypothesized that the pathogenic oral bacteria are individual-specific and they correlate with oxidative stress markers in saliva which reflect the inflammatory processes in the oral cavity. Temporally direct and lagged correlations between the markers and bacterial taxa were computed individually for 26 volunteers who provided saliva samples during one month (21.2 ± 2.7 samples/volunteer, 551 samples in total). The volunteers' microbiomes differed significantly by their composition and also by their degree of microbiome temporal variability and oxidative stress markers fluctuation. The results showed that each of the marker-taxa pairs can have negative correlations in some volunteers while positive in others. Streptococcus mutans, which used to be associated with caries before the metagenomics era, had the most prominent correlations with the oxidative stress markers, however, these correlations were not confirmed in all volunteers. The importance of longitudinal samples collections in correlation studies was underlined by simulation of single sample collections in 1000 different combinations which produced contradictory results. In conclusion, the distinct intra-individual correlation patterns suggest that different bacterial consortia might be involved in the oxidative stress induction in each human subject. In the future, decreasing cost of DNA sequencing will allow to analyze multiple samples from each patient, which might help to explore potential diagnostic applications and understand pathogenesis of microbiome-associated oral diseases.

Insight into Oral Biofilm: Primary, Secondary and Residual Caries and Phyto-Challenged Solutions

INTRODUCTION

Dental caries is known to be one of the most widespread, chronic infections affecting all ages and populations worldwide. The plethora of oral microbial population paves way for various endogenous infections and plays a crucial role in polymicrobial interactions contributing to biofilm-mediated diseases like caries and periodontal diseases.

METHODS

Extensive literature survey was conducted using the scientific databases like PubMed, Google scholar, Science Direct, etc. using the key words like dental caries, orodental infections, dental microbes, dental biofilm, secondary caries, phytotherapy, etc. The literature was analyzed thoroughly and critical review was performed.

RESULTS

The risk of development of secondary caries and residual caries further results in treatment failure. Drug resistance developed by oral microbes and further side effects pose serious hurdles in the current therapeutic strategies. The hyperactivities of various MMPs and the resulting massive ECM degradation are the challenging part in the design of effective therapeutic approaches. Anticariogenic phytotherapy is well appreciated owing to lesser side effects and versatility of their action. But appreciable outcomes regarding the phytochemical bioavailability and bioretention are still challenging. Site-specific delivery of phytoagents at the infected site may enhance the efficiency of these drugs. Accordingly emerging phytodentistry can be promising for the management of secondary and residual caries.

CONCLUSION

This article presents major cariogens and their mechanisms in initiating and aggravating dental caries. Effectiveness of phytotherapy and different mode of action of phytochemicals against cariogens are outlined. The article also raises major concerns and possibilities of phytochemical based therapeutics to be applied in the clinical arena of caries management.

Renoprotective Effects of Trigonella foenum and Cinnamon on Type 2 Diabetic Rats

Background: Herbal medicine is used in all parts of the world mainly for prevention and treatment of various disorders due to better cultural suitability, lower cost and less side effects. Objectives: The aim of this study was to determine the hypoglycemic and kidney-protective effects of the aqueous extract of Trigonella foenum and Cinnamon on diabetic rats. Methods: In this experimental study, rats were randomly divided into 6 groups as follows: Group 1: control group in which animals received chow diet, group 2: diabetic rats, group 3: diabetic rat + 2% T. foenum extract (w/w), group 4: diabetic rat + 8% of Trigonella foenum extract (w/w), group 5: diabetic rat + 2% Cinnamon extract (w/w) and group 6: diabetic rat + 8% of Cinnamon extract (w/w). Aqueous extract of T. foenum leaves and Cinnamon were administered to diabetic rats for 4 weeks. The malondialdehyde (MDA) level and total antioxidant capacity were also measured in kidney of the animals. In addition, morphological changes of the kidney were also analyzed by the light microscope. Results: Trigonella foenum and Cinnamon extract in diabetic animals significantly reduced MDA levels and restored antioxidant capacity (P<.05). T. foenum and Cinnamon also normalized plasma urea and creatinine concentration in diabetic rats (P<.05). Administration of T. foenum and Cinnamon extract especially at the dose of 8 mg/kg normalized histopatholgical changes of kidney in diabetic animal. Conclusions: The findings of this experiment showed that T. foenum extract and Cinnamon restored antioxidant capacity and structural changes of kidney.

Salivary and Urinary Total Antioxidant Capacity as Biomarkers of Oxidative Stress in Humans

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.

Salivary markers of oxidative stress in oral diseases

Saliva is an interesting alternative diagnostic body fluid with several specific advantages over blood. These include non-invasive and easy collection and related possibility to do repeated sampling. One of the obstacles that hinders the wider use of saliva for diagnosis and monitoring of systemic diseases is its composition, which is affected by local oral status. However, this issue makes saliva very interesting for clinical biochemistry of oral diseases. Periodontitis, caries, oral precancerosis, and other local oral pathologies are associated with oxidative stress. Several markers of lipid peroxidation, protein oxidation and DNA damage induced by reactive oxygen species can be measured in saliva. Clinical studies have shown an association with oral pathologies at least for some of the established salivary markers of oxidative stress. This association is currently limited to the population level and none of the widely used markers can be applied for individual diagnostics. Oxidative stress seems to be of local oral origin, but it is currently unclear whether it is caused by an overproduction of reactive oxygen species due to inflammation or by the lack of antioxidants. Interventional studies, both, in experimental animals as well as humans indicate that antioxidant treatment could prevent or slow-down the progress of periodontitis. This makes the potential clinical use of salivary markers of oxidative stress even more attractive. This review summarizes basic information on the most commonly used salivary markers of oxidative damage, antioxidant status, and carbonyl stress and the studies analyzing these markers in patients with caries or periodontitis.

Evaluation of Total Antioxidant Capacity of Saliva in High School Students

Background and Objective:

Imbalance between oxidative stress and saliva antioxidants plays a major role in initiation and spread of dental caries. The aim of this study was to evaluate the total antioxidant capacity (TAC) of saliva in dental caries.

Methods:

In this case-control study which employed high school students (14-18 years), the un-stimulated saliva samples of 60 students without dental caries (control group) and 60 students with dental caries (with at least 5 teeth levels of dental caries) were gathered. Each group comprised of males (half of cases) and females (half of cases). TAC of saliva was measured by Zellbio® (Netherlands) in terms of micmol/L. The data were analyzed using the SPSS software (ver. 17.0) and t-test with considering significance level at 0.05.

Results:

TAC of saliva was significantly lower in cases with dental caries (0.256±0.106) compared to those without dental caries (0.396±0.077); P< 0.001. There was no statistically significant difference of TAC of saliva between males (0.319±0.119) and females (0.333±0.113) irrespective of dental caries (P=0.507).

Conclusion:

The results of the study indicated that there was a reverse association between dental caries and TAC of saliva.

The effects of anti-hypertensives and type 2 diabetes on salivary flow and total antioxidant capacity

OBJECTIVE

The present cross-sectional study aimed to determine the effect of first-line anti-hypertensive drugs (enalapril, metoprolol, and combinations of enalapril with metoprolol and/or hydrochlorothiazide) on salivary gland function and salivary total antioxidant capacity (TAC) in hypertensive patients with/without diabetes mellitus (DM) type 2.

MATERIALS AND METHODS

Salivary gland function was measured as xerostomia (interview) and unstimulated whole saliva flow rate (UWSFR) in 447 subjects (387 hypertensive and 60 healthy). Salivary TAC was evaluated by spectrophotometric assay.

RESULTS

Enalapril is not xerogenic, while metoprolol and drug combinations are. In the presence of DM type 2, all drugs, except metoprolol, had pronounced xerogenic effect. Binary logistic regression analysis found enalapril to be significantly associated with decreased risk of xerogenic effect development, while DM type 2 with increased risk. In the presence of enalapril in hypertensive patients with/without DM type 2 salivary TAC was similar to that in healthy subjects, while for metoprolol was reduced.

CONCLUSIONS

Enalapril is not xerogenic but is antioxidant, which moderately reduces the risk of xerogenic effect development even in the presence of DM type 2. However, metoprolol and drug combinations exhibit xerogenic effect. In DM type 2, xerogenic effect of all drugs was pronounced except of metoprolol.