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BMJ Clinical Evidence Sep 2014Halitosis can be caused by oral disease or by respiratory tract conditions such as sinusitis, tonsillitis, and bronchiectasis, but an estimated 40% of affected...
INTRODUCTION
Halitosis can be caused by oral disease or by respiratory tract conditions such as sinusitis, tonsillitis, and bronchiectasis, but an estimated 40% of affected individuals have no underlying organic disease.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in people with physiological halitosis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 11 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: artificial saliva; cleaning, brushing, or scraping the tongue; regular use of mouthwash; sugar-free chewing gums; and zinc toothpastes.
Topics: Chewing Gum; Halitosis; Humans; Mouthwashes; Saliva, Artificial; Tongue; Toothpastes
PubMed: 25234037
DOI: No ID Found -
The Journal of Prosthetic Dentistry Apr 2019Complete dentures fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have become popular. The 2 principal CAD-CAM techniques,...
STATEMENT OF PROBLEM
Complete dentures fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have become popular. The 2 principal CAD-CAM techniques, milling and rapid prototyping (3D printing), used in the fabrication of complete dentures have been reported to yield clinically acceptable results. However, clinical trials or in vitro studies that evaluated the accuracy of the 2 manufacturing techniques are lacking.
PURPOSE
The purpose of this in vitro study was to compare the differences in trueness between the CAD-CAM milled and 3D-printed complete dentures.
MATERIAL AND METHODS
Two groups of identical maxillary complete dentures were fabricated. A 3D-printed denture group (3DPD) (n=10) and a milled denture group (MDG) (n=10) from a reference maxillary edentulous model. The intaglio surfaces of the fabricated complete dentures were scanned at baseline using a laboratory scanner. The complete dentures were then immersed in an artificial saliva solution for a period of 21 days, followed by a second scan (after immersion in saliva). A third scan (after the wet-dry cycle) was then made after 21 days, during which the complete dentures were maintained in the artificial saliva solution during the day and stored dry at night. A purpose-built 3D comparison software program was used to analyze the differences in the trueness of the complete dentures. The analyses were performed for the entire intaglio surface and specific regions of interest: posterior crest, palatal vault, posterior palatal seal area, tuberosity, anterior ridge, vestibular flange, and mid-palatal raphae. Independent t tests, ANOVA, and post hoc tests were used for statistical analyses (α=.05).
RESULTS
The trueness of the milled prostheses was significantly better than that of the rapid prototyping group with regard to the entire intaglio surface (P<.001), posterior crest (P<.001), palatal vault (P<.001), posterior palatal seal area (P<.001), tuberosity (P<.001), anterior ridge (baseline: P<.001; after immersion in saliva: P=.001; after the wet-dry cycle: P=.011), vestibular flange (P<.001), and mid-palatal raphae (P<.001).
CONCLUSIONS
The CAD-CAM, milled complete dentures, under the present manufacturing standards, were superior to the rapidly prototyped complete dentures in terms of trueness of the intaglio surfaces. However, further research is needed on the biomechanical, clinical, and patient-centered outcome measures to determine the true superiority of one technique over the other with regard to fabricating complete dentures by CAD-CAM techniques.
Topics: Computer-Aided Design; Denture Design; Denture, Complete; Humans; Maxilla; Printing, Three-Dimensional
PubMed: 30711292
DOI: 10.1016/j.prosdent.2018.09.001 -
Supportive Care in Cancer : Official... Jun 2020The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing... (Randomized Controlled Trial)
Randomized Controlled Trial
Alleviation of dry mouth by saliva substitutes improved swallowing ability and clinical nutritional status of post-radiotherapy head and neck cancer patients: a randomized controlled trial.
PURPOSE
The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients.
METHODS
Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake.
RESULTS
After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001).
CONCLUSIONS
Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients.
CLINICAL TRIAL REGISTRY
Clinicaltrials.gov NCT03035825.
Topics: Deglutition; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Nutritional Status; Saliva; Saliva, Artificial; Single-Blind Method; Treatment Outcome; Xerostomia
PubMed: 31732852
DOI: 10.1007/s00520-019-05132-1 -
Stroke Jan 2018The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibrillation.
METHODS
We performed a systematic review and meta-analysis of all observational real-world studies comparing apixaban with other available oral anticoagulant drugs.
RESULTS
From the original 9680 results retrieved, 16 studies have been included in the final meta-analysis. Compared with warfarin, apixaban regular dose was more effective in reducing any thromboembolic event (odds ratio: 0.77; 95% confidence interval: 0.64-0.93), but no significant difference was found for stroke risk. Apixaban was as effective as dabigatran and rivaroxaban in reducing thromboembolic events and stroke. The risk of major bleeding was significantly lower for apixaban compared with warfarin, dabigatran, and rivaroxaban (relative risk reduction, 38%, 35%, and 46%, respectively). Similarly, the risk for intracranial hemorrhage was significantly lower for apixaban than warfarin and rivaroxaban (46% and 54%, respectively) but not dabigatran. The risk of gastrointestinal bleeding was lower with apixaban when compared with all oral anticoagulant agents (<0.00001 for all comparisons).
CONCLUSIONS
Use of apixaban in real-life is associated with an overall similar effectiveness in reducing stroke and any thromboembolic events when compared with warfarin. A better safety profile was found with apixaban compared with warfarin, dabigatran, and rivaroxaban.
Topics: Anticoagulants; Atrial Fibrillation; Clinical Trials as Topic; Female; Humans; Intracranial Hemorrhages; Male; Polymers; Pyrazoles; Pyridones; Risk Factors; Rivaroxaban; Saliva, Artificial; Stroke; Vitamin K; Warfarin
PubMed: 29167388
DOI: 10.1161/STROKEAHA.117.018395 -
International Journal of Molecular... Jun 2019The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased... (Review)
Review
The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.
Topics: Animals; Anti-Infective Agents; Biomimetic Materials; Humans; Microfluidics; Saliva; Viscosity; Xerostomia
PubMed: 31261876
DOI: 10.3390/ijms20133199 -
Journal of Pharmacy & Bioallied Sciences Nov 2021In clinical practice, xerostomia or oral dryness is a chronic disease condition encountered by most dentists and dental hygienists, which often causes a negative impact... (Review)
Review
In clinical practice, xerostomia or oral dryness is a chronic disease condition encountered by most dentists and dental hygienists, which often causes a negative impact on the oral health-related quality of life of the affected individual. Xerostomia is caused due to salivary gland dysfunction. It is related to reduced salivary secretion or the absence of saliva flow, more frequently, exhibits qualitative changes in saliva proteins and immunoglobulin concentrations that arise due to salivary gland dysfunction. This condition causes discomfort and interferes with normal oral activities, and affected individuals are at high caries risk. There are several options for treatment and symptom management: salivary stimulants, topical agents, saliva substitutes, and systemic sialogogues. This review explores the current status of therapeutic management of patients affected by xerostomia and hyposalivation using artificial saliva.
PubMed: 35017895
DOI: 10.4103/jpbs.jpbs_236_21 -
Journal of Physiology and Pharmacology... Dec 2017Examination of dental materials and their properties at the initial stage of the digestive process requires the development of conditions that mimic the environment of... (Review)
Review
Examination of dental materials and their properties at the initial stage of the digestive process requires the development of conditions that mimic the environment of the oral cavity. One of the main components of this area is saliva, where many reactions occur under natural conditions. Human saliva is an important physiological fluid that is essential for the maintenance of good oral health and of the entire human body; it is the place where digestion begins and thus contributes to the supply of those nutrients and health-promoting substances that are essential to the body but may also cause release of potential toxins. Thereby, the main aim of the study was to review the use of artificial saliva models in the context of stomatological and biological research. Biological studies have shown that the amount of biologically active substances in biological material is not the same as their quantity released under the conditions of the human digestive system and thus bioavailable to it. These results show that tables of active ingredients in drugs and food stuffs do not present their actual usefulness and availability to the human body.
Topics: Humans; Saliva; Saliva, Artificial
PubMed: 29550792
DOI: No ID Found -
Pharmaceuticals (Basel, Switzerland) Aug 2023Xerostomia, commonly known as dry mouth, is a widespread oral health malfunction characterized by decreased salivary flow. This condition results in discomfort, impaired... (Review)
Review
Xerostomia, commonly known as dry mouth, is a widespread oral health malfunction characterized by decreased salivary flow. This condition results in discomfort, impaired speech and mastication, dysphagia, heightened susceptibility to oral infections, and ultimately, a diminished oral health-related quality of life. The etiology of xerostomia is multifaceted, with primary causes encompassing the use of xerostomic medications, radiation therapy to the head and neck, and systemic diseases such as Sjögren's syndrome. Consequently, there is a growing interest in devising management strategies to address this oral health issue, which presents significant challenges due to the intricate nature of saliva. Historically, natural products have served medicinal purposes, and in contemporary pharmaceutical research and development, they continue to play a crucial role, including the treatment of xerostomia. In this context, the present review aims to provide an overview of the current state of knowledge regarding natural compounds and extracts for xerostomia treatment, paving the way for developing novel therapeutic strategies for this common oral health issue.
PubMed: 37631049
DOI: 10.3390/ph16081136 -
Journal of Texture Studies Apr 2021The aim of this review is to assess the objective and subjective diagnosis, as well as symptomatic topical treatment of dry mouth conditions with a clear focus on... (Review)
Review
The aim of this review is to assess the objective and subjective diagnosis, as well as symptomatic topical treatment of dry mouth conditions with a clear focus on textural perspective. We critically examine both the current practices as well as outline emerging possibilities in dry mouth diagnosis and treatment, including a patent scan for saliva substitutes. For diagnosis, salivary flow rates and patient-completed questionnaires have proven to be useful tools in clinical practice. To date, objective measurements of changes in mechanical properties of saliva via rheological, adsorption, and tribological measurements and biochemical properties of saliva such as assessing protein, mucins (MUC5B) are seldom incorporated into clinical diagnostics; these robust diagnostic tools have been largely restricted to application in non-clinical settings. As for symptomatic treatments of dry mouth, four key agents including lubricating, thickening, adhesive, and moisturizing agents have been identified covering the overall landscape of commercial saliva substitutes. Although thickening agents such as modified celluloses, polysaccharide gum, polyethylene glycol, and so forth are most commonly employed saliva substitutes, they offer short-lived relief from dry mouth and generally do not provide boundary lubrication properties of real human saliva. Innovative technologies such as self-assembly, emulsion, liposomes, and microgels are emerging as novel saliva substitutes hold promise for alternative approaches for efficient moistening and lubrication of the oral mucosa. Their adoption into clinical practice will depend on their efficacies, duration of relief, and ease of application by the practitioners and patient compliance.
Topics: Humans; Lubrication; Mucins; Saliva; Saliva, Artificial; Xerostomia
PubMed: 33274753
DOI: 10.1111/jtxs.12575