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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 -
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 -
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 -
European Review For Medical and... Nov 2022We aimed at evaluating some chemical-physical properties of artificial saliva substitutes easily available on the E.U. market, such as viscosity, pH, buffering capacity,...
OBJECTIVE
We aimed at evaluating some chemical-physical properties of artificial saliva substitutes easily available on the E.U. market, such as viscosity, pH, buffering capacity, superficial tension, density and spinnbarkeit and to compare the results with human natural saliva bibliographic data.
MATERIALS AND METHODS
Based on the easy availability on the market, twelve artificial saliva solutions in liquid formulation were analyzed. Kinematic viscosity (cSt) was determined using a micro-Ubbelohde model capillary viscosimeter (ViscoClock, SCHOOT-GERATE Mainz, Germany). Dynamic viscosity (mPas) was determined, through a simple multiplication between density (g/cm3) and kinematic viscosity of each solution. pH analyses were carried out at room temperature using a pH-meter (Mettler Toledo®- Five Easy, Columbus, OH, USA). Spinnbarkeit analysis was performed by a self-owned instrument built for the purpose.
RESULTS
The median density value, obtained from the cohort of artificial saliva substitutes, was 1.036 g/cm3. The median value of the kinematic viscosity was 8.984 cSt. The median spinnbarkeit value was 3.2 mm and the median pH value was 6.29. In this study we found an almost linear correlation between the kinematic viscosity and spinnbarkeit values of the artificial saliva substitutes evaluated.
CONCLUSIONS
Saliva substitutes should be as faithful as possible to the characteristics of human saliva, in order to completely replace its functions in the oral cavity. Nevertheless, despite several R&D efforts, it is difficult to reproduce all the different features that belongs to natural saliva in one device. Therefore, it would be desirable to create more products reproducing saliva with various rheological characteristics in respect of the main salivary functions such as: chewing, speaking and tissue coating.
Topics: Humans; Saliva, Artificial; Viscosity; Rheology; Saliva; Physical Examination
PubMed: 36394731
DOI: 10.26355/eurrev_202211_30132 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Aug 2021To investigate the dynamic process of the self-assembly behaviors of a full-length human amelogenin (AM) and its functional fragments tyrosine-rich amelogenin peptide...
OBJECTIVES
To investigate the dynamic process of the self-assembly behaviors of a full-length human amelogenin (AM) and its functional fragments tyrosine-rich amelogenin peptide (TRAP) and leucine-rich amelogenin peptide(LRAP) and its role in hydroxyapatite (HA) crystal formation.
METHODS
The full-length human AM and its functional fragments, TRAP and LRAP, were reassembled and purified . The protein solution of 100 µg‧mL, pH=8, was prepared in Tris-HCl and incubated at room temperature for 1-15 min. Their self-assembly behaviors were observed and compared under a transmission electron microscope (TEM). The full-length AM was added to artificial saliva and incubated for 3 days. A scanning electron microscope (SEM) was used in observing the morphology of the induced new crystals. Then, TARP and LRAP were added. The resulting solution was incubated for 3 days and then observed again.
RESULTS
When pH=8, the full-length human AM and TRAP assembly started spontaneously and formed "nanospheres" after 15 min.The nanospheres formed by TRAP existed independently, with a uniform size but without obvious internal structures. The full-length AM was assembled hierarchically, which formed "nanospheres" and further extended in all directions, formed a chain structure, and then aggregated into a net. The self-assembly behavior of LRAP was not obvious. Proteins mostly existed in the form of monomers without "nanosphere" formation. Only few oligomers were observed. The full-length AM was induced independently for 3 days to form rod-shaped HA crystals. TRAP and LRAP proteins were added, after 3 days the crystal elongation was obvious in the c axis, but the growth in plane A and plane B was poor.
CONCLUSIONS
The self-assembly and mineralization behaviors of full-length human AM, TRAP, and LRAP were consistent with the directional growth mechanism of HA crystals , providing a theoretical basis for the role of the fragments in the growth and maturation of HA crystals.
Topics: Amelogenin; Dental Enamel Proteins; Durapatite; Humans
PubMed: 34409797
DOI: 10.7518/hxkq.2021.04.007 -
International Journal of Molecular... Mar 2020Saliva plays a crucial role in oral cavity. In addition to its buffering and moisturizing properties, saliva fulfills many biofunctional requirements, including...
Saliva plays a crucial role in oral cavity. In addition to its buffering and moisturizing properties, saliva fulfills many biofunctional requirements, including antibacterial activity that is essential to assure proper oral microbiota growth. Due to numerous extra- and intra-systemic factors, there are many disorders of its secretion, leading to oral dryness. Saliva substitutes used in such situations must meet many demands. This study was design to evaluate the effect of core-shell magnetic nanoparticles (MNPs) adding (gold-coated and aminosilane-coated nanoparticles NPs) on antimicrobial (microorganism adhesion, biofilm formation), rheological (viscosity, viscoelasticity) and physicochemical (pH, surface tension, conductivity) properties of three commercially available saliva formulations. Upon the addition of NPs (20 µg/mL), antibacterial activity of artificial saliva was found to increase against tested microorganisms by 20% to 50%. NPs, especially gold-coated ones, decrease the adhesion of Gram-positive and fungal cells by 65% and Gram-negative bacteria cells by 45%. Moreover, the addition of NPs strengthened the antimicrobial properties of tested artificial saliva, without influencing their rheological and physicochemical properties, which stay within the range characterizing the natural saliva collected from healthy subjects.
Topics: Anti-Infective Agents; Bacterial Adhesion; Biofilms; Candida; Elasticity; Electric Conductivity; Gold; Magnetite Nanoparticles; Pseudomonas; Saliva, Artificial; Silanes; Streptococcus; Surface Tension; Viscosity
PubMed: 32183193
DOI: 10.3390/ijms21061979 -
Polymers Nov 2019Polycaprolactone (PCL) and polylactide (PLA) are the two most common biodegradable polymers with potential use in oral applications. Both polymers undergo mainly slow...
Polycaprolactone (PCL) and polylactide (PLA) are the two most common biodegradable polymers with potential use in oral applications. Both polymers undergo mainly slow hydrolytic degradation in the human body. However, specific conditions of the oral cavity, like elevated temperature, low pH, and presence of saliva affect the rate of hydrolysis. The study examined the properties of solid samples of PCL and PLA subjected to degradation in phosphate buffered saline (PBS) and artificial saliva (AS) at temperatures of 37 or 42 °C, and pH values 2 or 7.4. A number of tests were performed, including measurement of the degree of swelling, weight loss, molecular weight, differential scanning calorimetry, and thermogravimetry of polymers, as well as hardness and tensile strength. Additionally, topography and stiffness of surfaces using atomic force microscopy are presented. It has been noticed that in the artificial saliva, the processes of polymer degradation occur slightly more slowly, and the effects of temperature and pH are less pronounced. We believe that a layer of porcine gastric mucin from artificial saliva that adsorbed on the surface of polymers may have a key role in the observed differences; this layer resembles protective mucin coating tissues in the oral cavity.
PubMed: 31739431
DOI: 10.3390/polym11111880