The relationship between levels of salivary and serum interleukin-6 and oral lichen planus: A systematic review and meta-analysis

Background

The relationship between levels of salivary and serum interleukin (IL)-6 and oral lichen planus (OLP) is not understood fully. The authors conducted a systematic review and meta-analysis to compare levels of salivary and serum IL-6 among people with OLP and healthy control participants.

Psychological problems and quality of life of patients with oral mucosal diseases: a preliminary study in Chinese population

Background

Psychological problems might play important roles in oral mucosal diseases such as recurrent aphthous ulcers (RAU), oral lichen planus (OLP), burning mouth syndrome (BMS), but the relevance to patients’ quality of life remained controversial. The aim of this study was to investigate the psychological problems and oral health-related quality of life in patients with RAU, OLP, and BMS in China, to assess the relationship between psychological problems and quality of life.

Method

Thirty-nine RAU patients, 45 OLP patients, 15 BMS patients and 45 healthy controls were enrolled in the study. Hospital Anxiety and Depression Scale (HADS) were chosen to analyze the patients’ psychological problems. Oral Health Impact Profile (OHIP-14) was used to measure the OHRQoL. The scores of HADS and OHIP-14 were used to analyze the relationship between psychological problems and the quality of life of oral mucosa patients.

Results

Each of OHIP-14 scores and HADS scores in RAU, OLP, BMS was higher than the control group, and there was significant difference in the patients groups with the control cases(P <?0.05). OHIP-14 score of RAU was the highest in three patient groups. Its OHRQoL was lowest in the three groups, which had statistical significance (P <?0.05). Positive correlations existed between the psychological problems and the quality of life of the three patient groups (r_s >?0, P <?0.05), except for the depression of the BMS group (r_s =?0.168, P =?0.395).

Conclusion

Patients with oral mucosal diseases such as RAU, OLP, and BMS had higher levels of anxiety, depression, and lower quality of life. The patient’s psychological problems were related to their quality of life, suggesting that the psychological state of patients with oral mucosal disease need more attention.

     

Assessment of orofacial dysfunctions, salivary cortisol levels and oral health related quality of life (ORHQoL) in young adults

Objective

To investigate the relationship of orofacial dysfunction and salivary cortisol levels with oral health quality of life (ORHQoL) in young adults.

Design

Thirty individuals of both genders (22.93 ± 2.42 years) participated. The orofacial dysfunction was evaluated using the Nordic Orofacial Test-Screening (NOT-S) and the ORHQoL using the Oral Health Impact Profile (OHIP-49). Saliva samples were collected during three days, at waking up and 30 min after, obtaining the awakening cortisol response – ACR. The data were analysed by Mann–Whitney test, Spearman's correlation and multiple linear regression (α = 0.05). The NOT-S scores and ACR (μg/dl) were dichotomized by the median (2.0 and 0.15, respectively).

Results

NOT-S and ACR showed similar values between genders (P > 0.05). The individuals with NOT-S scores above the median presented values of “physical pain” domain significantly higher than the individuals with scores bellow or equal to the median. Significant correlations were found between the OHIP-49 domains “physical pain” and “physical disability” and NOT-S scores. In multiple linear regression, significant values were observed between NOT-S and OHIP-49 and the domains physical pain, physical disability, psychological disability, social disability and handicap, with determination coefficients ranging from 0.09 to 0.15. There was not association with the ACR.

Conclusions

Individuals with orofacial dysfunction presented impairment in ORHQoL, but not enough to change salivary cortisol levels. Furthermore, gender did not have influence on ORHQoL in the studied sample.     

The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus

OBJECTIVE: The aim of this study was to determine any association between anxiety and salivary cortisol levels in oral lichen planus (OLP) patients by the case-control method. DESIGN RELEVANT: Forty patients with OLP were evaluated. The OLP diagnosis was established through a composite of accepted clinical and histopathological characteristics. Forty patients from the register of patients who obtained general dental care were selected as controls. MATERIAL AND METHOD: The saliva samples collected between 9:00 and 9:15 am were analysed for the level of cortisol with Cortisol EIA that used competitive enzyme-linked immunosorbent assay method. Trait and state anxiety levels of 80 patients were measured using the Spielberger's State-Trait Anxiety Inventory. RESULTS: The mean level of cortisol from 40 saliva samples in study group was 1.46 and 0.93 microg dl(-1) in 40 controls (P=0.001). The mean level for state anxiety in the study group were 48.85 and 39.45 in control group (P=0.001). Trait anxiety levels in study group were 49.77 and 38.51 in control group (P=0.001). We found that salivary cortisol, state and trait anxiety levels in OLP group were significantly higher than in the control group. CONCLUSION: Because of the fact that the level of anxiety and salivary cortisol of OLP patients were high, our findings concluded that this disease is closely related with stress. Thus besides traditional treatment of OLP patients, our findings suggest that psychological support is also needed.     

Salivary tissue factor concentration and activity in patients with oral lichen planus

Purpose

This study aimed to evaluate the tissue factor (TF) concentration and activity in patients with oral lichen planus (OLP) under oxidative stress.

复发性阿弗他溃疡患者焦虑与唾液皮质醇和脱氢表雄酮水平的相关性研究

目的:探讨复发性阿弗他溃疡(RAU)患者焦虑与唾液皮质醇水平、唾液脱氢表雄酮(DHEA)水平及其比值的相关性。方法:上午8~10点之间收集唾液样本,并采用医院焦虑抑郁量表焦虑分表(HAD-A)评估RAU实验组(30例)和对照组(30例)的焦虑状态,采用酶联免疫吸附法测定受试者唾液中皮质醇及 DHEA的水平,并计算二者间的比值。结果:RAU实验组的焦虑得分、唾液皮质醇水平及唾液皮质醇/DHEA比值均明显高于对照组(P<0.05);唾液DHEA水平虽低于对照组,但差异无统计学意义。RAU组唾液皮质醇水平及唾液皮质醇/DHEA的比值与焦虑得分呈正相关(r=0.685,r=0.641,P<0.01),而唾液DHEA水平与焦虑得分呈负相关(r=-0.494, P<0.01)。结论:焦虑与RAU的发病有关。因此,对于RAU患者除了传统的治疗方法外,适当的心理支持疗法也是必要的。     

Association of masticatory performance with age, gender, number of teeth, occlusal force and salivary flow in Japanese older adults: is ageing a risk factor for masticatory dysfunction?

Objective

In general, ageing is a risk factor for sensory and motor deterioration, with the rate of decline varying amongst individuals. Concerning masticatory function, missing teeth along with oral disease seem to accelerate the dysfunction. Here, we aimed to confirm whether masticatory dysfunction by ageing is inevitable. This study investigated the effect of age, gender, number of natural teeth, occlusal force and salivary flow on the masticatory performance in a large sample of elderly adults.

Design

The study sample consisted of 1288 independently living people aged 60–84 years. Masticatory performance was determined by the comminuted particles of test food. Bilateral maximal occlusal force in the intercuspal position was measured with pressure sensitive sheets. Stimulated whole saliva was collected.

Results

Masticatory performance was significantly correlated to age, number of residual teeth, occlusal force and stimulated salivary flow rate by Pearson's correlation test. The multiple linear regression analysis showed that, with other variables controlled, masticatory performance was significantly associated with the number of residual teeth (β = 0.456, P < 0.001), occlusal force (β = 0.244, P < 0.001) and stimulated salivary flow rate (β = 0.069, P = 0.003). Age was not related to masticatory performance (β = −0.007, P = 0.753).

Conclusions

Declines in the number of residual teeth, occlusal force and salivary flow were associated with a reduction of masticatory performance in older adults. If tooth loss is not considered as an attribute of physiological ageing, then ageing by itself may not be a risk factor for masticatory dysfunction.     

Levels of potential oral cancer salivary mRNA biomarkers in oral cancer patients in remission and oral lichen planus patients

Objectives

To gather preliminary data concerning the feasibility of using seven salivary mRNAs—IL-8; IL-1β; dual specificity phosphatase 1 (DUSP1); H3 histone family 3A (H3F3A); ornithin decarboxylase antizyme 1 (OAZ1); S100 calcium-binding protein P (S100P); and spermidine/spermine N1-acetyltransferase 1 (SAT1)—for detecting development of oral squamous cell carcinoma (OSCC) in oral lichen planus (OLP) patients and OSCC patients whose disease was in remission.

Materials and methods

Saliva samples were collected from five study groups (25 subjects/group): newly diagnosed OSCC, OSCC-in-remission, disease-active OLP, disease-inactive OLP, and normal controls. The salivary mRNA levels were determined by a pre-amplification RT-qPCR approach with nested gene-specific primers. Mean fold changes between each pair of study groups were analyzed by the Mann–Whitney U test.

Results

Salivary levels of OAZ1, S100P, and DUSP1 mRNAs were significantly higher in newly diagnosed OSCC patients, compared to: (1) normal controls (p?=?0.003; p?=?0.003; and p?<?0.001, respectively); (2) OSCC-in-remission (p?<?0.001; p?=?0.001; and p?<?0.001, respectively); (3) disease-active OLP (p?<?0.001; p?=?0.016; and p?<?0.001, respectively); and (4) disease-inactive OLP (p?=?0.043; p?<?0.001; and p?<?0.001, respectively). No significant differences were found in the levels of salivary IL-8, IL-1β, H3F3A, and SAT1 mRNAs between newly diagnosed OSCC patients and the normal controls (p?=?0.093, 0.327, 0.764, and 0.560, respectively).

Conclusion

Salivary OAZ1, S100P, and DUSP1 mRNAs are candidate biomarkers for detecting OSCC development in OSCC patients in remission and in OLP patients.

Clinical relevance

The results of this study serve as the basis for a further large-scale study which may lead to a non-invasive screening method for early detection of OSCC.     

Association of Gingival Crevicular Fluid Cortisol/Dehydroepiandrosterone Levels With Periodontal Status

Background: The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress‐related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. Methods: One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme‐linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non‐periodontitis; group 2, localized CP; and group 3, generalized CP. Results: There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non‐periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). Conclusions: Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.     

Unstimulated and stimulated salivary characteristics of 12-13-year-old schoolchildren with and without dental erosion

Objective

To evaluate unstimulated and stimulated salivary characteristics of 12–13-year-old schoolchildren with and without dental erosion.

Design

The subjects were sixty schoolchildren from 12–13 years old (30 boys and 30 girls) with dental erosion and sixty age- and sex-matched controls. Unstimulated and stimulated whole saliva were collected. Flow rate, pH level, buffering capacity, bicarbonate, buffer base, calcium, phosphorus and urea concentrations of whole saliva were measured. All data were analysed using SPSS 13.0.

Results

The flow rate, pH, bicarbonate, buffer base, calcium, phosphorus, and urea of unstimulated and stimulated saliva did not differ significantly between the dental erosion group and the control group (P > 0.05). The stimulated salivary buffering capacity did not vary between the two groups (Fisher's exact test, P > 0.05).

Conclusion

The salivary characteristics are similar amongst 12–13-year-old schoolchildren with and without dental erosion in Southern China.     

Evaluation des intraoperativen Einsatzes standardisierter Hypnose mit State-Trait-Angst-Inventar (STAI)

Background

Surgical treatment under local anesthesia is commonly restricted by limited compliance of patients. Hypnosis may represent an alternative to sedation or general anesthesia. As the procedure demonstrated promising prospects during 1-year experience, the observed hypnosis-induced effects are now being evaluated in clinical studies.

Patients and method

The prospective study included 50 patients scheduled for dental surgery. All procedures were performed under standardized surgical conditions. The experimental group (n=25) received supplementary standardized tape hypnosis, whereas the control group received standard treatment (only local anesthesia). Individual and situative anxiety levels were determined by the State-Trait Anxiety Inventory (STAI).

Results

After simultaneous increase of preoperative state anxiety, anxiety levels in the hypnosis group showed a significant intraoperative reduction to baseline level, whereas intraoperative anxiety of the control group (n=25) remained unchanged.

Conclusions

Hypnosis reduces intraoperative anxiety of oral and maxillofacial patients significantly. Further clinical studies on the use of hypnosis are considered useful.     

Oral lichen planus may enhance the expression of Th17-associated cytokines in local lesions of chronic periodontitis

Objectives

This study aims to compare the expression levels of interleukin (IL)-17 and IL-23 in local periodontal tissues from patients with both chronic periodontitis and oral lichen planus (CP-OLP), patients with chronic periodontitis (CP) only, patients with oral lichen planus (OLP) only, and healthy controls (HC).

Materials and methods

The periodontal tissues were collected from 15 CP-OLP patients, 15 CP patients, 15 OLP patients, and 10 healthy controls. Immunohistochemistry (IHC) and real-time quantitative PCR (qPCR) was performed to investigate the protein and mRNA expression level of IL-17 and IL-23 in periodontal lesions from these four groups.

Results

IHC statistical analysis showed that the expression level of IL-17- and IL-23p19-positive cells significantly increased in CP-OLP group compared with that in CP (P?<?0.01) and OLP groups (P?<?0.05), showing intense staining reaction in local lamina propria lesions. Meanwhile, qPCR result showed higher IL-17 mRNA level in CP-OLP compared with that in CP and OLP groups and demonstrated a significant increase than OLP group (P?<?0.05). Moreover, it was found that IL-17 mRNA expression level in erosive CP-OLP patients was significantly correlated with probing depth and attachment loss (P?<?0.05).

Conclusions

This study indicated that there was an increased expression level of IL-17 and IL-23 in periodontal tissues from periodontitis patients with oral lichen planus, which might aggravate the inflammatory response in local lesions.

Clinical relevance

Oral lichen planus and chronic periodontitis may have interaction in disease pathogenesis, while IL-17 detection in local lesions may be helpful in identifying the disease severity in periodontitis patients with oral lichen planus.     

Effects of smoking on salivary C-telopeptide pyridinoline cross-links of type I collagen and osteocalcin levels

Aim

This study was planned to investigate whether smoker patients with inflammatory periodontal disease exhibit different salivary concentrations of C-telopeptide pyridinoline cross-links of type I collagen (ICTP) and osteocalcin (OC) compared to the non-smoker and/or ex-smoker counterparts.

Methods

Whole saliva samples, full-mouth clinical periodontal recordings were obtained from 67 otherwise healthy patients with inflammatory periodontal disease. According to self-reports there were 34 smokers, 22 non-smokers and 11 ex-smokers. Salivary cotinine, ICTP and OC levels were determined by enzyme-linked immunoassays.

Results

Salivary cotinine measurements confirmed self-reports about smoking. Smoker patients revealed significantly higher plaque index values than non-smokers (p < 0.05). Bleeding on probing values were significantly lower in smoker group than ex-smoker group (p < 0.05). There was no significant difference between the study groups in salivary ICTP levels (p > 0.05). OC levels in smoker group was significantly lower than the other groups (p < 0.001). Salivary ICTP levels correlated negatively with number of teeth present (p < 0.05), positively with bleeding on probing (p < 0.01). Salivary OC levels correlated negatively with years smoked (p < 0.01).

Conclusions

Within the limits of this study, smoking seems to suppress salivary osteocalcin level but ICTP levels seem not to be affected by smoking status. This suppression in OC levels may be one mechanism of deteriorating effects of smoking on periodontal health.     

Evaluation of stress and pain during rapid maxillary expansion treatments

Summary The purpose of this study was to use salivary cortisol levels, pressure pain threshold (PPT) and Spielberger’s State‐Trait Anxiety Inventory for Children (STAIC) to assess stress, anxiety and pain during the expansion and retention phase of rapid maxillary expansion (RME) in children and investigate to whether this parameters are associated with gender or skeletal maturity stages. STAIC was used to assess the anxiety levels of the children. Salivary samples were collected for stress hormone determination. Visual Analog Scale was used for pain determination. Pressure pain threshold (PPT) was measured by using algometer. Data collection was performed a week before RME treatment (T0), at the day of the expansion appliance was bonded (T1), at the days of 1st, 4th, 7th, 14th, 25th, 36th activations of expansion screw (T2, T3, T4, T5, T6, T7) and after the retention period of 3 months (T8). The results of this study showed that the differences were statistically significant within‐day (P < 0·001) and within‐hours (P < 0·001) in cortisol levels during treatment. PPT levels were statistically significant within sex differences and skeletal maturity stages (P < 0·05). State‐trait anxiety scale scores were similar with respect to gender (P > 0·05). There were statistically significant differences of state‐trait anxiety levels between pre and post‐treatment stages (P < 0·05). The maximum number of patients reporting pain were days at T3 and T4. From day T5 the percentage of patients reporting pain then gradually reduced. Based on the findings of this study, it has been shown that RME leads to changes in patients’ state‐trait anxiety and cortisol levels.     

Levels of salivary stress markers in patients with anxiety about halitosis

Objective

To investigate the relationship between salivary stress markers and mental stress states in patients complaining of oral malodour. The utility of the salivary stress markers in assessment of mental conditions of those patients was also investigated.

Design

The study population included 74 patients, aged 20-59 years, who complained of oral malodour and were referred to the Breath Odor Clinic at Tokushima University Hospital. Patients were classified into two groups, genuine halitosis (GH) and psychosomatic halitosis (PH), according to the results of organoleptic rating measurement. All patients were subjected to examination by the Cornell Medical Index (CMI) Health Questionnaire. Resting saliva was collected and levels of salivary IgA, cortisol and chromogranin A were determined by ELISA. Twenty-three volunteers not complaining of halitosis were included as the control group. Kruskal-Wallis test and Mann-Whitney's U-test were used for statistical analysis.

Results

A significant increase was observed in the concentrations of salivary cortisol in the PH group as compared with GH and control groups (p < 0.05). Concentrations of IgA and chromogranin A in saliva were not significantly different among the three groups. In addition, higher salivary cortisol concentrations were found in CMI scale III and IV (tendency towards neurosis) than in scale I and II (normal) (p < 0.05). Since salivary cortisol reflects a status of chronic stress condition, psychosomatic halitosis might be closely related to this state of chronic stress.

Conclusions

Determination of cortisol levels in saliva may provide useful information for evaluating the mental status of patients complaining of halitosis.     

Lichen planus orale e lesioni lichenoidi. Una guida per l’odontoiatra

Objectives

To provide dentists with up-to-date information on the management of patients with oral lichen planus (OLP).

Materials and methods

We reviewed clinically relevant papers retrieved via a search of PubMed, Embase, and Scopus databases.

Results

OLP is a chronic inflammatory disease of unknown etiology, which is characterized by bilateral, symmetrically distributed, reticular lesions involving the oral mucosa (although other clinical variants are frequently observed). Patients may be asymptomatic or complain of a burning sensation of variable intensity. The diagnosis is based on clinical and histological data. Because of the chronic nature of the disease, topical immunosuppressive drug therapy is indicated when there are symptomatic or ulcerated lesions. Periodic reassessment is useful because of OLP is potentially malignant.