非刺激性混合睡液对全口义齿着色影响的实验研究

目的:本研究通过检测牙列缺失的患者全口义齿配戴前后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子的浓度,探讨非刺激性混合唾液对全口义齿着色的影响.方法:按全口义齿着色程度的不同,将90例全口义齿配戴者分成轻、中、重度3组.对各组患者全口义齿配戴前和配戴3个月后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子浓度进行检测.采用单因素方差分析和配对样本资料的t检验进行统计学分析.结果:(1)全口义齿配戴前与配戴后,轻度组的唾液流率以及pH值高于中度组和重度组,Ca2+、Na+、K+离子浓度则低于中度组和重度组,差别有统计学意义(P<0.01).(2)全口义齿配戴后唾液流率0.66±0.17mL/min高于配戴前0.50±0.20mL/min,配戴后pH值6.48±0.22低于配戴前6.71±0.18,Ca2+、Na+、K+离子浓度升高,差别均有统计学意义(P<0.01).结论:非刺激性混合唾液的流率、PH值以及Ca2+、Na+、K+离子浓度的变化影响全口义齿着色的严重程度;全口义齿修复前后唾液的分泌也有所改变.     

Gender difference in unstimulated whole saliva flow rate and salivary gland sizes

OBJECTIVE: A gender difference in the unstimulated whole saliva flow rate (UWSFR) may be due to a difference in the sizes of the salivary glands. In this study, we investigated the relationships among the UWSFR, gland sizes and body sizes of healthy young adult males and females. DESIGN: Unstimulated whole saliva was collected for 5 min by the spitting method in 50 healthy young adults, and the flow rate of the saliva was measured. Heights and weights were measured, and body mass indices (BMI) were calculated. The sizes of the salivary glands were measured by use of a magnetic resonance imaging technique. RESULTS: Parotid and submandibular gland sizes and flow rates in females were significantly smaller than those in males, as were also the weights, heights and BMI. In both males and females, there were significant positive correlations between gland sizes and the flow rates, weights and BMI. The variations of the flow rates were reduced by standardizing them with gland sizes, weights and BMI. CONCLUSIONS: These results suggest that the lower UWSFR in females as compared with males is due to the smaller gland sizes due to the smaller body sizes.     

The host defense peptide LL‐37 is detected in human parotid and submandibular/sublingual saliva and expressed in glandular neutrophils

The human host defense peptide, LL‐37, is an important player in the first line of defense against invading microorganisms. LL‐37 and its precursor, hCAP18, have been detected in unstimulated whole saliva but no reports showing hCAP18/LL‐37 in isolated, parotid, and/or submandibular/sublingual saliva have been presented. Here, we measured the levels of hCAP18/LL‐37 in human parotid and submandibular/sublingual saliva and investigated the expression of hCAP18/LL‐37 in parotid and submandibular gland tissue. Parotid and submandibular/sublingual saliva was collected from healthy volunteers, and the levels of hCAP18/LL‐37 in saliva were analyzed by dot blot, ELISA, and western blotting. Cellular expression of hCAP18/LL‐37 in human parotid and submandibular glands was investigated by immunohistochemistry. Immunoreactivity for hCAP18/LL‐37 was detected in both parotid and submandibular/sublingual saliva of all individuals. The concentration of hCAP18/LL‐37 was similar in parotid and submandibular/sublingual saliva, and was determined by densitometric scanning of each dot and normalization to the total protein concentration of each sample, and by ELISA. Double immunohistochemistry revealed that intravascular neutrophils of both parotid and submandibular glands express hCAP18/LL‐37. For the first time, we demonstrate hCAP18/LL‐37 in isolated human parotid and submandibular/sublingual saliva and expression of hCAP18/LL‐37 in glandular intravascular neutrophils, indicating that neutrophils of the major salivary glands contribute to the LL‐37 content of whole saliva.     

Relationship of chewing-stimulated whole saliva flow rate and salivary gland size

OBJECTIVE: We have recently reported that unstimulated whole saliva flow rates (UWSFR) correlate positively with salivary gland sizes and body profiles of weight and body mass indices. In the present study, the correlations of chewing-stimulated whole saliva flow rates (CWSFR) with salivary gland sizes and the body profiles were investigated, and the results were compared with those of UWSFR. DESIGN: Saliva samples were collected from 24 healthy young males and 26 females by the spitting method while chewing paraffin and the CWSFRs were measured. UWSFR and the estimated sizes of the three major salivary glands in our previous study were used. RESULTS: The CWSFRs in all subjects and in males correlated positively with UWSFR, but not in females. The CWSFRs in all subjects correlated positively with parotid and/or submandibular gland sizes, weights and body mass indices, just as with UWSFR; however, the correlation coefficients with salivary gland sizes were smaller than those of UWSFR. In contrast to the results of UWSFR, the correlation coefficients of the CWSFRs with parotid gland sizes in all subjects were larger than those with the sizes of the submandibular glands. The CWSFRs in males correlated only with parotid gland sizes, and those in females did not correlate with any of the parameters. CONCLUSIONS: The results suggest that the larger the size of the salivary glands, the greater the CWSFR, at least in males.     

一次性18Gy放射对大鼠颌下腺损伤的实验研究

目的:观察一次性18 Gy放射对大鼠颌下腺组织学形态和唾液流率的改变。方法:40只大鼠随机分为实验组和对照组,每组20只。实验组一次性18 Gy局部照射大鼠颌下腺区域,对照组只麻醉不放射。8周后处死所有大鼠,处死前插管法提取大鼠颌下腺唾液,称取其质量,计算唾液流率,比较两组唾液流率的改变。处死后取颌下腺组织,经4%多聚甲醛固定,切片,HE染色,镜下观察颌下腺的组织学形态。结果:放射后实验组进食进水量下降、活动减少。实验组饮水频率高于对照组。对照组的唾液流率为(18.64±8.23)μL/min,实验组的唾液流率是对照组的57.42%,为(10.70±2.22)μL/min。HE染色显示,放射后实验组颌下腺细胞变性,间质血管充血,腺泡细胞内的空泡数量明显增多。结论:放射后大鼠颌下腺唾液流率明显降低,放射后8周,组织学形态出现显著变化。放疗对大鼠颌下腺组织学形态和唾液分泌功能的远期影响,尚需进一步观察和研究。     

鼻咽癌放疗后唾液流率和pH值的变化

目的：研究鼻咽癌放疗对涎腺功能造成放射性损害,为尽量减少和预防鼻咽癌放疗后遗症寻求可能的途径。方法：对2002年收治的38例鼻咽癌患者进行分析,38例均为首次接受放疗的鼻咽癌患者,平均年龄41．4岁,分别在放疗前、后检测混合唾液流率和pH值。结果：放疗后多数患者出现口干,唾液流率显著减少,pH值稍微上升。结论：放射治疗使涎腺功能受到极大破坏,唾液的质和量有很大变化;精确设计放射野,改进放疗技术可以预防和减少放射性涎腺损伤。     

Minor gland and whole saliva in postmenopausal women using a low potency oestrogen (oestriol)

Many women undergo hormone replacement therapy in order to relieve menopausal and postmenopausal symptoms. Oral discomfort is common among these symptoms and studies have shown that the stimulated whole saliva flow rate is increased after combined oestradiol and progesterone replacement therapy. There is, however, no data regarding the effect of other oestrogens or of oestrogen alone on whole and minor gland saliva. In the present study, the flow rate from minor salivary glands (buccal, labial and palatal) and the secretion rate and buffer capacity of whole saliva was examined in 18 postmenopausal women (61-76 years) prior to, and during 1 year of a low potency oestrogen (oestriol) use. The ability of whole saliva to aggregate and mediate bacterial adherence as well as subjective feelings of dry mouth was also examined. For comparison, the same variables were examined in nine peri- and postmenopausal, non-medicated women (reference group, 53-61 years). During hormone treatment, the labial saliva flow was significantly increased and the complaints of dry mouth reduced. Increased stimulated whole saliva flow was seen in both the hormone and reference groups. This was also true for the stimulated whole saliva buffer capacity, which was increased parallel to the flow rate. The secretion rates were generally lower in the hormone group compared to the reference group throughout the study period. Except for stimulated whole saliva, statistical analysis at baseline revealed no age-related reduction of the saliva flow rates. The ability of whole saliva to mediate aggregation of Actinomyces naeslundii was significantly decreased after hormone treatment. Thus, the present findings indicate that a low dose oestrogen (oestriol) may affect the flow rate of labial salivary glands and the bacterial aggregation activity of whole saliva.     

Expectations and final evaluation of complete dentures by patients,dentist and dental technician

Summary There is a poor association between the dentist’s evaluation of denture quality and patients’ satisfaction with their dentures. Possible differences between dental professionals and patients’ expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post‐treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post‐treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0·001). The patients also presented higher post‐treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0·016, Kendall’s W = 0·207) and function (P = 0·002, Kendall’s W = 0·303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0·017) and function (P = 0·003). There was no correlation between expectations and post‐treatment completion ratings according to the patients’ age. There was also no correlation between the patients’ gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post‐treatment was significantly higher than his expectations.     

Salivary gland 99mTc-scintigraphy: a grading scale and correlation with major salivary gland flow rates

Sequential salivary gland scintigraphy with 99mTc-technetium pertechnetate (Tc-99) is a safe, minimally invasive test for study of major salivary glands. However, its relationship to salivary function has not been investigated in detail. We have investigated the relationship between major salivary gland flow rates and Tc-99 scans and developed a new rating scale using scans of a control group with normal salivary function. Salivary flow rates and Tc-99 scans were obtained from healthy, non-medicated subjects (n = 33) and from xerostomic patients (n = 22). There were significant differences between the groups for salivary flow rates and Tc-99 ratings. Significant correlations were found between salivary flow rates and Tc-99 ratings in the control and xerostomic groups. The Tc-99 rating scale proved reliable in assessing salivary dysfunction, and showed a high inter-examiner correlation. These results demonstrate the usefulness of salivary gland scintigraphy in assessing major salivary gland flow rates and the utility of a new rating scale.     

Correlation between patient satisfaction with complete dentures and denture quality,oral condition,and flow rate of submandibular/sublingual salivary glands

PURPOSE: The purpose of this study was to examine the correlation between patient satisfaction with complete dentures and parameters of denture quality, oral condition, and flow rate of the submandibular and sublingual salivary glands. MATERIALS AND METHODS: The parameters were evaluated on 50 denture wearers using semiquantitative scales and a recently described submandibular/sublingual saliva collector. RESULTS: Most patients had a medication-induced reduced salivary flow rate (mean 0.024 mL/min/gland; SD 0.040). Submandibular/sublingual salivary flow rate correlated statistically with six denture satisfaction parameters: maxillary denture retention and comfort, mandibular denture retention and comfort, abilities of chewing, and speech. Residual alveolar ridge resilience, maxillary ridge shape, and denture quality did not significantly correlate with denture satisfaction. Characteristics of musculature correlated significantly only with subjective maxillary denture retention, and mandibular ridge shape correlated with comfort. CONCLUSION: Submandibular/sublingual salivary flow rate is an important factor in denture satisfaction. The retention of the maxillary denture was correlated to the oral musculature characteristics, and the mandibular denture comfort was correlated to the mandibular ridge shape. Denture satisfaction was not affected by other anatomic or denture quality-related parameters.     

Dentist and patient appraisal of complete dentures in a Dutch elderly population

The majority of the Dutch elderly population wears full dentures. According to clinical standards these dentures are often of a poor quality. The treatment demand, however, is small. The purpose of the present study is to describe the quality of dentures by means of clinical criteria on the one hand and judgments of the patients on the other. 131 denture-wearing individuals, with a mean age of 71, participated. A "denture quality" scale was constructed, consisting of five clinical parameters. The judgments of the respondents were recorded in terms of complaints and satisfaction with the dentures. The results show weak or nonsignificant correlations between the denture quality and the subjective measures. After dichotomizing the denture quality score (treatment need vs no treatment need), however, the poorer dentures appeared to be related to more complaints. It was concluded that for planning purposes it seems valid to use clinical figures. On the individual level the prediction of the subjective appraisal of full dentures on the basis of a clinical appreciation appears not to be adequate.     

Helicobacter pylori and ammonia concentrations of whole, parotid and submandibular/sublingual saliva

The aim of this study was to determine the ammonia concentration in whole, parotid and submandibular/sublingual saliva of healthy volunteers using the indophenol direct method. It also investigated the hypothesis that higher saliva ammonia concentrations are associated with the presence of Helicobacter pylori (H. pylori) in the oral cavity. In healthy volunteers, the mean ammonia concentration of whole saliva (2574 μmol/l) was significantly higher (P<0.0001) than the mean ammonia concentration of both parotid (238 μmol/l) and submandibular/sublingual (355 μmol/l) saliva. In whole saliva, no difference in ammonia concentration was found between healthy controls and dyspeptic patients (mean ammonia values 2574 and 2489 μmol/l respectively, P=0.7). In addition, no significant differences were observed in the salivary ammonia concentration between dyspeptic patients with and without H. pylori carriage. It is concluded that the ammonia concentration in parotid and submandibular/sublingual saliva does not differ, but is significantly lower than the ammonia concentration of whole saliva. This difference is not due to carriage of H. pylori with its strong urease activity. Therefore, the determination of ammonia in whole saliva is an inappropriate screening test for patients being at risk for (chronic) gastritis and peptic ulcer disease. Received: 24 November 1998 / Accepted: 19 April 1999     

Fabrication of complete dentures in three visits using existing prosthesis—a simplified technique for geriatric patients

Complete edentulism often limits patients’ ability to masticate and perform other oral functions, resulting in a reduction of oral‐health‐related quality of life. Although the two‐implant mandibular overdenture may be considered as a minimum standard of treatment of complete edentulism, patients often prefer conventional complete dentures due to cost and surgical procedures related to implant supported dentures. Many complete denture patients may have limited access to dental care due to socioeconomic or health issues, hence there is a need in simplification of complete denture fabrication. Researchers have proposed “simplified” techniques to fabricate complete dentures by eliminating two stage impression procedures facebow transfer, and articulator programming, with impressive initial results. However, long‐term clinical data of these techniques is unavailable. A novel technique for fabricating simplified complete dentures in three visits, using patient's existing dentures is presented here. Unlike previously described techniques on “simplified” dentures, this technique does not eliminate vital steps such as border‐molded impressions, facebow transfer, verification of centric relations during try‐in, programming of the articulator, and balancing procedures.     

健康成人刺激性全唾液流速及一氧化氮含量的增龄性变化

目的:研究不同年龄阶段健康成人的刺激性全唾液流速及唾液一氧化氮含量的变化。方法:将97例健康成人分成4个年龄组,分别为青龄组(20~39岁)、中龄组(40~59岁)、老龄组(60~79岁)、长寿组(80岁以上)。在上午8:00~10:00空腹,以2.5ml/L洗必太漱口,以20ml/L柠檬酸刺激舌背前1/3,以双蒸水漱口后采集全唾液5min,记录样本容量,并计算其流速。用硝酸还原酶法检测唾液中NO浓度,并计算其唾液中NO的单位时间含量。结果:(1)青龄组刺激性全唾液流速高于中龄组、老龄组、长寿组(P<0.05);中龄组、老龄组、长寿组之间唾液流速无显著性差异(P>0.05);(2)不同年龄组间两两比较,刺激性全唾液NO浓度无显著性差异(P>0.05);青龄组NO单位时间含量显著高于中龄组、老龄组和长寿组(P<0.05),中龄组、老龄组、长寿组之间的NO单位时间含量无显著性差异(P>0.05)。结论:(1)中老年人群的刺激性全唾液流速显著低于青年人群;(2)随年龄增长,健康成人刺激性全唾液中的NO浓度未发生明显变化,但其单位时间含量呈降低趋势。     

不同颌位记录方法对全口义齿再修复患者咀嚼效率的影响

目的比较3种记录颌位关系方法对全口义齿再修复患者不同时期咀嚼效率的影响。方法随机选择20名全口义齿再修复患者采取自身对照的方法,每位患者分别采用直接咬合法、哥特式弓描记法、哥特式弓联合面弓转移颌位关系法制作3副全口义齿,并比较不同方法下制作的义齿在患者即刻佩戴义齿时、佩戴义齿3个月后的咀嚼效率的差异。结果患者即刻佩戴义齿时咀嚼效率测定结果显示,使用哥特式弓联合面弓转移颌位关系法制作全口义齿的患者咀嚼效率明显高于使用其他2种方法制作全口义齿的患者（P〈0．05）,而使用直接咬合法与哥特式弓描记法制作全口义齿的患者咀嚼效率没有差异;佩戴义齿3个月后,3组患者的咀嚼效率无明显差异。结论使用哥特式弓联合面弓转移颌位关系法可为患者提供更可靠的颌位记录方法,可以提高患者的即刻咀嚼效率,提高患者的满意度和医生的工作效率。     

Salivary flow rate and clinical characteristics of patients with xerostomia according to its aetiology

Summary The purpose of the present study was to investigate the differences in salivary flow rates and dry mouth‐related subjective symptoms and behaviours in patients with xerostomia according to its aetiology. One hundred and forty patients (24 men and 116 women, mean age, 58·1 ± 13·3 years) with a chief complaint of xerostomia were included. The patients were divided into five groups; Sjögren’s syndrome (n = 34), post‐radiation therapy in the head and neck region (n = 16), antipsychotic medications (n = 30), systemic diseases or medications affecting salivary flow (n = 35), and unknown aetiology (n = 25). The patients were asked a standardized series of questions concerning dry mouth, and their whole salivary flow rates were measured. Patients with a history of radiation therapy displayed the most decreased values of salivary flow rates and the most severe associated symptoms and behaviours while patients with unknown aetiology displayed the least decreased values of salivary flow rates and relatively favourable symptoms and behaviours. A burning sensation in the mouth was the most prevalent in patients with systemic diseases or those who were taking medications while altered taste perception was the most prevalent in patients taking antipsychotics. In conclusion, patients with xerostomia displayed various degrees of discomfort related to the quality of life according to the aetiology of their conditions.     

Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oral Candida infection in patients with oral lichen planus

Many factors have been proposed to influence oral infection with yeast. The aim of this study was to determine the prevalence of oral yeasts in oral lichen planus (OLP) patients and control subjects, and to perform a multiple logistic regression analysis to identify factors that influence oral Candida infection in OLP patients. In this cross‐sectional study, 90 new patients with OLP and 90 sex‐ and age‐matched control subjects with no mucosal lesions were interviewed about their health status, use of medication, and smoking and alcohol habits. Swab and unstimulated whole saliva samples were collected and salivary pH was measured. A positive Candida culture was more prevalent among OLP patients (48.9%) than among control subjects (26.7%). Candida albicans was the most frequently isolated species in both groups. By logistic regression analysis, unstimulated whole salivary flow rates of 0.11–0.24 ml min^?1 (OR = 5.90) and 0.25–0.32 ml min^?1 (OR = 3.51) and benzodiazepine anxiolytics intake (OR = 8.30) were independently associated with the presence of Candida among OLP patients. Age, denture wearing, levels of dentition, decreased salivary pH, antihypertensive drugs, and alcohol consumption were not associated with oral Candida infection in OLP patients. The results indicate that data on benzodiazepine anxiolytics intake and evaluation of unstimulated whole salivary flow rate should be considered as part of the clinical evaluation to identify OLP patients at risk for Candida infection.     

Patterns of secretion of mucins and non-mucin glycoproteins in human submandibular/sublingual secretion

The present investigation has characterised the influence of gustatory stimulation and duration of stimulation on the secretion pattern of salivary mucins MG1 and MG2 and non-mucin glycoproteins in submandibular/sublingual secretion (SMSL). Resting SMSL was collected for three 2 min intervals and stimulated SMSL was collected for ten 1 min intervals from six healthy subjects. Flow rates and total protein were significantly different under the two conditions. The secretion patterns of these proteins under resting and stimulated conditions was examined on periodic acid-Schiff reagent (PAS)-stained polyacrylamide gels using a Kodak Digital-Science Image Station. Image analyses revealed that the level of MG1 increased and the level of MG2 remained nearly the same after stimulation. Six other major glycoproteins (designated Band 1-6) were identified on the basis of their electrophoretic mobilities and immuno-reactivity on Western blots. After stimulation the intensity of Band 1 (lactoferrin and peroxidase) and Band 2 (amylase) decreased whereas the intensity of Band 3 (carbonic anhydrase), Band 4 (proline-rich glycoprotein) and Bands 5 and 6 (basic glycosylated proline-rich proteins) increased. These patterns probably reflect secretion from preformed vesicles since de novo synthesis would be unexpected within the time frame of these experiments. The variable patterns observed suggest that mucins and non-mucin glycoproteins in SMSL derive from different subsets of secretory vesicles, some of which may originate in mucous and others in serous acini, as well as in ductal cells. Quantification of mucins was performed by image analysis technology using purified MG1 and MG2 standards. Finally, the present investigation has shown that the secretory patterns of mucins and non-mucin glycoproteins from submandibular/sublingual glands are complex and represent an important aspect of salivary gland physiology.     

Relationship between salivary flow rate and clinical symptoms and behaviours in patients with dry mouth

The purpose of this study was to investigate the relationship between whole salivary flow rate and dry mouth-related subjective symptoms and behaviours in patients with dry mouth. Seventy-eight patients (13 men and 65 women, 58.2 +/- 13.5 years) with dry mouth were asked a standardized series of questions concerning dry mouth-related symptoms and behaviours. Whole salivary flow rates were measured under unstimulated and stimulated conditions. The effect of oral dryness on daily life was significantly associated with the flow rate of stimulated whole saliva (r(s) = -0.30, P < 0.01) and frequency of oral dryness (r(s) = 0.46, P < 0.01). Dry mouth-related symptoms and behaviours were significantly associated with the whole salivary flow rate and the correlation was more remarkable with respect to stimulated whole saliva. The most common dry mouth-associated complaint was sensation of burning mouth. The effect of oral dryness on daily life was significantly affected by the presence of taste disturbances. Collectively, dry mouth-related symptoms and behaviours were significantly associated with whole salivary flow rate. Moreover, the severity of dry mouth-related symptoms was more closely correlated with the flow rate of stimulated saliva, compared with the unstimulated flow rate.