Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

The use of conventional transcutaneous electrical nerve stimulation in chronic facial myalgia patients

Objectives

The aim of this study was to evaluate the efficacy of conventional TENS in women affected by chronic facial myalgia.

Materials and methods

The study was performed on 49 women affected by chronic facial myalgia randomly allocated in the TENS group (34 women) and the control group (15 women). The subjective level of pain was assessed by the Visual Analogue Scale indicating the mean (VAS MEAN), the maximum (VAS MAX) and the current intensity of pain (VAS NOW). The level of pain at the muscular palpation sites was assessed by the Pericranial Muscle Tenderness Score (PTS) and the Cervical Muscle Tenderness Score (CTS).

The TENS therapy lasted for 10 weeks, and data were collected at baseline, after 5, 10, 15 and 25 weeks. The differences between groups before and after treatment were compared with the Mann-Whitney and the Kolmogorov-Smirnov tests. The intra-group differences were compared with the one-way ANOVA test.

Results

The results showed that the VAS MEAN, VAS MAX, PTS and CTS were significantly reduced in the TENS group compared to the control group after 10 weeks of TENS (p < 0.05). The intra-group analysis revealed a decreasing tendency of VAS MEAN, VAS MAX, VAS NOW, PTS and CTS in the TENS group in a 25-week period (p < 0.05).

Conclusions

The study demonstrated the efficacy of conventional TENS in patients with chronic facial myalgia and the decrease in both subjective and objective pain.

Clinical relevance

Conventional TENS is a safe, non-invasive, easy-to-administer therapy for chronic facial myalgia.

     

Platelet indices (mean platelet volume and platelet distribution width) have correlations with periodontal inflamed surface area in coronary artery disease patients: A pilot study

1 Background

The plausible mechanisms regarding the relationship between periodontitis and coronary artery disease (CAD) has long been the focus of studies. This study aimed to test the hypothesis that higher periodontal inflamed surface area (PISA) values have positive correlations with increased complete blood parameters in patients with CAD.

2 Methods

Patients who underwent coronary angiography with a suspicion of CAD between the ages 30 to 75 years were included. Clinical periodontal parameters (probing depth [PD], clinical attachment loss, bleeding on probing) were recorded, and the participants were divided into four groups after the coronary angiography: group 1: CAD (+) with periodontitis (n = 20), group 2: CAD (+) without periodontitis (n = 20), group 3: CAD (‐) with periodontitis (n = 21), group 4: CAD (‐) without periodontitis (n = 16). Complete blood counts were analyzed regarding the differences and correlations between the investigated parameters.

3 Results

CAD (+) P (+) individuals had significantly higher platelet distribution width (PDW) values than the other groups (P < 0.0125). Positive lower correlations were found between PISA scores and mean platelet volume (MPV, P = 0.021, rho = 0.264), PISA and PDW (P = 0.240, rho = 0.036) in the whole study group; and moderate correlation between PD and red blood cell distribution width (RDW, P = 0.049, rho = 0.445) in CAD (‐) groups with/without periodontitis were found. Age was found to predict CAD with o lower OR (1.17, P < 0.01).

4 Conclusion

The results of the present study highlight some blood parameters (PDW, RDW, and MPV) in CAD patients with/without periodontitis in terms of the relationship between inflammatory diseases and their significant low and moderate correlations with PISA values.     

Evaluation of the xerostomia,taste and smell impairments after Covid-19

Background The purpose of this study was to explore the effects of coronavirus disease 19 (Covid-19) on the oral cavity by evaluating the oral findings in the patients who recovered after treatment.Material and Methods This study involved confirmed Covid-19 patients whose treatment completed at least two weeks ago. A questionnaire consist of eight parts was applied to explore the oral findings after Covid-19. Also stimulated salivary flow rate was evaluated with a salivary flow test.Results 177 patients reached and 107 of them participate in the study. Regarding gender significant differences were found in terms of the presence of taste impairment after treatment (p=0.007), the degree of taste (p=0.021) and smell (p=0.010) impairment. 18 % (5/27) of the patients evaluated were showed hyposalivation. No significant differences were observed regarding salivary flow between males (mean±SD: 1.14±0.65) and females (mean±SD: 1.12±0.43), (p=0.928); among the patients having treatment at home (mean±SD: 1.03±0.48) or hospital (mean±SD: 1.33±0.65), (p=0.187). In some of the patients’ taste [15], smell [23] impairment, and xerostomia [43] still observed at least two weeks after the treatment is completed.Conclusions The most frequent finding in patients after the treatment was xerostomia. Taste and smell impairments were more frequently observed in females. Key words:Saliva, oral findings, hyposalivation, Covid-19.     

Progressive muscle relaxation therapy to relieve dental anxiety: a randomized controlled trial

Dental anxiety causes patients to refuse or delay treatment, which may exacerbate oral diseases. The aim of the current randomized controlled trial was to determine whether progressive muscle relaxation therapy could relieve dental anxiety. The trial included 68 periodontal patients with dental anxiety scores of ≥13 who were randomly assigned to either an intervention group or a control group (n = 34 per group). The intervention group was administered progressive muscle relaxation therapy for 20 min and oral health education for 15 min before periodontal treatment once per week for 4 wk. The control group was provided with oral health education only, for the same duration. Changes in dental anxiety, depression symptoms, blood pressure, heart rate, and salivary cortisol were evaluated 4 wk and 3 months after the intervention. The intervention group exhibited statistically significantly greater reductions in dental anxiety scores than did the control group at the 4‐wk (?3.82 vs. ?0.89) and 3‐month (?4.22 vs. ?0.28) assessments. They also exhibited significantly greater reductions in depression symptoms, systolic and diastolic blood pressure, pulse rate, and salivary cortisol levels at both time‐points. Progressive muscle relaxation therapy relieves tension and anxiety in dental patients.     

Design of a randomized controlled double-blind crossover clinical trial to assess the effects of saliva substitutes on bovine enamel and dentin in situ

Background  

Hyposalivation is caused by various syndromes, diabetes, drugs, inflammation, infection, or radiotherapy of the salivary glands. Patients with hyposalivation often show an increased caries incidence. Moreover, hyposalivation is frequently accompanied by oral discomfort and impaired oral functions, and saliva substitutes are widely used to alleviate oral symptoms. However, preference of saliva substitutes due to taste, handling, and relief of oral symptoms has been discussed controversially. Some of the marketed products have shown demineralizing effects on dental hard tissues in vitro. This demineralizing potential is attributed to the undersaturation with respect to calcium phosphates. Therefore, it is important to modify the mineralizing potential of saliva substitutes to prevent carious lesions. Thus, the aim of the present study was to evaluate the effects of a possible remineralizing saliva substitute (SN; modified Saliva natura) compared to a demineralizing one (G; Glandosane) on mineral parameters of sound bovine dentin and enamel as well as on artificially demineralized enamel specimens in situ. Moreover, oral well-being after use of each saliva substitute was recorded.     

Impact of SARS-CoV-2 on saliva: TNF-⍺, IL-6, IL-10, lactoferrin,lysozyme, IgG,IgA, and IgM

ObjectivesUnderstanding the role of certain salivary components, such as TNF-?, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM, in airway defense during the ongoing SARS-CoV-2 pandemic is essential. The salivary immune barrier of patients with COVID-19 may play a role in their prognosis. The present study aims to evaluate the impact of SARS-CoV-2 on saliva composition.MethodsA longitudinal study was carried out with male and female firefighters aged 24–48 years. The study sample (n = 34) was divided into 3 groups: asymptomatic volunteers with a negative polymerase chain reaction (PCR) test for SARS-CoV-2 (group 1, Control, n = 21); patients with symptoms of COVID-19 of less than 7 days’ duration and a diagnosis of SARS-CoV-2 infection by PCR (group 2, COVID-19, n = 13); and recovered patients from group 2 who were free of COVID-19 symptoms for at least 2 months (group 3, post-COVID-19 recovery, n = 13). All groups underwent real-time PCR to detect the presence of SARS-CoV-2, as well as analysis of the salivary concentrations of TNF-?, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM by the ELISA method.ResultsLactoferrin concentrations were significantly decreased in the infected group (COVID-19) when compared to those not infected by SARS-CoV-2 (control) (p = 0.032). IgA concentrations were decreased in the COVID-19 and post-COVID-19 groups compared to the control group (p = 0.005 and p = 0.016, respectively). Comparison of the COVID-19 and post-COVID-19 groups also revealed an increase in IgM concentrations during acute SARS-CoV-2 infection (p = 0.010).ConclusionSARS-CoV-2 alters the composition of the salivary immune barrier.     

Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures

The aim of this study was to compare patient-reported outcome measures (PROMs) of soft tissue substitutes versus autogenous grafts for soft tissue augmentation procedures at implant sites. Comprehensive and systematic literature searches were performed until December 2021. A focused question was formulated based on the Population, Intervention, Comparison and Outcome criteria (PICO): In patients with dental implants undergoing soft tissue augmentation (P), do soft tissue substitutes (I) compared to autogenous soft tissue graft (SCTG [subepithelial connective tissue graft]) (C) limit the post-operative morbidity and other patient reported-outcomes measures (O). Randomized controlled clinical trials, prospective-, retrospective- and case-series studies were included. Meta-analyses were performed whenever possible and the results were expressed as weighted mean differences (WMD). A total of 29 clinical studies were included. For mucosal thickness gain, soft tissue substitutes significantly reduced the pain perception compared to SCTG (n = 4; WMD = 14.91 Visual Analog Scale [VAS] units; 95% confidence interval [CI] 6.42-23.40; P < .0006) based on a 0-100 VAS scale. Based on a 0-10 VAS scale, a borderline significance of pain reduction was found when soft tissue substitutes were applied (n = 4; WMD = 1.62 VAS units; 95% CI 0.01-3.23; P = .05). For keratinized tissue gain, soft tissue substitutes significantly reduced the pain perception after keratinized tissue augmentation compared to SCTG based on a 0-100 VAS scale (n = 2; WMD = 21.43 VAS units; 95% CI 12.58-30.28; P < .0001). Based on the 0-10 VAS scale, soft tissue substitutes significantly reduced the pain as compared to SCTG (n = 4; WMD = 1.65 VAS units; 95% CI 0.66-2.64; P = .001). Regarding pain medication, soft tissue substitutes required less painkillers (n = 6; WMD = 1.56 tablets; 95% CI 1.22-1.91; P < .00001) after soft tissue augmentation. The surgery time was significantly reduced when soft tissue substitutes were used (n = 5; WMD = 10.9 minutes; 95% CI 4.60-17.19; P < .00001). There were no significant differences in satisfaction, aesthetics, and quality of life (OHIP-14) between soft tissue substitutes and autogenous grafts following soft tissue augmentation at implants sites. Soft tissue substitutes, compared to autogenous grafts, significantly improve PROMs following soft tissue augmentation at implant sites. Soft tissue substitutes can reduce pain perception, amounts of painkillers and surgery time while achieving similar levels of patient´s satisfaction as autogenous grafts without impairing the clinical outcomes. The current evidence indicates that they constitute a valid and reliable alternative to minimize the invasiveness in soft tissue augmentation procedures at implant sites.     

Factors influencing relative speech intelligibility in patients with oral squamous cell carcinoma: a prospective study using automatic,computer-based speech analysis

Oral squamous cell carcinoma (OSCC) and its treatment impair speech intelligibility by alteration of the vocal tract. The aim of this study was to identify the factors of oral cancer treatment that influence speech intelligibility by means of an automatic, standardized speech-recognition system. The study group comprised 71 patients (mean age 59.89, range 35–82 years) with OSCC ranging from stage T1 to T4 (TNM staging). Tumours were located on the tongue (n = 23), lower alveolar crest (n = 27), and floor of the mouth (n = 21). Reconstruction was conducted through local tissue plasty or microvascular transplants. Adjuvant radiotherapy was performed in 49 patients. Speech intelligibility was evaluated before, and at 3, 6, and 12 months after tumour resection, and compared to that of a healthy control group (n = 40). Postoperatively, significant influences on speech intelligibility were tumour localization (P = 0.010) and resection volume (P = 0.019). Additionally, adjuvant radiotherapy (P = 0.049) influenced intelligibility at 3 months after surgery. At 6 months after surgery, influences were resection volume (P = 0.028) and adjuvant radiotherapy (P = 0.034). The influence of tumour localization (P = 0.001) and adjuvant radiotherapy (P = 0.022) persisted after 12 months. Tumour localization, resection volume, and radiotherapy are crucial factors for speech intelligibility. Radiotherapy significantly impaired word recognition rate (WR) values with a progression of the impairment for up to 12 months after surgery.     

Influence of periodontal treatment on subgingival and salivary microbiotas

1 Background

The purpose of this study was to characterize and compare subgingival and salivary microbiotas before and after periodontal treatment to learn if any changes of the subgingival microbiota were reflected in saliva. We tested the hypothesis that salivary levels of specific periopathogens correlate with corresponding subgingival levels before and after periodontal treatment.

2 Methods

Twenty‐five patients with generalized chronic periodontitis completed the study. Stimulated saliva samples and subgingival plaque samples were collected at baseline and 2, 6, and 12 weeks after nonsurgical periodontal therapy. Subgingival and salivary microbiotas were processed by means of the Human Oral Microbe Next Generation Sequencing (HOMINGS) technique and characterized based on relative abundance. Spearman signed rank test was used to test correlation of periopathogens in subgingival and saliva samples.

3 Results

Periodontal treatment resulted in significantly higher relative abundance of Streptococcus, Rothia and Actinomyces in combination with a significant decrease in Porphyromonas and Treponema in subgingival plaque samples. Relative abundance of the overall predominant genera in saliva was not influenced by periodontal treatment. However, there was a positive correlation between samples of subgingival plaque and saliva before and after periodontal treatment (p < 0.0001) with respect to relative abundance of specific periopathogens, such as Porphyromonas gingivalis (r = 0.68), Prevotella intermedia (r = 0.72), Filifactor alocis (r = 0.58), Treponema denticola (r = 0.51), Tannerella forsythia (r = 0.45) and Parvimonas micra (r = 0.45).

4 Conclusions

Subgingival and salivary abundance of periodontal pathogens correlated before and after treatment. Thus, data from this study suggest that periopathogens identified in saliva may be spill‐over from the subgingival microbiota.     

Survival and complications: A 9- to 15-year retrospective follow-up of dental implant therapy

Long-term follow-up of oral implant therapy seldom report all biological and technical complications. The objective of this study was to evaluate the long-term (9-15 years) outcome after dental implant therapy, assess survival and complication rates. In addition, to identify the risk indicators of these complications at patient and implant levels. Patients (n = 376) treated with dental implants (n = 1095) between 1999 and 2005 at a specialist clinic in Stockholm, Sweden, were included. Longitudinal data were collected retrospectively from digital dental records. A subset of the included patient underwent a clinical examination at the 9-15 years follow-up (n = 163). Chi-square tests, Kaplan-Meier analyses and the general estimating equations (GEE) procedure were adopted for multilevel analyses. The cumulative implant survival rate up to 15 years was 82.6% (SE 4.1%). The prevalences of biological and technical complications at patient level were 52% and 32%, respectively. In total, 763 complications occurred, 65% of patients experienced at least one complications. Implant loss occurred significantly more frequently in subjects with a history of treated severe periodontitis Stage III-IV (P = .008) and in cases when complications were registered during implant surgery (P = .010). Smoking was a significant risk indicator for peri-implantitis (P = .006). The long-term implant survival and complication rates at patient level were 83% and 79%, respectively. Implant loss was significantly more frequent for subjects with a history of treated severe periodontitis and if complication was registered during implant surgery. Smoking was a significant risk indicator for peri-implantitis.     

A prospective study of salivary gland function in patients undergoing radiotherapy for squamous cell carcinoma of the oropharynx

OBJECTIVE: We sought to investigate the impact of head and neck cancer treatment on salivary function. STUDY DESIGN: The study was conducted on 54 patients with advanced squamous cell carcinoma with confirmed (n = 50) or suspected (n = 4) primary oropharyngeal localization who were treated with radiation alone or in combination with surgery or chemotherapy, or both. The following groups were considered in the evaluation: 1, the entire pool of patients; 2, those undergoing surgery and those not undergoing surgery before radiation; 3, those undergoing resection and those not undergoing resection of the submandibular gland. The flow rates, pH, and buffering capacity were determined before, during, and up to 12 months after the completion of radiation. RESULTS: Head and neck surgery, particularly when submandibular gland resection was performed, had a negative impact on salivary flow rates but did not influence pH or buffering capacity. Nonetheless, the effect of surgery on salivary flow rates decreased progressively and disappeared at 3 to 6 months after radiotherapy. More than two thirds of the salivary output was lost during radiation treatment. All patients were experiencing salivary dysfunction at 1 year after completion of radiotherapy, with average decreases of 93% (P < .0001) and 95% (P < .0001) for whole resting salivary flow and whole stimulated salivary flow, respectively, compared with the preradiotherapy values. The buffering capacity decreased to 67% of its preradiotherapy value, and whole stimulated saliva became acidic. CONCLUSIONS: The result of this study confirms that cancer treatment involving full-dose radiotherapy (RTH) to all major salivary glands for locally advanced squamous cell carcinoma of the oropharynx induces severe hyposalivation with alteration of salivary pH and buffering capacity. Head and neck surgery has a negative impact on salivary flow rates, especially when the submandibular gland is removed. However, surgery before irradiation is not a factor aggravating hyposalivation when postoperative radiotherapy includes all the major salivary glands.     

Stem cells and the repair of radiation‐induced salivary gland damage

Oral Diseases (2011) 17 , 143–153 Hyposalivation underlying xerostomia after radiotherapy is still a major problem in the treatment of head and neck cancer. Stem cell therapy may provide a means to reduce radiation‐induced hyposalivation and improve the quality of life of patients. This review discusses the current status in salivary gland stem cell research with respect to their potential to attenuate salivary gland dysfunction. Knowledge on the embryonic development, homeostasis and regeneration after atrophy of the salivary glands has provided important knowledge on the location of the salivary gland as well as on the factors that influence proliferation and differentiation. This knowledge has helped to locate, isolate and characterize cell populations that contain the salivary gland stem cell, although the exact tissue stem cell is still unidentified. The role that stem/progenitor cells play in the response to radiation and the factors that can influence stem/progenitor induced proliferation and differentiation are discussed. Finally, the mobilization and transplantation of stem cells and supportive cells and their potential to attenuate radiation‐induced salivary gland damage are discussed. Based on the major advances made in the field of stem cell research, stem cell‐based therapy has great potential to allow prevention or treatment of radiation‐induced hyposalivation.     

Malignant salivary gland tumours: treatment outcomes from a tertiary referral centre in the UK

Salivary gland malignant tumours are a complex and highly variable pathological group. Their diagnosis can be challenging, and management is guided by multidisciplinary teams. This project aimed to establish clinicopathological and sociodemographic features that significantly impacted overall disease-free or progression-free survival in patients diagnosed with malignant salivary gland disease between 2010 and 2019 in a tertiary referral centre. In total, 86 patients were included for analysis, with a female:male gender ratio of 1.3:1. Mean age at diagnosis was 57.7 years. Mucoepidermoid carcinomas constituted almost 25% (n = 20) of all cases, with adenoid cystic carcinomas (20%, n = 17) and acinic cell carcinomas (17.5%, n = 15) being the next most frequently diagnosed. The parotid gland was the most frequently affected site (80.2%, n = 69). Perineural and lymphovascular invasion, and a maximum tumour dimension of ≥4 cm were highly associated with the decision to provide a neck dissection as part of treatment. Involved margins, extracapsular spread, and lymphovascular and perineural invasion were associated with the need for adjuvant treatment. However, no factors remained statistically significant on multivariate analysis. This retrospective service evaluation demonstrates the difficulty of predicting treatment outcomes for patients diagnosed with malignant salivary gland disease.     

Inflammatory and fibroblastic effects of azithromycin on cyclosporine-induced gingival overgrowth in renal transplanted patients with and without scaling: A randomized clinical trial

BackgroundThis study aimed to evaluate the effect of azithromycin (AZM) on the inflammatory and fibroblastic part of cyclosporine A (CsA)-induced gingival overgrowth (GO) in renal transplanted patients.MethodsIn this randomized clinical trial, subjects with GO receiving CsA were randomly divided into two groups: those receiving 5-day AZM only (n = 12; group 1) and those receiving scaling and prescribed AZM after 2 months (n = 12; group 2). Both groups were evaluated for several indices (gingival hyperplastic index, plaque and bleeding index, clinical crown length) at the first visit and the 4th and 8th week in group 1, and at the first visit and the 4th, 8th, 12th, and 16th week in group 2.ResultsThe sample included 24 individuals. The mean (SD) age of participants was 30.81 (11.13) and 34.80 (9.33) years in group 1 and 2, respectively. Based on ANCOVA, the changes in the hyperplastic index (GHI) and apico-coronal dimension (ACD) of it were statistically significant in professional scaling accompanied by AZM group (P = 0.012 and 0.031, respectively). However, no significant change was observed in mean indices after prescribing AZM in 5-day AZM regimen group (P = 0.664 and 0.882, respectively). According to one-way ANOVA, we found a statistically significant correlation in GHI, ACD, bleeding index (BI), and plaque index (PI) accounting for P = 0.012, 0.003, 0.002, and <0.001, respectively.ConclusionsFindings suggest that AZM cannot influence the fibroblastic part of GO in presence of gum inflammation while the therapy can improve GO after resolving it with scaling.     

Cone beam computed tomography findings in temporomandibular joint of chronic qat chewers: Dimensional and osteoarthritic changes

The social habit of chewing qat (also known as khat) is widely practised in East Africa and the Arabian Peninsula. It has been linked with various oro-facial conditions, including temporomandibular joint disorders (TMD). This cross-sectional, comparative study sought to investigate the effects of qat chewing on temporomandibular joint (TMJ), using cone beam computed tomography (CBCT). A total of 85 Yemeni males were included. The participants were divided into two groups: Qat chewers (QC; n = 41) and non-qat chewers (NQC; n = 44). Relevant data were obtained using a structured questionnaire and standardised clinical examination. Additionally, CBCT images of the TMJs were obtained, and then, osteoarthritic changes and TMJ dimensions were analysed. SPSS 21 was used for statistical analyses, with a significant level was set at 0.05. Compared to NQC, a significantly higher proportion of QC presented with clinical signs of TMDs. The qualitative CBCT findings revealed significantly higher osteoarthritic changes in QC than in NQC: osteophyte (51.2% vs 22.7%; P = .008), subcortical sclerosis (48.8% vs 27.3%; P = .047), articular surface flattening (46.3% vs 6.8%; P = .009) and subcortical cysts (43.9% vs 4.5%; P < .001). However, CBCT quantitative findings (condylar dimensions) did not show significant differences between the two groups. The chewing side of the QC group showed slightly more changes compared to the non-chewing side. The results demonstrate that qat chewing has detrimental effects on TMJ manifested mainly as osteoarthritic changes. Further large-scale studies are recommended.     

Effect of prosthetic restoration on oral health‐related quality of life in patients with shortened dental arches: a multicentre study

The aim of this multicentre prospective study was to investigate the effect of prosthetic restoration for missing posterior teeth in patients with shortened dental arches (SDAs). SDA patients with 2–12 missing occlusal units (a pair of occluding premolars corresponds to one unit, and a pair of occluding molars corresponds to two units) were consecutively recruited from seven university‐based dental hospitals in Japan. Patients chose no replacement of missing teeth or prosthetic treatment with removable partial dentures (RPDs) or implant‐supported fixed partial dentures (IFPDs). Oral health‐related quality of life (OHRQoL) was measured using the oral health impact profile (Japanese version – OHIP‐J) at baseline and follow‐up/post‐treatment evaluation. Of the 169 subjects who completed baseline evaluation, 125 subjects (mean age; 63·0 years) received follow‐up/post‐treatment evaluation. No‐treatment was chosen by 42% (53/125) of the subjects, and 58% (72/125) chose treatment with a RPD (n = 53) or an IFPD (n = 19). In the no‐treatment (NT) group, the mean OHIP summary score at baseline was similar to that at follow‐up evaluation (P = 0·69). In the treatment (TRT) group, the mean OHIP summary score decreased significantly after the RPD treatment (P = 0·002), and it tended to decrease, though not statistically significant (P = 0·18), after the IFPD treatment. The restoration of one occlusal unit was associated with a 1·2‐point decrease in OHIP summary score (P = 0·034). These results suggest that the replacement of missing posterior teeth with RPDs or IFPDs improved OHRQoL. Prosthetic restoration for SDAs may benefit OHRQoL in patients needing replacement of missing posterior teeth.     

Clinical oral dryness score: evaluation of a new screening method for oral dryness

The purpose of this study was to explore the association of the clinical oral dryness score (CODS) with salivary flow rates, xerostomia inventory (XI), and bother index (BI). 147 patients were screened using CODS, which determined 10 features of oral dryness. Each feature contributed 1 point, and the total score varied from 0 to 10. Unstimulated (UWS), chewing-stimulated (CH-SWS) and acid-stimulated (A-SWS) whole salivary flows and the XI and BI were measured. Associations were explored with a bootstrapped Spearman rank correlation test (1000 × bootstrapping). Based on unstimulated salivary flow, 55 patients were classified as hyposalivators, 31 as low salivators, 48 as normosalivators and 13 as high salivators. Median CODS in the hyposalivation group was 5 (IQR 3–6) compared with 3 (IQR 2–5) in the low salivation group, 2 (IQR 1–4) in the normal salivation group and 2 (IQR 1–2.5) in the high salivation group. Significant associations between CODS and the other parameters were only found in the hyposalivation group between CODS and UWS (ρ(53) = ? 0.513; p < 0.01), between CODS and CH-SWS (ρ(53) = ? 0.453; p < 0.01), between CODS and A-SWS (ρ(53) = ? 0.500; p < 0.01), CODS and XI (ρ(53) = 0.343; p < 0.001) and between CODS and BI (ρ(53) = 0.375; p = 0.01). In patients with hyposalivation, CODS is associated with unstimulated and stimulated salivary flow and XI and BI. CODS alone or a combination of CODS with a subjective measure, such as the XI or BI, could be recommended during routine clinical assessment to detect hyposalivation.     

Symptom severity in burning mouth syndrome associates with psychological factors

Burning mouth syndrome (BMS) patients are psychologically distressed, but whether this associates with symptom severity is unclear. The aim was to investigate the association of psychological factors with pain intensity and interference in BMS. Fifty-two women (mean age 63.1, SD 10.9) with BMS participated. Pain intensity and interference data were collected using 2-week pain diaries. Psychological factors were evaluated using Depression Scale (DEPS), Pain Anxiety Symptom Scale (PASS) and Pain Vigilance and Awareness Questionnaire (PVAQ). The local ethical committee approved the study. Patients were divided into groups based on pain severity distribution tertiles: low intensity (NRS ≤ 3.7) or interference (NRS ≤ 2.9) (tertiles 1-2, n = 35) and moderate to intense intensity (NRS > 3.7) or interference (>2.9) (tertile 3, n = 17). T test, Wilcoxon's test and Pearson's correlation coefficient were used in the analyses. Patients in the highest intensity and interference tertiles reported more depression (P = .0247 and P = .0169) and pain anxiety symptoms (P = .0359 and P = .0293), and were more preoccupied with pain (P = .0004 and P = .0003) than patients in the low intensity and interference groups. The score of the pain vigilance questionnaire correlated significantly with pain intensity (r = .366, P = .009) and interference (r = .482, P = .009). Depression (r = .399, P = .003) and pain anxiety symptoms (r = .452, P = .001) correlated with pain interference. Symptom severity in BMS associates with symptoms of psychological distress emphasising the need to develop multidimensional diagnostics for the assessment of BMS pain.     

The relationship between diabetes and carotid artery calcifications detected via dental cone-beam computed tomography in patients undergoing implant treatment planning

BackgroundThe authors investigated the association between carotid artery calcifications (CACs) detected incidentally on dental cone-beam computed tomographic scans and positive diabetes status.MethodsTwo patient groups were identified retrospectively from a patient database: positive for CACs based on cone-beam computed tomographic scans and positive diabetes status. In addition to demographic characteristics, data including diabetes status and presence, type, and absence of CACs were obtained. A χ² statistical analysis was completed by means of dividing the data into sets of known CAC and known history of diabetes; significance level was P < .05.ResultsTo satisfy the a priori power analysis, records from 2010 through 2021 were used.For the positive CAC group, data were obtained from 288 patients (171 men, 117 women) and 68 patients (24%) had a positive diabetes status at the time of cone-beam computed tomography (P < .001). There were significantly more male patients (n = 47) than female patients (n = 21) with diabetes (χ² = 9.9; P = .002). For the positive diabetes group, data were obtained from 225 patients (149 men, 76 women), and 100 patients (44%) had an identifiable CAC. There were significantly more male patients (n = 73) than female patients (n = 27) with CAC (χ² = 21.2; P < .001).ConclusionsThere was a significant relationship to diabetes for patients with CACs, indicating potential undiagnosed diabetes. Male patients with diabetes are significantly more at risk of developing CACs.Practical ImplicationsPeople with CAC may be at risk of having undiagnosed diabetes and require heightened awareness during implant treatment planning.