Comparison of the effect of the linseed extract Salinum® and a methyl cellulose preparation on the symptoms of dry mouth

The effect of a linseed extract Salinum® and a sodium carboxymethyl cellulose preparation called MAS-84 was compared with regard to its effect on the symptoms of dry mouth. Twenty patients with xerostomia, who had been treated for cancer in the head and neck by radiation were recruited from the clinic for maxillofacial surgery, Malmö University Hospital. Following radiation treatment the salivation was severely reduced. The symptoms of a general feeling of a dry mouth, difficulties in chewing and swallowing, taste disturbances, problems with speech and mouth burning were registered on a subjective verbal rating scale. In addition plaque index and gingival bleeding index were determined. The study design was crossover and performed single blind. The experimental period was 7 weeks. The patients were randomly divided into 2 groups, One group used Salinum® and the other MAS-84 for 3 weeks. The fourth week was a wash out period and for the next three weeks the patients shifted preparation. Each of the preparations was used ad libitium. Registrations of the various parameters were undertaken on days 0, 7 and 21 of the respective period. At the initial examination all patients reported considerable disturbances from mouth-dryness. These symptoms were reduced in 15 patients during the Salinum® period and in 9 during the MAS-84 period. The relief was significantly more pronounced during the use of Salinum® compared to that during the use of the methyl cellulose preparation. On day 21 plaque and gingival bleeding were significantly reduced during the Salinum® period but not during the MAS-84 period. The results of the present study confirm those of a previous pilot study and indicate that the linseed mucilage significantly reduced the symptoms of dry mouth. This effect increased with increasing time of saliva substitute use. The linseed mucilage Salinum® appeared to be a suitable saliva replacement in mouth dry patients.     

Effects of mouthrinses with linseed extract Salinum® without/with chlorhexidine on oral conditions in patients with Sjögren's syndrome. A double‐blind crossover investigation

Objectives: To study the effect of mouthrinses with salivary replacement substances on oral conditions in patients with primary Sjögren's syndrome. Design: Cross‐over, double‐blind study. Setting: Facilities at the Centre for Oral Health Sciences, Malmö University and at Malmö University Hospital, Malmö, Sweden. Subjects: Twenty‐two patients with Sjögren's syndrome. Intervention: Linseed extract Salinum® alone ( Sal ) or with addition of chlorhexidine ( Sal/Chx ) was used for mouthrinsing during 3‐week periods of rinsings separated by a 3‐week “wash‐out” period. Measurements: Recordings of percentages of sites with dental plaque and bleeding on probing, mirror friction test and microbiological analyses. Questionnaire on oral symptoms due to reduced salivation. Results: Dental plaque and bleeding on probing were reduced after Sal and after Sal/Chx. Friction was reduced after both treatments. No significant differences for counts of studied microbial groups were seen after Sal but the total anaerobically cultured microorganisms and of mutans streptococci fell after Sal/Chx (p<0.05 and p<0.001). Symptoms of oral dryness improved following Sal and Sal/Chx (p<0.05 and p<0.001 respectively). Speaking problems and burning mouth symptoms improved after use of Sal (p<0.05). Conclusions: Positive effects on symptoms in patients with Sjögren's syndrome were seen after use of Salinum® without or with chlorhexidine.     

'Inadequate' dietary habits and mastication in elderly men

Objective: The aim of this study was to re‐evaluate data about oral status, mastication and nutrition in elderly men in Malmö, Sweden, recorded in 1985–1987, to assess associations between inadequate dietary habits, oral conditions and masticatory function. Materials and methods: Four hundred and eighty‐one men, aged 67–68, participated in a comprehensive health examination, including tooth and denture status and masticatory tests. A separate study of dietary habits and nutritional status was made. Ninety‐five men had inadequate dietary habits. The databases of dental/denture status, mastication, nutritional status and social network factors were re‐evaluated for assessment of associations. Results: No significant differences between those with adequate or inadequate nutrition were found with regard to the number of teeth, occlusal contacts or removable dentures. Also self‐assessed chewing did not show any differences. Conclusion: Inadequate dietary habits were independent of teeth and denture status. Some correlations to social network conditions could be identified. Overweight, obesity, low physical activity and high alcohol intake were more common among those with inadequate nutritional intake.     

Oral glucose clearance in nonagenarians in relation to functional capacity,medication and oral variables

Objectives: To study oral sugar (glucose) clearance and to examine some factors which were believed to either influence or be dependent upon oral glucose clearance. Design: Cross-sectional, clinical study with analysis of records. Setting: Göteborg gerontological and geriatric population studies, Göteborg University, Sweden. Subjects: 71 community-dwelling individuals, 27 men and 44 women, of a representative sample of 260 92-year-old persons. Intervention and Main outcome measures : Glucose concentration was measured in saliva after chewing of a glucose tablet and the clearance was assessed by three different variables: (i) the initial salivary glucose concentration, (ii) the area under the curve (AUC) and (iii) the clearance time. Results: The glucose clearance showed a wide inter-individual variation, which could be explained partly by differences in oral state, chewing time, stimulated salivary secretion rate and medication use. A positive correlation was found between the clearance variables and the number of lactobacilli and mutans streptococci in saliva and the percentage of untreated root caries lesions of the total number of exposed root surfaces. Conclusions : A slow oral sugar clearance is more common among 92-year-olds than younger adults earlier reported in other studies, particularly in those who have uncompensated functional impairments and a high medication history. A decreased oral glucose clearance was associated with high counts of salivary lactobacilli and mutans streptococci and a high proportion of untreated root caries lesions.     

The influence of rinsing routines on fluoride retention after toothbrushing

Objective: An important determinant of the anticaries effect of brushing with a fluoride dentifrice is the retention of fluoride in the oral fluids. This study measured the influence of various post‐brushing rinsing routines on fluoride retention. Setting: The Faculty of Odontology, Göteborg University, Sweden. Subjects: Twenty‐one healthy dental students, aged 23±2 yr. Desing: A randomised, cross‐over protocol, comparing various post‐brushing rinsing procedures, with the following variables: volume of rinsing water (5 mL vs. 10×3mL) and duration of rinsing (10 vs. 60 s). Samples of whole saliva, interdental fluid and interdental plaque were analysed for fluoride content. Results: The duration of rinsing did not influence fluoride retention in whole saliva, interdental fluid or interdental plaque. Rinsing with a higher volume of water substantially decreased fluoride retention in all samples. Conclusion: Brushing with a fluoride dentifrice should be followed by rinsing procedures which enhance the retention of fluoride. Rinsing with large volumes of water decreases fluoride retention in the oral fluids, and should be discouraged.     

唾液的增加加速了含羧甲基壳聚糖口香糖的抗菌效果

目的:本论文采用了含羧甲基壳聚糖的口香糖,咀嚼这种口香糖的机械效果加速了其对口腔细菌的抑制作用,还比较口腔嗽洗液和咀嚼口香糖的抗菌效果,证明了通过咀嚼这种口香糖加速了唾液的分泌.方法:从青岛大学口腔科的老师和学生中选取了12名健康的受试者.在测试前取受试者的唾液测试细菌含量.在测试口香糖的试验中,受试者咀嚼5分钟口香糖然后休息5分钟.在测试口腔嗽洗液时,受试者用10ml嗽洗液漱口30秒后,休息9分30秒.同一天中这些测试步骤在50分钟内连续不断的进行了5次.5次测试后分别在0、30和60min收集被试者的唾液测试细菌含量.在测试唾液分泌的试验中,受试者每天咀嚼三次口香糖持续两天.结果:与使用口腔嗽洗液相比,咀嚼含羧甲基壳聚糖口香糖的受试者,在三个取样时间内口腔细菌的含量基本都明显减少,但是在60分钟的取样时间结果有点差异.咀嚼含羧甲基壳聚糖的口香糖明显提高了唾液的分泌量.结论:咀嚼含羧甲基壳聚糖的口香糖具有明显的抗菌效果.目前的研究结果强有力的证明了:使用像壳聚糖以及其衍生物这样的天然物质,对我们的口腔健康以及生活质量都有很大的帮助.     

In vivo assessment of the effect of an adhesive for complete dentures on colonisation of Candida species

doi: 10.1111/j.1741‐2358.2009.00345.x
In vivo assessment of the effect of an adhesive for complete dentures on colonisation of Candida species Objective: Denture adhesives have long been recognised by denture wearers as a useful adjunct to denture retention and stability. The objective of the present study was to evaluate, in vivo, the effect of a denture adhesive on oral quantities of Candida species by determination of absolute counts of colony‐forming units (CFU) per ml of saliva of individuals who use this denture adhesive for a period of 14 days. Materials and methods: Twenty‐four individuals were randomised in two equal groups of 12 (test and control), with the individuals of the test group using the adhesive for 14 days. Samples of saliva were collected from all individuals on days 0 (initial), 7 and 14. Aliquots of saliva were diluted and plated in duplicate on Sabouraud dextrose agar with chloramphenicol and incubated for 37°C for 48 h, the CFU/ml were counted in the individuals of each group and the data of each group were compared at the different time periods and analysed statistically by the non‐parametric Mann‐Whitney U‐test (α ≤ 5%). Results: There were no statistically significant differences between the test and control groups during the test periods. Conclusion: Within of the limitations of this study, the data suggested that the denture adhesive tested did not significantly alter the oral microbiota during the 14‐day trial period.     

The effect of Salinum on the symptoms of dry mouth: a pilot study

The effect of a new saliva substitute. Salinum®, was tested in 37 patients with severe symptoms of reduced salivation. The majority of the patients had suffered from hyposalivation and dry mouth for more than 8 years. The saliva substitute consisted of a water soluble extract of linseed. The physical properties of this extract are similar to those of the glycoproteins of the salivary secretions. The patients used the saliva substitute for a seven days period. Prior to the use of the extract the patients reported that the most severe symptoms of decreased salivation were a feeling of dryness in the mouth and burning sensations in the tongue, pharynx and oesophagus, The majority of the patients reported that the use of Salinum reduced the symptoms of hyposalivation. Great variation in effect occurred from patient to patient. Generally the patients with the most severe symptoms experienced the greatest relief of the symptoms when they used Salinum. Although of short duration the results of this pilot study indicate that an extract of linseeds may compensate for some aspects of the consequences of reduced salivation. Further studies are needed to elucidate the feasibility of the extract as saliva replacement.     

Effect of denture adhesive on the micro-organisms in vivo

doi: 10.1111/j.1741‐2358.2010.00381.x Effect of denture adhesive on the micro‐organisms in vivo Background: Denture adhesives increase the retention and stability of dentures in edentulous patients, especially in cases where salivary flow is impaired or in the management of traumatised oral mucosa. Objectives: The effect of a denture adhesive on the oral flora at different time intervals. Method: Thirty denture‐wearing patients were involved in this study. While half of the group received a denture adhesive, the other half did not. At baseline, 1 and 2 months after delivering the dentures, smear samples were obtained from the saliva, palate and the dentures. Candida albicans, Candida krusei, Candida glabrata, Candida spp., Staphylococcus aureus, Moraxella catarrhalis, α‐haemolytic streptococci, β‐haemolytic streptococci, Pneumococcus aureus, S. anginosus, S. intermedius, S. constellatus, S. sanguis, S. gordonii, S. mitis, S. mutans, S. salivarius, and yeasts were investigated. The data were statistically analysed using anova and repeated measures. Results: Most types of the micro‐organisms were not seen and could not be analysed statistically except α‐haemolytic streptococci and C. albicans. No statistically significant difference was found for α‐haemolytic streptococci and C. albicans in saliva, palate and the denture at all time intervals. Conclusions: Prolonged use of the denture adhesive tested up to 2 months did not yield to increase in micro‐organisms of the oral flora.     

Clinical Anaerobic Infections

Clinical anaerobic infections are often associated with and in proximity to the mucous membranes where they are predominantly normal human flora. This wide variety of infections can be associated with significant morbidity and mortality, especially when clinically unrecognized or ineffective antimicrobial therapy is selected or inadequate surgical therapy is utilized. These diverse infections may be located anywhere in the body but are usually associated with the mucous membranes of the oral cavity, respiratory tract, gastrointestinal tract, female genitourinary tract and the fecal stream. Abscess formation and foul odor to a discharge or wound, and the presence of necrotic tissue are clinical clues of anaerobic infections.     

Intensity of the humoral immune response to herpesviruses as an indicator the body immune deficiency

The state of the local immunity system of the oral cavity was studied by the level of saliva immunoglobulins in patients with different processes on their mucous membranes: herpetic infection, respiratory allergosis and malignant tumors of the mouth cavity and the laryngopharynx. The suppression of the production of sIgA, was accompanied by the enhanced production of antibodies to the most widespread herpesviruses (herpes simplex virus, cytomegalovirus and Epstein-Barr virus). The maximum levels of serum IgG to herpesviruses were determined in patients with malignant tumors. The role of herpesviruses in the pathogenesis of immunodeficient states is discussed.     

Effect of saliva processing on bacterial DNA extraction

More than 700 bacterial species inhabit oral cavity of humans. Various oral diseases are related to changes in the structure of this complex community. Their pathogenesis can, thus, be better understood by study of oral microbial flora. As many bacteria are refractory to cultivation, molecular approaches based on PCR followed by downstream analysis are more suitable for community analysis than culture dependent methods. Effective DNA extraction from the sample matrix is a fundamental part of the pre-analytical phase but it can be influenced by processing of the starting material. The aim of this study was to analyze the effects of saliva processing on DNA extraction using several non-commercial isolation procedures. Bacterial chromosomal DNA was extracted from three different sample matrices: fresh saliva, diluted saliva and pelleted saliva using four different extraction methods: phenol chloroform protocol, benzyl-chloride protocol, extraction with Chelex-100 and extraction with Triton X. Extraction from different saliva samples and the use of different extraction methods significantly affected the effectiveness of DNA extraction. The most suitable material for bacterial DNA extraction for molecular analysis is a fresh saliva sample. The most effective methods for isolating salivary DNA are the benzyl-chloride protocol and Chelex-100 extraction. Our results have implications for studies concentrating on salivary microbiome and its role in the pathogenesis of oral diseases.     

Effect of saliva viscosity on the co-aggregation between oral streptococci and Actinomyces naeslundii

doi: 10.1111/j.1741‐2358.2011.00595.x Effect of saliva viscosity on the co‐aggregation between oral streptococci and Actinomyces naeslundii Background: The co‐aggregation of oral bacteria leads to their clearance from the oral cavity. Poor oral hygiene and high saliva viscosity are common amongst the elderly; thus, they frequently suffer from pneumonia caused by the aspiration of oral microorganisms. Objectives: To examine the direct effect of saliva viscosity on the co‐aggregation of oral streptococci with actinomyces. Materials and methods: Fifteen oral streptococcal and a single actinomyces strain were used. Co‐aggregation was assessed by a visual assay in phosphate buffer and a spectrophotometric assay in the same buffer containing 0–60% glycerol or whole saliva. Results: Nine oral streptococci co‐aggregated with Actinomyces naeslundii ATCC12104 in the visual assay and were subsequently used for the spectrophotometric analysis. All tested strains displayed a decrease in co‐aggregation with increasing amounts of glycerol in the buffer. The co‐aggregation of Streptococcus oralis with A. naeslundii recovered to baseline level following the removal of glycerol. The per cent co‐aggregation of S. oralis with A. naeslundii was significantly correlated with the viscosity in unstimulated and stimulated whole saliva samples (correlation coefficients: ?0.52 and ?0.48, respectively). Conclusion: This study suggests that saliva viscosity affects the co‐aggregation of oral streptococci with actinomyces and that bacterial co‐aggregation decreases with increasing saliva viscosity.     

健康青少年口腔正常菌群的初步研究

本文采用非选择性培养基对22名健康青少年的唾液、沟裂菌斑、龈上菌斑及龈下菌斑中的需氧菌、兼性厌氧菌及专性厌氧菌进行了分离培养,并计算其在不同标本中占可培养菌的百分比及检出率。结果共分离到包括18个菌属的35种细菌。其中,链球菌、放线菌、奈瑟氏球菌、二氧化碳噬纤维菌、类杆菌、梭杆菌,奴卡氏菌及棒状杆菌在口腔4个部位的检出率及所占比例均较高,是健康青少年口腔中的优势菌群.通过比较还发现,其中一些菌在口腔4个部位的分布存在一定差异.本文还采用刚果红负性染色涂片法,镜下观察龈上、龈下菌斑中的螺旋体,并计算其相对比例.结果龈下菌斑中螺旋体的相对比例明显高于龈上菌斑.     

Screening and modulation of extracellular signals by mucous barrier. Serum glycosylphosphatidylinositol phospholipase D (GPI-PLD) releases protective mucous barrier from oral mucosa.

BACKGROUND: Performance of mucosal epithelial barrier is modified by numerous agents that exert effects on mucin- Mucin Binding Protein (MBP) complex. The aim ofthe studies described was to determine the nature of the damage or modification of oral mucous barrier by the short-term exposure to ethanol. METHODS: Culture of rat buccal mucosa in the presence of ethanol and [3H]-labeled proline and palmitate revealed substantial decrease in MBP synthesis and the release of MBPto the medium. The radioscanning of the samples prepared from the culture medium and the apical epithelial membranes subjected to SDS-PAGE and western blotting disclosed that the released, water soluble 97kDa MBP glycopeptide was labeled with proline and palmitate. When the experiments were conducted in the presence of 5mM EDTA, the GPI-PLD inhibitor, the majority of radiolabeled MBP remained in the membrane-bound form and was extractable with Triton X- 114. The results on the purified GPI-linked MBP degradation by serum enzyme, by the saliva containing serum transudate, and the suppression of the process by inclusion of GPI-PLD-specific inhibitor support our contention that membrane MBP is released to medium by GPI-PLD-like activity. RESULTS: The release of MBP from apical epithelial surfaces was induced by depletion of mucin and the presence of serum-derived GPI-PLD in the tissue homogenate. Strong likelihood exists that under in situ conditions ethanol-induced transudation of serum to saliva provides the vehicle for the transfer of GPI-PLD activity to salivary contents. Defacement of the oral surfaces from mucous barrier signals prospect of lumenal agent influence on the unprotected epithelial exterior, and allows ingression of microbes and untoward acting substances into the organism.     

The short-term effects of various oral care methods in dependent elderly: comparison between toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine

doi: 10.1111/j.1741‐2358.2011.00577.x The short‐term effects of various oral care methods in dependent elderly: comparison between toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine Objectives: To explore the short‐term effects from toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine. Background: Numerous reports have been seen in recent years proving the effectiveness of mouth cleaning with a toothbrush for the prevention of respiratory infections among the dependent elderly. However, the short‐term effects from each oral care method have not yet been clarified. Hence, an investigation was conducted by having each subject independently perform various oral care methods for five consecutive days. Materials and Methods: The subjects consisted of 12 assistance‐dependent elderly who have difficulties with tooth brushing by themselves, have 10 or more residual teeth and are not yet using plate dentures. After the pre‐intervention examination, each of the following oral care methods were performed on the same subject on an approximately three week basis: 1) Tooth brushing 2)Tongue cleaning with sponge brush 3)Wiping on oral mucous with sponge brush by chlorhexidine. Each method was performed independently, once a day for 5 consecutive days and the subjects were reexamined on the sixth day for comparative verification. Results: Consequently, toothbrushing decreased the plaque index and gingival index significantly and an improvement of oral malodour was also acknowledged (p < 0.01). Tongue cleaning with a sponge brush decreased the tongue coat score significantly (p < 0.05) and oral malodour was also improved (p < 0.01). Wiping on oral mucous with a sponge brush soaked in chlorhexidine significantly decreased opportunistic infections in the pharynx region (p < 0.05). Conclusions: It was suggested that the use of not only a toothbrush but also chlorhexidine gluconate may be indicated for dependent elderly people in whom pathogens of opportunistic infection are detected.     

聚乙烯醇复合水凝胶外用膜剂的制备与性能

目的：考察PVA／葡聚糖／羧甲基纤维素钠复合水凝胶外用膜剂的制备方法,并与纯PVA水凝胶贴膜进行对比,考察本膜剂在物理性能和药物体系的体外释放行为上所具备的优越性。方法：利用冷冻-解冻物理交联方法制备水凝胶装载胰岛素模型药物的外用膜剂,通过万能拉力机和差示扫描量热法考察膜剂的物理性能,利用高效液色谱法考察该膜剂的体外释放行为。结果：PVA复合水凝胶外用贴膜相较于纯PVA水凝胶贴膜的韧性减小、刚性增加,体外释放变好。结论：通过将具有材料友好性的PVA和多糖葡聚糖、羧甲基纤维素钠合并使用制备胰岛素复合水凝胶贴膜,既能保证贴膜具有良好的物理性能,又具有较好地释放行为,优于目前文献报道的纯PVA水凝胶贴膜性能,有望继续研究优化性能。     

The malmö polymorphism of coagulation factor IX, an immunologic polymorphism due to dimorphism of residue 148 that is in linkage disequilibrium with two other F.IX polymorphisms

A mouse monoclonal antibody (MAB 9.9) to coagulation factor IX (F.IX) detects a polymorphism in the plasma of normal people. Its epitope has been narrowed down to <6 amino acids in the activation peptide of the X-linked F.IX protein. The activation peptide contains a dimorphism—Thr:Ala—at position 148 of the protein. Using synthetic oligonucleotides, we have demonstrated that (1) the F.IX which reacts with 9.9 has Thr at position 148 and (2) that which does not has Ala. Positive reactors (148^thr) are designated Malmö A, and negative reactors (148^ala) are designated Malmö B. The plasma levels of AA women are indistinguishable from those of A men, and both B men and BB women are null against MAB 9.9. The plasma level of Malmö A in AB women is approximately half that of AA women, and “lyonization” is clearly operating in the heterozygotes. The dimorphism is in strong linkage disequilibrium with two other intragenic RFLPs, TaqI and XmnI. Furthermore, intragenic crossing-over—including double crossing-over—appears to have occurred between the three sites. Seven of the eight possible haplotypes have been identified, five in men and two others in women. The immunoassay that identifies ～50% of the AB women in the pool of Malmö A females with 95% confidence identifies men unambiguously as A or B. The assay would be very useful for population-genetic studies of the Malmö epitope if the studies were limited to men.     

Formation of biocompatible nanoparticles by self-assembly of enzymatic hydrolysates of chitosan and carboxymethyl cellulose

A simple preparation method for biocompatible nanoparticles in high concentration (0.5 wt %) by self-assembly of chitosan and carboxymethyl cellulose hydrolysates was developed. Chitosan and carboxymethyl cellulose were hydrolyzed beforehand with chitosanase and cellulase respectively to make fragments having lower molecular weights. Nanoparticles were spontaneously formed only by mixing the two hydrolysate solutions. The particle size distribution was relatively narrow, about 200 nm in mean size. The mean particle size decreased from 226 nm to 165 nm with decreasing molecular weight of chitosan hydrolysate from 9.5 to 6.8 kDa. The mixing ratio of chitosan and carboxymethyl cellulose hydrolysates also affected particle size. Changes in particle size are discussed in relation to a possible mechanism of polyionic complexation. The chitosan-carboxymethyl cellulose nanoparticles were stably suspended over 1 week even under low pH (pH 3.0), high ionic strength (NaCl 1 M), or low temperature (4 degrees C) conditions.     

Microbiocenosis of the mucous membranes of the upper respiratory tract and its correction with acipol in the treatment of patients with acute respiratory virus infections

Clinical and laboratory evaluation of the preparation Acipol in 45 children greatly susceptible to acute respiratory virus infections (ARVI) was carried out. Simultaneously with the clinical analysis, the study of the microflora of the mucous membranes of the upper respiratory tracts and intestine, as well as the levels of secretory IgA in saliva and coprofiltrates before and after treatment, was made. The inclusion of Acipol into the therapy of ARVI patients facilitated their clinical convalescence, uncomplicated course of the disease, correction of disturbances in the biocenosis of the upper respiratory tracts and increased infectious resistance.