LIMITED EVIDENCE SUGGESTS THAT END STAGE KIDNEY DISEASE AND HEMODIALYSIS MAY IMPACT SALIVARY FLOW RATE AND COMPOSITION.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Rodrigues RP, Vidigal MT, Vieira WA, Nascimento GG, Sabino-Silva R, Blumenberg C, Siqueira MF, Siqueira WL, Paranhos LR. Salivary changes in chronic kidney disease and in patients undergoing hemodialysis: a systematic review and meta-analysis. Journal of Nephrology. 2022 Mar 2:1-29. SOURCE OF FUNDING: The work has been partially funded by CAPES-Finance Code 001. The authors have also acknowledged The Brazilian National Council for Scientific and Technological Development (CNPq) and Minas Gerais State Agency for Research and Development, Brazil (FAPEMIG) for the support. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Methods of salivation reduction assessment at a dental appointment.

OBJECTIVE: The aim: To develop and study the methods of assessing the decrease in salivation during a dental appointment. PATIENTS AND METHODS: Materials and methods: We formed an observation group of 185 people (61 men and 124 women), which complained of dry mouth. RESULTS: Results: According to the results of the survey, we found that 10.3% (19 patients) had moderate xerostomia and 89.7% (166 patients) had pronounced xerostomia. In 179 patients (96.8%) with complaints of dry mouth and with a subjective assessment as pronounced xerostomia, salivation rate was, on average, 0.08 ± 0.01 ml/min. That was reliably objectified by laboratory indicator of hyposalivation - less than 0.1 ml/min. CONCLUSION: Conclusions: In our studies, we proved a direct relationship between patient complaints of dry mouth and laboratory-confirmed data. This makes it possible for a stomatologistto quickly identify this pathology, analyze it and choose the right treatment tactic during clinical appointment.

Assessment of dental caries and salivary nitric oxide levels in children with dyspepsia.

BACKGROUND: The increase in nitric oxide (NO) levels in the oral cavity and saliva have been associated with various oral diseases; however, the gastro-salivary interaction of NO remains controversial. Thus, the aim of this study was to determine and compare salivary NO levels of dyspeptic and non-dyspeptic healthy children and to conduct an evaluation of its association with dental caries. METHODS: Seventy children with dyspepsia (dyspeptic group) and 30 children without any gastrointestinal complaints (control group) were included in the study. Two biopsies from the gastric tissues were collected from dyspeptic children for histopathologic examination. Oral examination involved the assessment of dental caries, gingival index, plaque index, buffering capacity, salivary flow rate and pH. Salivary Streptococcus mutans (S. mutans) and Lactobacilli sp. counts were performed by commercial kits. For the comparison of the normal distribution between dyspeptic and control groups, Student t-test and for the comparison of the non-normal distribution, Kruskal-Wallis and Mann-Whitney-U tests were used. Chi-square test was used for comparison of qualitative data and the Pearson correlation test was used to evaluate the association between certain variables. Significance was assessed at p < 0.05 level. RESULTS: Helicobacter pylori (H.pylori) were found in gastric biopsies of 84.2% (59/70) of the dyspeptic children. While the mean salivary NO values did not differ significantly between gastric H.pylori positive, negative and control groups, the salivary NO level of the dyspeptic group (213.7 ± 51.68 µmol/dL) was found to be significantly higher than the control group (185.7 ± 16.66 µmol/dL). No significant relationship was found between the mean salivary NO values, DMFT/dmft numbers and other oral parameters. CONCLUSIONS: The association of dental caries and salivary NO levels could not be considered specific in the current study. Although there were no statistically significant differences between salivary NO levels of gastric H.pylori positive, gastric H.pylori negative and control groups, greater salivary NO levels among dyspeptic children compared with the control group demonstrated that the concentration of NO in the saliva could be used as a biological marker in dyspepsia, which could lead to the improvement of more specified, uncomplicated and susceptible methods for analysis.

Assessment of Risk of Xerostomia After Whole-Brain Radiation Therapy and Association With Parotid Dose.

Importance: Whole-brain radiation therapy (WBRT) delivers a substantial radiation dose to the parotid glands, but the parotid glands are not delineated for avoidance and xerostomia has never been reported as an adverse effect. Minimizing the toxic effects in patients receiving palliative treatments, such as WBRT, is crucial. Objective: To assess whether xerostomia is a toxic effect of WBRT. Design, Setting, and Participants: This observational cohort study enrolled patients from November 2, 2015, to March 20, 2018, at 1 academic center (University of North Carolina Hospitals) and 2 affiliated community hospitals (High Point Regional Hospital and University of North Carolina Rex Hospital). Adult patients (n = 100) receiving WBRT for the treatment or prophylaxis of brain metastases were enrolled. Patients who had substantial baseline xerostomia or did not complete WBRT or at least 1 postbaseline questionnaire were prospectively excluded from analysis and follow-up. Patients received 3-dimensional WBRT using opposed lateral fields covering the skull and the C1 or C2 vertebra. Per standard practice, the parotid glands were not prospectively delineated. Main Outcomes and Measures: Patients completed the University of Michigan Xerostomia Questionnaire and a 4-point bother score at baseline, immediately after WBRT, at 1 month, at 3 months, and at 6 months. The primary end point was the 1-month xerostomia score, with a hypothesized worsening score of 10 points from baseline. Results: Of the 100 patients enrolled, 73 (73%) were eligible for analysis and 55 (55%) were evaluable at 1 month. The 73 patients included 43 women (59%) and 30 men (41%) with a median (range) age of 61 (23-88) years. The median volume of parotid receiving at least 20 Gy (V20Gy) was 47%. The mean xerostomia score was 7 points at baseline and was statistically significantly higher at each assessment period, including 21 points immediately after WBRT (95% CI, 16-26; P < .001), 23 points (95% CI, 16-30; P < .001) at 1 month, 21 points (95% CI, 13-28; P < .001) at 3 months, and 14 points (95% CI, 7-21; P = .03) at 6 months. At 1 month, the xerostomia score increased by 20 points or more in 19 patients (35%). The xerostomia score at 1 month was associated with parotid dose as a continuous variable and was 35 points in patients with parotid V20Gy of 47% or greater, compared with only 9 points in patients with parotid V20Gy less than 47% (P < .001). The proportion of patients who self-reported to be bothered quite a bit or bothered very much by xerostomia at 1 month was 50% in those with parotid V20Gy of 47% or greater, compared with only 4% in those with parotid V20Gy less than 47% (P < .001). At 3 months, this difference was 50% vs 0% (P = .001). Xerostomia was not associated with medication use. Conclusions and Relevance: Clinically significant xerostomia occurred by the end of WBRT, appeared to be persistent, and appeared to be associated with parotid dose. The findings from this study suggest that the parotid glands should be delineated for avoidance to minimize these toxic effects in patients who undergo WBRT and often do not survive long enough for salivary recovery.

Oral health assessment for users of marijuana and cocaine/crack substances.

The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

Impacto da laserterapia na qualidade de vida de pacientes oncológicos portadores de mucosite oral / Impact of laser therapy on quality of life of cancer patients with oral mucositis

Introdução: O uso da laserterapia em pacientes oncológicos com mucosite oral tem efeitos biológicos por meio de processos fotofísicos e bioquímicos que aumentam o metabolismo celular, estimulando a atividade mitocondrial, atuando como analgésicos, anti-inflamatórios e reparadores da lesão da mucosa. Objetivo: Averiguar a qualidade de vida dos pacientes com mucosite oral induzida pelos tratamentos antineoplásicos previamente à aplicação de laserterapia e posterior à regressão das lesões orais. Metodologia: Trata-se de um ensaio quase-experimental com 18 pacientes oncológicos em atendimento hospitalar que desenvolveram mucosite oral. Utilizou-se um questionário sociodemográfico e o questionário de Qualidade de Vida (UW-QOL) aplicado antes das sessões com laser de baixa potência e após a regressão das lesões. Os testes estatísticos utilizados foram o teste t de Student e o teste Quiquadrado, admitindo ser significativo o p<0,05. Resultado: A faixa etária mais prevalente foi entre 65 e 74 anos, etnia branca, sexo masculino, casado, frequentou o ensino fundamental, usuários do SUS e moradores de cidades diversas. O diagnóstico oncológico mais frequente foi a Leucemia aguda, sendo a quimioterapia o tratamento em 100% dos casos e em 50%, a radioterapia. A média dos escores de qualidade de vida dos pacientes foi 456,2, anterior ao início do tratamento com laserterapia, e 678,3, posterior à intervenção. Conclusão: A qualidade de vida melhorou após as sessões de laserterapia, sendo que as mudanças mais significativas ocorreram nos domínios ligados à dor, aparência, deglutição, mastigação, fala, paladar e salivação, sendo o laser de baixa potência uma ferramenta adequada no manejo da mucosite oral.

Introduction: The use of laser therapy in cancer patients with oral mucositis have biological effects through biochemical and photophysical processes that increase the cell metabolism by stimulating mitochondrial activity, acting as analgesics, anti-inflammatory and reparative mucosal injury. Objective: The objective is to ascertain the quality of life of patients with oral mucositis induced by anticancer treatments prior to application of laser therapy and subsequent regression of oral lesions. Methodology: This is a Quasi-experimental Study with 18 cancer inpatient in hospital who developed oral mucositis. The instruments used were lifting sociodemographic data, the Survey of Quality of Life (UW-QOL) was applied before the sessions with low-power laser and after the regression of the lesions. Result: The data were analyzed was Student's t test and chi-square test, admitting be significant p<0.05. The results analyzed revealed the most prevalent age group 65-74 years old, Caucasian ethnicity, male, married, elementary school as the predominant school, US users and residents of other cities. The most common cancer diagnosis was acute leukemia; chemotherapy appeared as treatment at 100% and 50% radiation. The mean quality of life scores of patients found was 456.2 prior to initiation of treatment with laser therapy and 678.3 after the intervention. Conclusion: The quality of life improved after the sessions of laser therapy and it can be seen that the most significant changes occurred in areas related to pain, appearance, swallowing, chewing, speech, taste and salivation, and the low laser power an appropriate tool in the management of oral mucositis.

Oral health assessment for users of marijuana and cocaine/crack substances

Abstract: The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

Caries risk assessment in schoolchildren--a form based on Cariogram software.

UNLABELLED: Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram software provides this analysis, and protocols simplifying the method were suggested. OBJECTIVES: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. MATERIAL AND METHODS: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. RESULTS: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. CONCLUSION: The use of the form based on the Cariogram software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk.

Caries risk assessment in schoolchildren - a form based on Cariogram® software

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion: The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk. .

An evaluation of the Head and Neck Cancer Patient Concerns Inventory across the Merseyside and Cheshire Network.

The Patient Concerns Inventory (PCI-H&N) is a carefully designed 57-item checklist specifically for use in routine follow-up clinics for patients with head and neck cancer. Although developmental work at one hospital has been very positive, its use had not been evaluated across a wider network. The aim of this project was to evaluate use of the inventory across the Merseyside and Cheshire cancer network. Patients from 5 hospitals were included and 66 patients, 8 doctors, and 6 nurse specialists took part. Almost all patients found the inventory easy or very easy to complete and it caused no notable problems with the running of appointments. Two-thirds felt that all or most of the items mentioned were talked about in the consultations and no patient felt that the consultation had been made worse. Two-thirds felt that it had helped them communicate with the doctor, while some felt that communication was already excellent and beyond improvement. Only a small minority (12%) thought that it could or definitely would lead to disappointment because needs might not be met. Most patients definitely wanted to continue using the inventory and only 5% definitely did not. Most of the doctors and specialist nurses saw its potential benefit in clinical practice. However, some practical, administrative, and educational aspects need to be addressed before it can be used more widely. It is likely that the inventory will be incorporated into practice at each clinic and locality in different ways.

Análise sialométrica em indivíduos portadores da síndrome de Down / Sialometric assessment of individuals with Down

A síndrome de Down (SD) é a alteração cromossômica mais comum no ser humano e caracteriza-se pelo aparecimento de um cromossomo extra, localizado no par 21. Objetivo: Nesta pesquisa estudou-se a velocidade de fluxo, o pH e a capacidade de tamponamento salivar em pacientes portadores da síndrome de Down. Materiais e Métodos: Foram selecionados 60 indivíduos não aparentados, pareados em idade e sexo, residentes em Curitiba, Paraná, sendo 30 indivíduos diagnosticados com SD (grupo experimental) e 30 indivíduos normorreativos (grupo controle). Para as avaliações bioquímicas salivares coletaram-se as amostras pelo método Spitting preconizado por Navazesh (1992) e posteriormente realizaram-se as análises. O fluxo salivar foi calculado através da fórmula de Banderas-Tarabay (1997). O pH salivar foi mensurado com o auxílio de um medidor digital e a capacidade tampão com o kit Caritest® – SL. Resultados: O valor médio do fluxo salivar foi estatisticamente menor para os indivíduos portadores da SD e os valores médios de pH e capacidade tampão salivar não diferiram entre os grupos. Conclusão: Indivíduos com SD apresentaram alterações uantitativas e não qualitativas do fluido salivar...

Down syndrome (DS) is the most common chromosomal abnormality in humans and is characterizedby the appearance of an extra chromosome, located at par 21. Objective: In this research we studiedthe flow rate, pH and buffering capacity of saliva in patients with Down syndrome. Materials and methods:60 unrelated individuals were selected matched by age and sex, living in Curitiba, Paraná, with 30 patientsdiagnosed with DS (experimental group) and 30 normoreactive individuals (control group). For biochemicalassessment, salivary samples were collected by Spitting method, recommended by Navazesh (1992) and thenthe analyses were carried out. Salivary flow was calculated using the formula of Banderas-Tarabay (1997).Salivary pH was measured with the aid of a digital meter and buffering capacity with the Caritest® – SL kit.Results: The mean salivary flow was statistically lower for patients with SD and the average values of pH andsalivary buffer capacity did not differ between groups. Conclusion: Individuals with SD showed no quantitativeand qualitative changes in salivary fluid...

Can we predict sputum eosinophilia from clinical assessment in patients referred to an adult asthma clinic?

BACKGROUND: There is overwhelming evidence that asthma guidelines aimed at reducing airway inflammation are superior to those based on clinical symptoms alone. This involves targeting eosinophilic inflammation with inhaled corticosteroids. AIM: Because induced sputum is not readily available, our study set out to investigate whether the collective or singular use of routine asthma investigations can predict sputum eosinophilia. METHODS: Eighty patients underwent skin prick testing, blood tests (IgE, full blood count), spirometry, exhaled fraction nitric oxide (FeNO), PD15 to hypertonic saline, and induced sputum testing at first assessment. A predictive model for sputum eosinophilia (defined as ≥3% eosinophils) was sought using routinely available tests. RESULTS: Fifty-four subjects underwent both induced sputum and FeNO testing. Seventeen (30%) revealed eosinophilic inflammation, nine (16%) neutrophilic, four (7%) mixed granulocytic and 26 (46%) paucigranulocytic. Positive predictors for sputum eosinophilia included low forced expiratory volume in 1 s (FEV(1))% predicted, raised serum eosinophil, positive smoking history, Polynesian ethnicity and negative asthma family history. There was a non-statistically significant trend for FeNO predicting sputum eosinophilia. The best combination of predictors was low FEV(1)% predicted, raised serum eosinophil, positive smoking history and negative family history of asthma. CONCLUSION: This study demonstrates that the serum eosinophil count and FEV(1) combined with aspects of a clinical history may provide a simple and practical alternative to assessment of airway (sputum) eosinophilia in the clinical setting. A full blood count can be performed at a substantially lesser cost and with greater accessibility than induced sputum. We feel the time has come for the clinical utility of the serum eosinophil count to be revisited.

Diagnostic performance of labial minor salivary gland flow measurement for assessment of xerostomia.

OBJECTIVE: Minor salivary gland flow rate (MF) has been proposed as a key feature of xerostomia (subjective feeling of dry mouth). To assess its diagnostic performance, MF was compared in xerostomia and control subjects. DESIGN: Sixty-six subjects with xerostomia and 30 controls were enrolled. MF was measured in the lower labial mucosa using the iodine-starch filter paper method. Stimulated whole salivary flow rates were also measured using the gum test (stimulated-WF). RESULTS: Both labial-MF and stimulated-WF were significantly lower in xerostomia subjects than in controls. There was a positive correlation between labial-MF and stimulated-WF in control but not xerostomia subjects. In xerostomia subjects compared to controls, there was a significantly larger reduction in labial-MF than in stimulated-WF. Xerostomia was most accurately diagnosed using a labial-MF cutoff value of 0.25 µL/cm(2)/min. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy at this cutoff value were 1.00, 0.87, 0.93, 1.00, and 0.96, respectively. Compared to respective values of 0.64, 1.00, 1.00, 0.56, and 0.75 for stimulated-WF at the traditional cutoff of 1.0 mL/min, these data indicate the higher sensitivity, negative predictive value, and diagnostic accuracy of labial-MF. CONCLUSIONS: Xerostomia was more strongly related to reduction of labial-MF than to that of stimulated-WF. Xerostomia was most likely triggered at a labial-MF cut-off value of 0.25 µL/cm(2)/min based on results from the iodine-starch method.

Assessment of post-radiotherapy salivary glands.

Salivary glands are usually irradiated during radiotherapy for head and neck cancers, which can lead to radiation-induced damage. Radiation-induced xerostomia (oral dryness) is the most common post-radiotherapy complication for head and neck cancer patients and can reduce the patient's quality of life. Accurate and efficient salivary gland assessment methods provide a better understanding of the cause and degree of xerostomia, and may help in patient management. At present, there are different methods for the assessment of salivary gland hypofunction; however, none of them are considered to be standard procedure. This article reviews the value of common methods in the assessment of post-radiotherapy salivary glands.

Assessment of quality of life after implant-retained prosthetically reconstructed maxillae and mandibles postcancer treatments.

PURPOSE: The aim of this prospective study was to assess treatment outcome and impact on quality of life with implant-retained prosthesis in reconstructed jaws in head and neck cancer patients. MATERIALS AND METHODS: Twelve patients were rehabilitated with implant-retained dental prosthesis following free fibular graft after segmental resection. These subjects were evaluated by standardized questionnaires European Organization for Research and Treatment of Cancer QLQ-C30 (version 3) and clinical assessment for quality of life. Objective assessment of speech parameters was done with Dr. Speech Software (Tiger DRS Inc., Seattle, WA). The questionnaire consisting of information on evaluation of deglutition, salivation, status of the mandible and teeth in relation to predisease level was used for subjective judgment of speech. RESULTS: Consumption of solid, semisolid, and overcooked food was considerably better with the prosthesis. Drinking ability was not affected. Patients' voice resonance was improved, and they could sustain phonation for longer duration without difficulty. They were able to speak loudly, and their intonation pattern was also slightly better. Failure of the implants to osseointegrate at the end of 18 months was observed in 37% of the patients. This was attributed to radiation before implant insertions and periimplantitis. Despite the observed improvement in some patients, the statistical analysis of speech, swallowing parameters, and quality of life were not significant because of the paucity of numbers in this pilot study. There was no improvement in the symptoms scale scores. CONCLUSION: Reconstruction and rehabilitation of the jaws affected by tumor restores the patient anatomically, esthetically, and functionally to optimum levels. However, a study with larger numbers of patients is necessary to ascertain the benefits of this treatment modality.

Assessment of mastication with implications for oral rehabilitation: a review.

During chewing, food is reduced in size, while saliva moistens the food and binds the masticated food into a bolus that can be easily swallowed. Characteristics of the oral system, like number of teeth, bite force and salivary flow, will influence the masticatory process. Masticatory function of healthy persons has been studied extensively the last decades. These results were used as a comparison for outcomes of various patient groups. In this review, findings from literature on masticatory function for both healthy persons and patient groups are presented. Masticatory function of patients with compromised dentition appeared to be significantly reduced when compared with the function of healthy controls. The influence of oral rehabilitation, e.g. dental restorations, implant treatment and temporomandibular disorder treatment, on masticatory function will be discussed. For instance, implant treatment was shown to have a significant positive effect on both bite force and masticatory performance. Also, patient satisfaction with an implant-retained prosthesis was high in comparison with the situation before implant treatment. The article also reviews the neuromuscular control of chewing. The jaw muscle activity needed to break solid food is largely reflexly induced. Immediate muscle response is necessary to maintain a constant chewing rhythm under varying food resistance conditions. Finally, the influence of food characteristics on the masticatory process is discussed. Dry and hard products require more chewing cycles before swallowing than moist and soft foods. More time is needed to break the food and to add enough saliva to form a cohesive bolus suitable for swallowing.

Method of assessment of the dynamics of salivary function in rats during the experiment.

The dynamics of salivary function was studied on 80 laboratory rats. It was found that construction of a graph showing the dynamics of stimulated salivation in small laboratory animals could be successfully used in various studies.

Behavioral economic analysis of cue-elicited craving for alcohol.

AIMS: Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. DESIGN: One-way within-subjects design. SETTING: Human laboratory environment. PARTICIPANTS: Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. ASSESSMENTS: Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. FINDINGS: Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (O(max)), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized P(max)). Craving was significantly correlated with demand measures at levels ranging from 0.21-0.43. CONCLUSIONS: These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving.

Avaliação quantitativa do fluxo salivar estimulado em crianças e adolescentes / Quantitative assessment of stimulated saliva flow rate in children and adolescents

Objetivo: Esse estudo avaliou o fluxo salivar estimulado em crianças e adolescentes e testou sua associação com as variáveis clínicas idade e condição dentária. Metodologia: A amostra foi constituída de 100 crianças e adolescentes, que estavam em tratamento nas Clínicas do Curso de Odontologia da UFMA no período de agosto de 2006 até julho de 2007, os quais foram divididos em dois grupos: G1 (6-12 anos) e G2 (13-19 anos). Foram coletados dados referentes ao gênero, idade e condição dentária (índice de CPO-D). As amostras de saliva total foram obtidas através do método de coleta de saliva estimulada mecanicamente pela mastigação de um pedaço de látex por 5min e expectorada a cada 1min. Os dados foram analisados por ANOVA e teste de correlação de Pearson, ao nível de significância de 5%. Resultados: Não houve diferença significativa no fluxo salivar de acordo com o gênero, idade ou grupos etários. No entanto, houve uma correlação negativa significativa entre a condição dentária e o fluxo salivar de crianças e adolescentes. Conclusão: Os resultados obtidos sugerem que houve associação entre condição dentária satisfatória e maior fluxo salivar nesta amostra de crianças e adolescentes.

Purpose: This study evaluated stimulated whole saliva flow rates in children and adolescents, and tested the association of salivary flow rate with age and dental status. Methods: The sample consisted of 100 children and adolescents, who were undergoing dental treatment at the dental clinics of UFMA from August 2006 to July 2007. Subjects were divided into two groups: G1 (6 -12 years) and G2 (13-19 years). Data were collected on age, sex, and caries experience (DMFT). The samples of stimulated whole saliva were obtained by the method of chewing a piece of rubber band for 5min and spitting every 1min. Data were analyzed by ANOVA and Pearson correlation tests at the 5% significance level. Results: There was no significant difference in salivary flow rates as a function of sex, age or age groups. However, there was a significant negative correlation between dental status and salivary flow rates in children and adolescents. Conclusion: The results suggest that there is an association of better dental conditions and higher salivary flow rates in this sample of children and adolescents.