ABSTRACT
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 Sjogren'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.
Subject(s)
Flax , Phytotherapy , Plant Extracts/therapeutic use , Saliva, Artificial/therapeutic use , Sjogren's Syndrome/drug therapy , Adult , Aged , Aged, 80 and over , Anti-Infective Agents, Local/therapeutic use , Burning Mouth Syndrome/complications , Burning Mouth Syndrome/drug therapy , Chi-Square Distribution , Chlorhexidine/therapeutic use , Cross-Over Studies , Dental Plaque/complications , Dental Plaque/drug therapy , Double-Blind Method , Drug Combinations , Female , Flax/chemistry , Humans , Male , Middle Aged , Mouth/microbiology , Mouthwashes/therapeutic use , Periodontal Attachment Loss/complications , Periodontal Attachment Loss/drug therapy , Saliva/metabolism , Sjogren's Syndrome/complications , Statistics, Nonparametric , Surveys and Questionnaires , Treatment OutcomeABSTRACT
The aim of this clinical study was to compare the treatment outcome following root surface conditioning using an EDTA gel preparation in conjunction with surgical therapy with that following conventional flap surgery in periodontal intraosseous defects. 36 patients, each of them contributing one intraosseous defect > or =4 mm in depth participated. Defect sites had a probing pocket depth > or =5 mm and bled on probing following hygienic treatment phase. No furcation involvement or endodontic complications were present. In the EDTA group, 18 consecutive patients, defects were treated by root conditioning with EDTA gel for 3 minutes in combination with surgical therapy. In the control group, 18 patients, conventional flap surgery was performed without root conditioning. Chlorhexidine rinsings 0.2% were prescribed following surgery for 2-3 weeks with modified oral hygiene instruction. A strict recall program was implemented including professional prophylaxis and oral hygiene reinforcement every 4-6 weeks until 6-month re-evaluation. Baseline probing pocket depths and defect depths of 7.1+/-1.3 mm and 6.9+/-1.6 mm in the EDTA group and 7.6+/-1.9 mm and 6.6+/-1.7 mm, respectively, in the control group were measured. 6-month clinical results showed a significant probing attachment level gain of 1.8+/-1.5 mm and 1.0+/-1.7 mm in the EDTA and control groups respectively. A probing bone gain of 1.0+/-1.3 mm in the EDTA group was measured with a non-significant gain of 0.4+/-1.2 mm in the control group. Radiographic analysis confirmed these results. There were no statistically significant differences in treatment outcome between the group treated by root conditioning in combination with flap surgery and conventional flap surgery alone.
Subject(s)
Acid Etching, Dental/methods , Alveolar Bone Loss/surgery , Edetic Acid/therapeutic use , Tooth Root/drug effects , Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/pathology , Alveolar Process/diagnostic imaging , Anti-Infective Agents, Local/administration & dosage , Anti-Infective Agents, Local/therapeutic use , Chlorhexidine/administration & dosage , Chlorhexidine/therapeutic use , Dental Prophylaxis , Edetic Acid/administration & dosage , Female , Follow-Up Studies , Gels , Gingival Hemorrhage/pathology , Gingival Hemorrhage/surgery , Humans , Male , Middle Aged , Mouthwashes/therapeutic use , Oral Hygiene , Patient Education as Topic , Periodontal Attachment Loss/pathology , Periodontal Attachment Loss/surgery , Periodontal Pocket/pathology , Periodontal Pocket/surgery , Radiography , Reproducibility of Results , Surgical Flaps , Treatment OutcomeABSTRACT
This study investigated the perspective of a stress system disorder in the pathogenesis of therapy-resistant periodontitis. The goal was to find indications that the stress-behaviour-immune system model holds as an explanatory model for the understanding of periodontal disease. 2 patient-groups were compared: one group classified as responding well to periodontal treatment (responsive-group, R-group, n=11); the other group was classified as responding less well to treatment (non-responsive-group, NR-group, n=11). Somatic and psychological factors were described as obtained by interviews and psychological testings. These findings were related to clinical data documented during the treatment of the patients. An exact logistic multivariate regression analysis was performed on a model based on variables selected by bivariate analysis (variable versus group). The results indicated that the NR-group patients displayed indications of more psychosocial strain and a more passive-dependent personality. The R-group patients displayed a more rigid personality and possibly a less stressful psychosocial situation in the past. The report highlights the possible contribution of stress factors in the context of therapy resistant periodontal disease, and the results seem to be understandable within the context of a stress system disorder perspective.
Subject(s)
Periodontitis/psychology , Stress, Psychological/psychology , Adult , Case-Control Studies , Dependent Personality Disorder/psychology , Educational Status , Family Relations , Female , Heart Rate/physiology , Humans , Interview, Psychological , Logistic Models , Male , Middle Aged , Multivariate Analysis , Periodontal Pocket/immunology , Periodontal Pocket/psychology , Periodontal Pocket/therapy , Periodontitis/immunology , Periodontitis/therapy , Personality , Psychological Tests , Psychoneuroimmunology , Pulse , Sleep Wake Disorders/psychology , Stress, Psychological/immunologyABSTRACT
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, Malmo 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 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 libitum. 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.
Subject(s)
Carboxymethylcellulose Sodium/therapeutic use , Cranial Irradiation/adverse effects , Linseed Oil/therapeutic use , Saliva, Artificial/therapeutic use , Xerostomia/drug therapy , Aged , Cross-Over Studies , Dental Plaque Index , Female , Head and Neck Neoplasms/radiotherapy , Humans , Male , Middle Aged , Periodontal Index , Saliva, Artificial/administration & dosage , Saliva, Artificial/chemistry , Salivary Glands/radiation effects , Salivation/radiation effects , Secretory Rate , Single-Blind Method , Statistics, Nonparametric , Xerostomia/etiologyABSTRACT
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.