Saliva and oxidative stress in oral cavity and in some systemic disorders.

Saliva is a liquid environment of the oral ecosystem that to some extent reflects the local state of oral cavity or the general state of health of the human body. Since saliva reflects general health status of the human organism and is easy to collect, it can be used as a non-invasive diagnostic tool. In the present review the authors discuss and highlight the role of oxidant-antioxidant balance in the blood and saliva in human pathology. Particularly, the evaluation of oxidative stress status was proposed as an important factor in diagnosing the development and progress of such general diseases as periodontal disease, oral cancer, diabetes, rheumatoid arthritis, chronic renal failure, obstructive sleep apnea syndrome, and HIV. Moreover, the tryptophan metabolites via kynurenine pathway measured in the plasma and saliva are proposed as new and sensitive markers of oxidative stress status. It is concluded that measurement of oxidative stress in salivary fluid may provide a tool for diagnosing, monitoring and treatment of some systemic diseases as well as of local pathologic disturbances (e.g. periodontal disease).

Periodontal pharmacotherapy - an updated review.

Periodontal disease is mainly associated with the activity of bacteria which adhere to the tooth surface and form specific structure of bacterial biofilm. Periodontal bacteria cause inflammation of the gums and aggressive immune response, affecting the periodontium. The first phase of initial therapy - mechanical removal of dental plaque and calculus - is necessary. If this non-surgical therapy has proved to be unsuccessful, an alternative treatment with antimicrobial agents is then considered. Pharmacotherapy is based on systemic or local antibiotics and/or antiseptics, which are applied according to the severity of the disease. A number of recent periodontal studies present some of the pharmacological agents, that are directed against bacteria or a host immune response, are often chosen as an adjunct treatment option, but none of these antimicrobials were established as 'a gold standard' in the periodontal treatment. This review provides some present recommendation of pharmacological strategies, with particular emphasis on systemic and local antimicrobial therapy of periodontal disease.

Preliminary evaluation of morphological parameters of the saliva in patients undergoing orthodontic treatment.

PURPOSE: In recent years, many reports have focused on clinical changes in the oral cavity of orthodontic patients, manifested in general inflammation of the mucosa. In order to better understand histopathological alterations in the mouth and the use of easily available diagnostic material, we decided to assess the morphology of salivary cells at different time points of treatment with orthodontic appliances. MATERIAL AND METHODS: The study material included non-stimulated saliva obtained from 21 orthodontic patients and 11 healthy secondary school students (controls). After fixation in 96% ethanol the smears were stained with PAS + hematoxylin or H+E, and using the methods of May-Grünwald-Giemsa and Feulgen. RESULTS: As revealed by the histopathological examinations of saliva smears, patients treated with intra-oral fixed orthodontic appliances showed morphological changes in oral epithelial cells and in the number of leukocytes as compared to the control group. The changes were most pronounced in the first months of treatment. CONCLUSIONS: The preliminary data indicate that orthodontic patients develop changes in the composition and morphology of salivary cells, the intensity of which depends on the time of exposure to the appliance.

Preliminary evaluation of saliva composition in allergic patients subjected to orthodontic treatment; morphological examination.

PURPOSE: Intra-oral fixed orthodontic appliances, so frequently used in the treatment of malocclusions, may cause pathomorphological changes in the mouth and can be a potential source of antigen stimulation. Therefore, the aim of the current study was to assess the changes in salivary cells of orthodontically treated allergic patients. MATERIAL AND METHODS: The study material was the non-stimulated saliva samples collected from 28 allergic patients subjected to orthodontic treatment with intra-oral fixed appliances and from 11 healthy secondary school students (controls). After fixation in 96% ethanol, saliva smears were stained with PAS + hematoxylin or H+E, and using the methods of May-Grünwald-Giemsa and Feulgen. The microscopic analysis was made of oral epithelial cells and inflow elements, with regard to their shape, size, the nucleus-to-cytoplasm ratio and nuclear chromatin condensation. RESULTS: The results of preliminary investigations indicate that allergic patients with fixed orthodontic appliances exhibit changes in the morphology and composition of salivary cells as compared to control patients. Differences in the morphological picture were most pronounced in the first months of orthodontic treatment. CONCLUSIONS: It was shown that the number and morphology of salivary cells in allergic patients altered in response to ions released from dental alloys. Thus, saliva can be used as diagnostic material.

Oral cavity status and IgE level in orthodontic patients.

PURPOSE: Considering nickel release from fixed orthodontic appliances, determination of the relationship between the clinical status of the mouth, IgE level and treatment duration in orthodontic patients seems to be advisable. MATERIAL AND METHODS: Twenty-one patients with symptoms of nickel hypersensitivity observed during treatment with fixed orthodontic appliances were separated from a group of 50 subjects, aged 11-33 years, undergoing orthodontic treatment for malocclusion. The patients were divided into two subgroups PgA and PgB. RESULTS: The mean IgE level in PgA was 39.20 IU/ml and in PgB 210.61 IU/ml. In PgA, the majority of patients were wearing ear-rings (8/10), but not in PgB (4/11). The mean treatment duration in PgA was 21.3 +/- 4.83 months, while in PgB 14.4 +/- 2.84. There were no statistically significant differences in the symptoms indicating stomatitis between the groups of patients subjected to treatment with intra-oral appliances. CONCLUSIONS: The immunologic profile of the patient plays a key role in the choice of the type of appliance used to treat abnormalities of the masticatory organ. Determination of IgE is necessary in the case of allergy-positive history.

Tryptophan and its metabolites in patients with oral squamous cell carcinoma: preliminary study.

PURPOSE: It has been showed that tryptophan (TRP) degradation has been linked to modulation of cancer cell proliferation. The aim of our study was to estimate the concentration of TRP and its derivatives, such as anthranilic (AA) and kynurenic acid (KYNA) in plasma, saliva, squamous cell carcinoma (SCC) tissues and healthy oral mucosa in patients with oral SCC. MATERIAL AND METHODS: The study was performed on plasma, non-stimulated, mixed saliva and squamous cell carcinoma tissues and healthy oral mucosa in patients with oral SCC. The concentration of TRP and its metabolites were determined by high-performance liquid chromatography (HPLC). RESULTS: In plasma the concentration of TRP was 33.73 +/- 2.52 microM, of KYNA was 26.97 +/- 5.35 nM and of AA was 32.40 +/- 2.30 nM. In saliva the concentration of TRP was 3.81 +/- 0.62 microM, of KYNA was 8.06 +/- 1.86 nM and of AA was 20.41 +/- 10.77 nM. In cancer tissues the levels of TRP (30.21 +/- 5.88 microM), KYNA (15.85 +/- 1 .82 nM) and AA (265.32 +/- 1 51.45 nM) were higher in respect to the concentration of TRP (13.28 +/- 0.62 microM), KYNA (12.75 +/- 2.28 nM) and AA (31.68 +/- 8.89 nM) in normal tissues. The increase in the content of TRP, KYNA and AA in cancer tissues reached 127.48 +/- 5.95%, 24.31 +/- 4.35% and 737.50 +/- 206.96%, respectively. CONCLUSIONS: Our study has demonstrated the change of TPR metabolism, which is reflected by the increase TRP, AA and KYNA concentrations in patients with oral squamous cell carcinoma. We can suppose that these substances may be one of many factors responsible for cancer development.

The concentration of anthranilic acid in saliva of orthodontic appliances.

PURPOSE: Anthranilic acid is an important, the aromatic intermediate in the degradation of tryptophan in kynurenine pathway. This compound plays an important role in the regulation of immunological processes as well shows antibacterial activity. The aim of our study was to estimate the concentration of anthranilic acid in saliva of young patients with orthodontic apparatus. We also assessed correlation between saliva anthranilic acid concentrations and time of orthodontic treatment. For the first time we have demonstrated the enhanced concentration of anthranilic acid in saliva of young orthodontic appliances. MATERIAL AND METHODS: The study was performed on non-stimulated, mixed saliva of patients with orthodontic appliances. The concentration of anthranilic acid and was determined by high-performance liquid chromatography. RESULTS: The concentration of anthranilic acid was significantly higher in orthodontic patients (p = 0.043) in comparison to healthy volunteers. The mean time of orthodontic treatment was 15.0 +/- 2.03 months. We did not observe existence of correlation between anthranilic acid concentration in saliva and time of orthodontic treatment (r = -0.250; p = 0.517). CONCLUSION: These results might indicate that anthranilic acid can be one of many factors initiating of periodontal disease in orthodontic appliances.