Mikael Sonesson

Mucins MUC5B and MUC7 in minor salivary gland secretion of children and adults

OBJECTIVE The study was designed to investigate the relative amount of MUC5B and MUC7 in minor salivary glands in children and adults, in order to test the hypothesis that secretion of salivary mucins changes between childhood and adulthood. METHODS Ninety individuals in the age-groups 3-year-olds, 14-year-olds, and young adults 20-25 year-olds were recruited. Sialopapers were applied on the labial and the buccal mucosa and then placed in the Periotron 8,000 (Proflow ) for calculation of the amount of saliva. The assessment of MUC5B and MUC7 was carried out in an ELISA using the LUM5B-2 and the LUM7-1 antiserum, respectively. RESULTS MUC5B and MUC7 were detected in the labial minor gland saliva in all age groups. In buccal gland saliva, only a few individuals in each age group showed detectable amounts of the mucins. In the labial area, a significantly lower level of MUC7 was noted in 3-year-olds compared with adults. CONCLUSION The results indicate a site-dependent difference in minor gland mucin secretion and an age-related difference in the labial gland secretion of MUC7.

Minor salivary gland secretion in children and adults.

The minor salivary glands are of great importance in the physiology and pathology of the oral cavity. So far, studies of the minor glands have concentrated on adults. In the present study, minor salivary gland secretion was studied in the buccal and labial mucosa of 3-year-old children, adolescents and young adults. In addition, the number of glands per surface area was assessed in the labial mucosa. A total of 90 individuals were included, 30 in each age-group. Saliva was collected on filter paper discs and the salivary secretion rate was measured using a Periotron 8000. The number of secreting labial glands was assessed on PAS-stained filter paper discs under a microscope. Salivary secretion in the buccal mucosa was found to be age-related, with a statistically significant lower rate of secretion (P=0.003) in the 3-year-olds (mean 7.7 microl x cm(-2) x min(-1)) compared with the young adults (11.9 microl x cm(-2) x min(-1)). No significant differences between the sexes were noted. For the labial glands, no age- or sex-related differences were found. In all age-groups, salivary secretion was significantly higher in the buccal than in the labial mucosal area. A statistically significant difference in number of secreting glands was found between all age-groups, with a decreasing number of glands per surface unit with age. The number of glands was significantly lower in males compared with females in the group of adults. The lower rate of buccal salivary secretion in the young children may imply that the oral mucosa is more vulnerable to external injury and that caries protection on the buccal molar surfaces is lower. Previous studies indicate that adults with a reduced rate of minor salivary gland secretion are more susceptible to caries.

A systematic review of methods to diagnose oral dryness and salivary gland function

BackgroundThe most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva (sialometry). Since there is an expected and wide variation in salivary flow rates among individuals, the assessment of dysfunction can be difficult. The aim of this systematic review is to evaluate the quality of the evidence for the efficacy of diagnostic methods used to identify oral dryness.MethodsA literature search, with specific indexing terms and a hand search, was conducted for publications that described a method to diagnose oral dryness. The electronic databases of PubMed, Cochrane Library, and Web of Science were used as data sources. Four reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.ResultsThe database searches resulted in 224 titles and abstracts. Of these abstracts, 80 publications were judged to meet the inclusion criteria and read in full. A total of 18 original studies were judged relevant and interpreted for this review. In all studies, the results of the test method were compared to those of a reference method.Based on the interpretation (with the aid of the QUADAS tool) it can be reported that the patient selection criteria were not clearly described and the test or reference methods were not described in sufficient detail for it to be reproduced. None of the included studies reported information on uninterpretable/intermediate results nor data on observer or instrument variation. Seven of the studies presented their results as a percentage of correct diagnoses.ConclusionsThe evidence for the efficacy of clinical methods to assess oral dryness is sparse and it can be stated that improved standards for the reporting of diagnostic accuracy are needed in order to assure the methodological quality of studies. There is need for effective diagnostic criteria and functional tests in order to detect those individuals with oral dryness who may require oral treatment, such as alleviation of discomfort and/or prevention of diseases.

Salivary IgA in minor-gland saliva of children, adolescents, and young adults.

According to previous studies, minor glands produce about 35% of the total salivary immunoglobulin A (salivary IgA). The age-dependent increase in whole-saliva salivary IgA concentrations has been studied extensively, but we found no published reports comparing the minor-gland saliva concentrations of salivary IgA in children, adolescents, and adults. In this study we measured the concentration of salivary IgA in saliva from the labial and the buccal minor glands of children, adolescents, and adults. Three age groups donated saliva for analysis: 3-yr-old children, 14-yr-old adolescents, and 20- to 25-yr-old adults. Minor-gland saliva was collected on filter paper and unstimulated whole saliva was collected by draining into a tube, and the salivary IgA concentration was determined by ELISA. The salivary IgA concentration in labial saliva was significantly lower among 3-yr-old children (0.037 mg 100 ml(-1), SD = 0.035) than among 14-yr-old adolescents (0.126 mg 100 ml(-1), SD = 0.128) and adults (0.128 mg 100 ml(-1), SD = 0.13). The 3-yr-old children also had significantly lower whole-saliva salivary IgA values compared with the other age groups (0.09 mg 100 ml(-1), SD = 0.091; 0.179 mg 100 ml(-1), SD = 0.149; and 0.170 mg 100 ml(-1), SD = 0.099, respectively). This increase in salivary IgA concentrations with age might reflect a developing immune response in the growing child.

Effectiveness of high-fluoride toothpaste on enamel demineralization during orthodontic treatment-a multicenter randomized controlled trial.

OBJECTIVE To evaluate the effectiveness of daily tooth brushing with high-fluoride toothpaste on white spot lesion (WSL) formation in adolescents during treatment with fixed orthodontic appliances (FOA). MATERIALS AND METHODS Four hundred and twenty-four healthy 11- to 16-year-old patients, referred to five Orthodontic Specialist Clinics, were randomized to use either toothpaste containing 5000 ppm fluoride or regular toothpaste with 1450 ppm fluoride. To be eligible for inclusion, the patients had to be scheduled for bimaxillary treatment with FOA for an expected duration of at least 1 year. The primary and secondary outcome measures were prevalence and incidence of WSL, as registered from digital photos of the maxillary incisors, canines, and premolars taken before onset and immediately after debonding. The photos were evaluated separately by two blinded and calibrated clinicians using a 4-step score. A random sample of 50 cases was reassessed to check intra- and interexaminer reliability (Kappa = 0.70; 0.74). RESULTS The use of high-fluoride toothpaste resulted in fewer WSL (P = 0.042) with a prevented fraction of 32%. The lateral incisor was most commonly affected in both groups. CONCLUSION To prevent WSL during treatment of FOA, daily use of high-fluoride toothpaste may be recommended.

Management of post-orthodontic white spot lesions: an updated systematic review

Background/objectives The management of post-orthodontic white spot lesions is based on remineralization strategies or a minimal-invasive camouflage of the lesions. Aim The aim of this systematic review was to identify and assess the quality of evidence for the various clinical technologies. Search methods Four databases were searched for relevant literature published in English between 2011 and 31 October 2015 according to a pre-determined PICO. Only controlled clinical studies were considered. Abstract lists and the selected full-text papers were independently examined by two reviewers and any differences were solved in consensus. The Cochrane handbook and the AMSTAR tool were used for grading the risk of bias. The quality of evidence was rated according to GRADE. Results Out of 280 identified publications, seven studies on remineralization, micro-abrasion and resin infiltration met the inclusion criteria. Two of them were assessed with low risk of bias. No pooling of results was possible due to study heterogeneity. The quality of evidence for all technologies was graded as very low. Limitations Only papers published in English with more than 20 adolescents or young adults were considered. Furthermore, a follow-up period of at least 8 weeks was required. The publication bias could not be assessed due to the paucity of included trials. Conclusions/clinical implications There is a lack of reliable scientific evidence to support re-mineralizing or camouflaging strategies to manage post-orthodontic white spot lesions. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

Efficacy of low-level laser therapy in accelerating tooth movement, preventing relapse and managing acute pain during orthodontic treatment in humans : a systematic review

BackgroundRecently low-level laser therapy (LLLT) has been proposed to improve orthodontic treatment. The aims of this systematic review were to investigate the scientific evidence to support applications of LLLT: (a) to accelerate tooth movement, (b) to prevent orthodontic relapse and (c) to modulate acute pain, during treatment with fixed appliances in children and young adults.MethodsTo ensure a systematic literature approach, this systematic review was conducted to Goodman’s four step model. Three databases were searched (Medline, Cochrane Controlled Clinical Trials Register and Scitation), using predetermined search terms. The quality of evidence was rated according to the GRADE system.ResultsThe search identified 244 articles, 16 of which fulfilled the inclusion criteria: three on acceleration of tooth movement by LLLT and 13 on LLLT modulation of acute pain. No study on LLLT for prevention of relapse was identified. The selected studies reported promising results for LLLT; elevated acceleration of tooth movement and lower pain scores, than controls. With respect to method, there were wide variations in type of laser techniques.ConclusionsThe quality of evidence supporting LLLT to accelerate orthodontic tooth movement is very low and low with respect to modulate acute pain. No studies met the inclusion criteria for evaluating LLLT to limit relapse. The results highlight the need for high quality research, with consistency in study design, to determine whether LLLT can enhance fixed appliance treatment in children and young adults.

Oral Administration of Lactobacillus plantarum 299v Reduces Cortisol Levels in Human Saliva during Examination Induced Stress: A Randomized, Double-Blind Controlled Trial

Objective. To clarify the effect of Lactobacillus plantarum 299v on the salivary cortisol and salivary IgA levels in young adults under examination stress. Design. Forty-one students with an upcoming academic exam were included in a randomized double-blind, placebo-controlled study. The probiotic bacteria or the placebo product was administered in capsules once a day during 14 days. Saliva was collected and a perceived stress test was filled out at each sampling occasion. Saliva was collected for cortisol analysis by Electrochemiluminescence Immunoassay (ECLI) and salivary IgA was analysed by Enzyme-Linked Immunosorbent Assay (ELISA). Abundance of lactobacilli was evaluated by cultivation of saliva on selective medium and identification of L. plantarum 299v was done on randomly selected colonies by a random amplification of polymorphic DNA (RAPD) typing. Results. A significant difference in cortisol levels was found between the treatment group and the placebo group (P < 0.05), together with a significant increase in levels of lactobacilli in the treatment group compared with the placebo group (P < 0.001). No significant changes were found for salivary IgA. Conclusion. A probiotic bacterium with ability to reduce symptoms of irritable bowel syndrome (IBS) prohibited increased levels of the stress marker cortisol during the examination period. The registration number of the study is NCT02974894, and the study is registered at ClinicalTrials.gov.

Glycoprotein 340 and sialic acid in minor-gland and whole saliva of children, adolescents, and adults.

Glycoprotein 340 (gp-340) is a bacterial-binding glycoprotein found in major-gland and minor-gland saliva. Sialic acid, a common terminal structure of salivary glycoproteins, interacts with microorganisms and host ligands, as well as with free radicals. This study investigated the contents of gp-340 and sialic acid in minor-gland saliva and whole saliva of children (3 yr of age), adolescents (14 yr of age), and adults (20-25 yr of age). Labial-gland saliva and buccal-gland saliva were collected on filter paper, and unstimulated whole saliva was collected by draining into a tube. The relative amount of gp-340 and sialic acid was determined by ELISA and by enzyme-linked lectin assay (ELLA), respectively. In minor-gland saliva, no statistically significant differences in gp-340 and sialic acid were seen between the age-groups. Among adults, significantly lower amounts of gp-340 and sialic acid were seen in labial saliva compared with buccal saliva. In whole saliva, the amount of gp-340 was significantly lower among adults compared with children. No differences between genders were seen. Stable content of gp-340 and sialic acid in minor-gland saliva across the age-groups, and a higher content of gp-340 in the whole saliva of the youngest age-group (3-yr-olds) compared with the adult group, may reflect that those components are vital innate factors of immunity in childrens saliva.