Rehardening properties of mucin- or CMC-containing saliva substitutes on softened human enamel. Effects of sorbitol, xylitol and increasing viscosity.
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Biomedical subjects
Publications and source records attributed to A Vissink.
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Apparent viscosities at different shear rates were measured for 3 types of saliva substitutes: (a) mucin-containing saliva; (b) substitutes based upon carboxymethylcellulose (CMC), and (c) solution of polyethylenoxide (PEO). The apparent viscosities were compared with those of human whole saliva. Human whole saliva and mucin-containing saliva substitutes appeared to be similar in their rheological properties. Both types of solution are viscoelastic solutions and adjust their apparent viscosities to their biological functions. Preparations containing CMC or PEO are non-Newtonian liquids. From this study it is concluded that mucin-containing saliva substitutes appear to be the best substitutes for natural saliva, as far as rheological properties are concerned.
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In this investigation, the subjective impressions of patients, suffering from severe xerostomia, have been recorded after symptomatic treatment with different CMC- and mucin-containing artificial saliva over 3 years. A total number of 137 patients divided into 3 groups participated. Group I (40 patients) used CMC-containing artificial saliva, group II (61 patients) alternately used CMC- and mucin-containing artificial saliva and group III (36 patients) used mucin-containing artificial saliva. From this study it is concluded that artificial saliva containing mucins proved to be of benefit to patients suffering from xerostomia.
The rehardening properties of four saliva substitutes on artificially softened human enamel have been investigated by microhardness measurements. The saliva substitutes were all based on the same formula, containing calcium, phosphate and fluoride as the main electrolytes, and mucin or carboxymethylcellulose as the main macromolecules. It has been shown that a rehardening potential exists in the saliva substitutes when calcium and phosphate are present. Omitting F- greatly reduces the rehardening potential. The rehardening is better in case of the CMC-containing saliva than in that containing mucin.
It is often assumed that salivary secretion reduces with age. About 25% of the elderly suffer from oral dryness and related complaints. Nevertheless, data on stimulated salivary flow rate in healthy elderly revealed no significant age-related decrease other than a slight decrease of the secretion from the (sero)mucous glands under conditions of minimal or extended stimulation. With regard to salivary gland morphology and composition of saliva, age-related changes have been reported in healthy individuals, too. With increasing age, the number of acini reduces and the amount of fatty and fibrous tissue increases. Moreover, animal studies revealed that the synthesis of proteins is reduced by 60% in advanced years. These data indicate that changes might occur in concentration and/or activity of the organic components of saliva. In human studies, the concentration of sIgA in labial saliva and the concentrations of high-molecular and low-molecular mucins in mucous saliva appeared to be reduced with age. Since sIgA and mucins are important in the immunologic and non-immunologic defense of the oral cavity, both defense systems are reduced in healthy elderly. Analysis of these data suggests that the oral soft tissues may become somewhat more susceptible to environmental factors due to a reduction of the immunological and non-immunological defense systems.
Secondary retention refers to cessation of tooth eruption after emergence. The aim of this study was to evaluate the clinical, radiographic, and histological characteristics of secondary retention as well as the treatment results in a group of thirty-four patients with seventy-seven secondarily retained primary molars. The most important clinical and radiographical criterion for diagnosing secondary retention was infraclusion. Percussion was not a reliable diagnostic tool. Secondary retention in the primary dentition may predispose to a similar disorder in the permanent dentition. In many cases, occlusal disturbances and underdevelopment of the alveolar process disappeared spontaneously after eruption of the permanent successor, unless a similar disorder was observed in the permanent dentition. Active therapy is necessary only in case of severe infraclusion, severe malocclusion, dislocation or agenesis of the successor.
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Edentulous patients with a severely resorbed mandible often experience problems with their dentures. Treatment concepts involving two to four implants for the support of an overdenture have been proposed. The aim of this study was to develop a treatment concept for mandibular overdentures supported by endosseous implants based on a review of the literature. It is proposed that two implants supporting a mandibular overdenture (bar construction) are sufficient for most applications. Four implants were indicated in situations involving a dentulous maxilla, a narrow mandibular arch, extreme resorption of the mandible (bone height greater than 12 mm), and mandibular soreness and pain.