Salivary alkaline phosphatase and calcium in caries-active type II diabetes mellitus patients: An in vivo study

Computational Evaluation of Phytocompounds From Selective Medicinal Plants as Potential Antidiabetic Agents

The distinguishing characteristic of diabetes mellitus (DM), chronic hyperglycemia emphasizes the need for safer, more efficient antidiabetic treatments. This study employs computational approaches to explore the therapeutic potential of phytochemicals from medicinal plants as antidiabetic drugs. Molecular docking against phosphorylated insulin receptor (IR) tyrosine kinase and human dipeptidyl peptidase IV (DPP-IV) identified eriodictyol (-7.13 kcal/mol) and petunidin (-6.61 kcal/mol) as potent inhibitors. Molecular dynamics simulations confirmed the structural stability of these complexes, with root mean square deviation values stabilizing within 2.8-4.5 Å. Binding free energy calculations using Molecular Mechanics Generalized Born Surface Area evealed strong binding affinities of eriodictyol-IR (ΔGbinding = -44.63 ± 4.05 kcal/mol), and petunidin-DPP-IV complex (ΔGbinding = -49.86 ± 6.13 kcal/mol). Additionally, pharmacokinetic assessments showed that these compounds adhered to Lipinski's rule, with no significant hepatotoxicity or cytotoxicity. These findings underscore the potential of these phytocompounds as antidiabetic candidates, warranting further in vitro and in vivo investigations.

Comparison between Serum and Salivary Albumin and Calcium Levels in Adolescent Age-group with Dental Caries

Aim

The aim of our pilot study is to analyze the relationship between dental caries and albumin and calcium levels in serum and saliva in adolescent patients with varying caries experience as determined by their caries progression between the age-group of 9 and 19 years.

Materials and methods

A total of 20 subjects were selected based on their level of caries progression and divided into four groups of subjects, five in each as follows: group I-enamel caries, group II-dentinal caries, group III-pulpal caries, and group IV-control group. The saliva and serum were collected under standardized conditions from selected patients and analyzed for the presence of albumin and calcium, and then they were correlated to the same level in serum. The statistical analysis was done using the Chi-squared test.

Results

According to the present study, there is an increase in the levels of caries with a decrease in the levels of salivary albumin and calcium. Serum albumin and calcium levels were also found to be decreased in caries-prone individuals; hence, a significant correlation between serum and salivary albumin and calcium levels was found.

Conclusion

According to a review of the literature, we found an inverse relationship between the levels of albumin and calcium in serum and saliva with dental caries patients. So, it confirms the importance of albumin and calcium levels in inhibiting carrier progression. So it may be used as a biochemical indicator to evaluate the susceptibility of caries.

How to cite this article

Vaish S, Gautam K, Agrawal D, et al. Comparison between Serum and Salivary Albumin and Calcium Levels in Adolescent Age-group with Dental Caries. Int J Clin Pediatr Dent 2024;17(3):328-333.

Association between salivary flow and dental caries in institutionalized adolescents: Cross-sectional study

Background

Brazil has a larger number of adolescent offenders, but studies evaluating their oral health are still limited.

Objective

Assess the association between salivary flow and caries experience in youngsters deprived of liberty.

Methodology

Sixty-eight male adolescents in conflict with the law, aged between 15 and 19 years, from a Socio-Educational Assistance Center in Brazil participated in the present study. They answered a structured questionnaire, and oral examination was performed by the Decayed, Missing, and Filled Teeth (DMFT) index. The salivary flow rate was obtained using the mechanically stimulated total saliva method. Adjusted Poisson regression was used for the association with total DMFT and its decayed component, using the salivary flow (continuous fashion) or the hyposalivation (≤1 ml/min) as independent variables.

Results

Participants were divided into two groups, those who did not have any decayed teeth at the moment of the examination (n = 39) and those who had at least one decayed tooth (n = 29). Moreover, two groups were formed based on the DMFT: those who had DMFT = 0 (n = 20) and those who had DMFT≥1 (n = 48). In the multivariate analysis, hyposalivation was associated with DMFT≥1 (p = 0.048), but when the salivary flow was included, no significant association with DMFT index was identified (p = 0.178). Conversely, the presence of at least one decayed tooth was significantly associated with the salivary flow (p = 0.004), but not with hyposalivation (p = 0.091).

Conclusions

Institutionalized adolescents who present hyposalivation or low salivary flow are associated with DMFT≥1 index or presence of at least one decayed tooth, respectively.

An Update on the Interdisciplinary Dental Care Approach for Geriatric Diabetic Patients

Diabetes mellitus is a prevalent health issue escalating worldwide that gives rise to numerous problems. Periodontal disorders are recognized as the sixth consequence associated with diabetes mellitus. Research shows that dental health affects overall health, and this knowledge is changing the dental field. The correct choice of glucose goal levels and the optimal selection of glucose-lowering medications are determined by a comprehensive geriatric assessment, an estimate of life expectancy, and a rationale for therapy at regular intervals in elderly diabetics. This article provides an overview of the correlation between diabetes and oral health, with a specific emphasis on xerostomia, periodontal disease, and dental caries. Thus, dentists play a significant role within the allied health profession by contributing to the provision of oral care for those diagnosed with diabetes, with a special focus on geriatric patients.

Pre-treatment oral microbiome analysis and salivary Stephan curve kinetics in white spot lesion development in orthodontic patients wearing fixed appliances. A pilot study

BACKGROUND

White spot lesions (WSLs) are a formidable challenge during orthodontic treatment, affecting patients regardless of oral hygiene. Multifactorial in nature, amongst potential contributors to their development are the microbiome and salivary pH. The aim of our pilot study is to determine if pre-treatment differences in salivary Stephan curve kinetics and salivary microbiome features correlate with WSL development in orthodontic patients with fixed appliances. We hypothesize that non-oral hygiene determined differences in saliva could be predictive of WSL formation in this patient population through analysis of salivary Stephan curve kinetics, and that these differences would further manifest as changes in the oral microbiome.

METHODS

In this prospective cohort study, twenty patients with initial simplified oral hygiene index scores of "good" that were planning to undergo orthodontic treatment with self-ligating fixed appliances for at least 12 months were enrolled. At pre-treatment stage, saliva was collected for microbiome analysis, and at 15-minute intervals after a sucrose rinse over 45 min for Stephan curve kinetics.

RESULTS

50% of patients developed a mean 5.7 (SEM: 1.2) WSLs. There were no differences in saliva microbiome species richness, Shannon alpha diversity or beta diversity between the groups. Capnocytophaga sputigena exclusively and Prevotella melaninogenica predominantly were found in WSL patients, while Streptococcus australis was negatively correlated with WSL development. Streptococcus mitis and Streptococcus anginosus were primarily present in healthy patients. There was no evidence to support the primary hypothesis.

CONCLUSIONS

While there were no differences in salivary pH or restitution kinetics following a sucrose challenge and no global microbial differences in WSL developers, our data showed change in salivary pH at 5 min associated with an abundance of acid-producing bacteria in saliva. The results suggest salivary pH modulation as a management strategy to inhibit the abundance of caries initiators. Our study may have uncovered the earliest predecessors to WSL/caries development.

Engineered Peptides Enable Biomimetic Route for Collagen Intrafibrillar Mineralization

Overcoming the short lifespan of current dental adhesives remains a significant clinical need. Adhesives rely on formation of the hybrid layer to adhere to dentin and penetrate within collagen fibrils. However, the ability of adhesives to achieve complete enclosure of demineralized collagen fibrils is recognized as currently unattainable. We developed a peptide-based approach enabling collagen intrafibrillar mineralization and tested our hypothesis on a type-I collagen-based platform. Peptide design incorporated collagen-binding and remineralization-mediating properties using the domain structure conservation approach. The structural changes from representative members of different peptide clusters were generated for each functional domain. Common signatures associated with secondary structure features and the related changes in the functional domain were investigated by attenuated total reflectance Fourier-transform infrared (ATR-FTIR) and circular dichroism (CD) spectroscopy, respectively. Assembly and remineralization properties of the peptides on the collagen platforms were studied using atomic force microscopy (AFM). Mechanical properties of the collagen fibrils remineralized by the peptide assemblies was studied using PeakForce-Quantitative Nanomechanics (PF-QNM)-AFM. The engineered peptide was demonstrated to offer a promising route for collagen intrafibrillar remineralization. This approach offers a collagen platform to develop multifunctional strategies that combine different bioactive peptides, polymerizable peptide monomers, and adhesive formulations as steps towards improving the long-term prospects of composite resins.

Salivary Calcium Level and Its Correlation with Salivary pH, Salivary Volume, and Calcium Intake in Hypertensive Female Patients with Different Blood Sugar Levels

Aims

This study aimed to evaluate the salivary calcium level and its correlation with salivary pH, salivary volume, and calcium intake in hypertensive female patients with different blood sugar levels.

Materials and Methods

This cross-sectional study included 49 female subjects with hypertension. Subjects were divided into three groups based on the HbA1c test: normal, prediabetes, and diabetes. Unstimulated whole saliva was collected using the spitting method. Salivary calcium levels were evaluated using an Atomic Absorption Spectrophotometer. Salivary pH was obtained using a universal indicator pH paper test. Calcium intake was assessed by a semi-quantitative food frequency questionnaire. The Kruskal-Wallis test was used to compare salivary parameters and total calcium intake within study groups. Spearman rank correlation and multiple regression analysis were used to evaluate the correlation between salivary calcium levels and all variables in the study.

Results

No significant difference in salivary calcium, volume, pH, and total calcium intake was observed within the study groups. However, a significant correlation was found between salivary calcium levels and salivary pH in hypertensive females with normal blood glucose levels. Moreover, salivary calcium levels have a significant correlation with systolic blood pressure in prediabetes and diabetes groups.

Conclusions

This study found a decrease in all salivary parameters (calcium, pH, and volume) as well as a low calcium intake in hypertensive females, despite no significant difference found in groups with different blood glucose levels. Blood glucose levels appeared to be a confounder in the relationship between salivary calcium with salivary pH and systolic blood pressure.

Development of a Paper-Based Analytical Method for the Colorimetric Determination of Calcium in Saliva Samples

A novel, rapid, and facile method for the colorimetric determination of calcium using micro-analytical paper-based devices (μ-PADs) was developed. The proposed analytical method utilizes the color differences developing, after the addition of calcium, on the surface of the devices because of the complexation reaction of calcium with Methylthymol Blue (MTB) at room temperature, in alkaline pH. The devices were manufactured with chromatographic paper, using wax barriers, and the analytical protocol was easily implemented without the need of any experimental apparatus except for a simple imaging device. The user must regulate the pH, add the solutions on the paper, and measure the color intensity of the formed Ca(II)-MTB complex with a flatbed scanner. The experimental conditions for optimum color development, the possible interfering substances, and the reliability of the paper devices in different preserving conditions were optimized, with satisfactory results. The method exhibited acceptable detection limits (2.9 mg L^-1) with sufficiently good precision, which varied from 4.2% (intra-day) to 6.4% (inter-day). Saliva samples from healthy volunteers were successfully analyzed, and the calcium levels were calculated in the range of 30.71 to 84.15 mg L^-1.

Associations between dental caries and systemic diseases: a scoping review

BACKGROUND

The objective of this study was to evaluate and present evidence from animal and human clinical studies on associations between dental caries and systemic diseases, and to suggest potential mechanisms that might explain such associations.

METHODS

An electronic search was conducted of PubMed, Embase and Cochrane Central Register of Controlled Trials for articles published from 2010 to 2020 in the English language. From the initial search, 404 full-text studies were assessed for eligibility. After excluding studies for technical and study limitations, a total of 67 studies were included in the summary tables and additional studies were included in the review to support evidence.

RESULTS

Few systemic disease and conditions were found to be clinically meaningfully associated with caries experience. Best evidence from human and animal studies described association between metabolic diseases and dental caries. Several interesting animal studies were noted that could generate clinical hypotheses and further investigations in rodent models for cardiovascular injury and hyperglycemia. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines.

CONCLUSIONS

Limited clinical evidence was found connecting several systemic diseases and dental caries. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines.

CLINICAL SIGNIFICANCE

Understanding of associations between dental caries and systemic diseases play a crucial role in the treatment planning and education of the dental patient.

Detection of Salivary Alkaline Phosphatase Levels in Smokers, Diabetic Patients, Potentially Malignant Diseases and Oral Malignant Tumours

Aim:

Alkaline phosphatase (ALP) is present in human and plays a key role in intracellular destructive processes and cellular damage. It has bicarbonate and phosphate ions, which help in buffering against acids. ALP activity is affected by smoking, which changes pH in oral environment and has harmful effects. Thus, the evaluation of ALP activity of smokers and healthy nonsmoker along with patients who were diabetic, potentially malignant, and malignant was carried out in this study.

Materials and Methods:

The study took place between 2016 and 2017. A total of 150 smokers, non-smokers, and patients who were diabetic, potentially malignant, and malignant were included. Collection of unstimulated whole saliva was done from each participant, and salivary ALP levels were measured by spectrophotometric assay.

Results:

Mean salivary ALP levels were significantly higher in smokers compared to those in nonsmokers. Mean ALP levels were also increased in patients who were diabetic, potentially malignant, and malignant compared to those in controls.

Conclusion:

ALP levels were significantly higher among smokers when compared to a healthy control group. Oral tissue function and side effects among smokers can be evaluated by these salivary enzyme alterations, which can serve as biomarkers for the diagnosis of any disease process. These salivary alterations could potentially be used as biochemical markers for the evaluation and early diagnosis. The higher levels were also found in patients who were diabetic, potentially malignant, and malignant, and ALP levels may also be used as biomarkers for the evaluation of the disease process.

Evaluation of Salivary Parameters and Oral Health Status Among Asthmatic and Nonasthmatic Adult Patients Visiting a Tertiary Care Hospital

Introduction: Asthma is a chronic inflammatory disorder of the airways characterized by attacks of bronchoconstriction causing shortness of breath, coughing, and rapid breathing. Patients undergoing inhalation therapy are subjected to a higher risk of dental caries due to the reduced saliva secretion, decreased pH value, increased number of cariogenic bacteria caused by inappropriate oral hygiene, and the use of inhaling medicaments with dry powder.

Methods: The descriptive study was carried out among 200 patients aged (18-45 years) visiting Yenepoya Hospital, Mangalore during the period from May 2018 to October 2018 to evaluate salivary parameters and oral health status in asthmatic and nonasthmatic patients. Data were collected using WHO criteria (2013) and samples of unstimulated saliva were collected for evaluation of salivary flow rate, pH, buffering capacity, and calcium. Statistical analysis was done using SPSS version 21.0 software with the level of significance set at p < 0.05.

 Results: A decreased mean score of salivary flow rate, pH, and buffering capacity were found in asthmatic patients compared to nonasthmatic patients (p < 0.001). A higher mean decayed, missing, and filled teeth (DMFT) score and an increased dental erosion score were found in asthmatics compared to nonasthmatics (p < 0.05). Asthmatics had higher gingival bleeding score than nonasthmatics.

Conclusion: In order to prevent disease progression in the hard dental tissue and oral cavity of asthmatic patients, it is necessary to apply adequate preventive measures and motivate their continuous application in this caries-risk population.

Evaluation of salivary parameters and dental status in adult hemodialysis patients in an indian population

Background

Renal failure is a process that expresses a loss of functional capacity of the nephrons, independently of its etiology. The most widely used technique to combat renal failure is hemodialysis. Renal failure causes various systemic alterations including oral complications such as variations in the flow and composition of the saliva. Caries is a multifactorial disease and impaired stimulated salivary flow rate and buffering capacity are the best-known risk factors. The present study aims to evaluate the salivary pH, buffering capacity and the flow rate of saliva to the DMFT status in adult hemodialysis patients among the Indian population.

Material and Methods

Twenty healthy individuals and sixty patients undergoing hemodialysis were divided into four groups based on the following criteria: Group 1: Control group; healthy individuals,Group 2: Patients before undergoing dialysis or undergoing dialysis<3 months, Group 3: Patients undergoing dialysis since 6 months-2 years, Group 4: Patients undergoing dialysis>2 years. Dental examinations were performed according to the modified WHO oral health survey 2013 criteria and DMFT index. Saliva was collected after pre-stimulation to measuring the flow rate, buffering capacity and pH.

Results

The results exhibited a decrease in the salivary flow rate and buffering capacity with the increase in the time interval of hemodialysis, but salivary pH was found to be increasing with time. A direct relationship was seen between the DMFT scores with the increasing time interval. There was a significant correlation between DMFT index, stimulated salivary flow rate, and buffering capacity in the patients.

Conclusions

Oral health impairment can beacon to grave problems in infection-prone hemodialysis patients. Hence, the patients on hemodialysis should have regular dental examinations and treatment. Regular dental examination and instruction in patients awaiting a renal transplantation is of vital importance to ensure optimal oral health.

Key words:Saliva, pH, Buffering Capacity, Flow Rate, Hemodialysis, DMFT.

Salivary evaluation in radioactive I131 treated patients with thyroid carcinoma

BACKGROUND AND OBJECTIVE

radioiodine treatment (I¹³¹) used to treat thyroid carcinomas produces side effects (sialadenitis, xerostomia, dysphagia and caries susceptibility) reflecting in a poor patient quality of life. This study aimed to evaluate the effect of I¹³¹ on salivary function and possible oral impairment.

MATERIAL AND METHODS

Thirty-seven patients undergoing I¹³¹ were submitted to oral examination, answer questions regarding xerostomia/hyposalivation and collect saliva at three moments (M1: 30-45 days before I¹³¹, M2: 1-2 days after I¹³¹ and M3: 7-10 days after treatment). Saliva was assayed for flow rate and calcium/phosphate concentrations.

RESULTS AND CONCLUSIONS

significant difference in calcium/phosphate concentration was shown between M1 and M2, with evident decrease at M2. Flow rate reduced right after treatment with 41% of patients returning to previous rate at M3 (no statistical difference). A higher number of patients related xerostomia and difficulty in swallowing food at M2. The results showed that xerostomia/hyposalivation, dysphagia and calcium/phosphate concentration decrease may be considered early radioiodine side effects.

Association between numbers of decayed teeth and HbA1c in Japanese patients with type 2 diabetes mellitus

BACKGROUND

Dental caries (DC) are more prevalent in individuals with diabetes than in healthy individuals. However, the association between glycaemic control and DC has not been well characterized in patients with type 2 diabetes mellitus (T2DM). We therefore assessed the association between glycated haemoglobin (HbA1c) serum concentrations and the prevalence of DC in patients with T2DM.

METHODS

Retrospective analyses of data pertaining to 108 Japanese patients with T2DM hospitalized because of poor or worsened glycaemic control were included. We divided the patients based on HbA1c into two groups: HbA1c level ≥75 mmol/mol (9.0%) as poorly controlled T2DM, and HbA1c level <75 mmol/mol (9.0%) as a control group. We compared the association of lifestyle factors, dental caries, and periodontal health between patients with poorly controlled T2DM and controls. Stepwise multiple regression analyses were performed to evaluate the association between HbA1c, the absolute number of decayed teeth (DT), the sum of decayed, missing, and filled teeth, and the Met Need Index (MNI).

RESULTS

DT was higher and MNI was lower in patients with poorly controlled T2DM as compared to that in controls (P = 0.006 and P = 0.004, respectively). Multiple regression analyses revealed a significant association between HbA1c levels and DT (adjusted β = 0.039, 95% confidence interval [CI], 0.005 to 0.072, P = 0.025) and the MNI (adjusted β = -0.216, 95% CI -0.374 to -0.058, P = 0.008).

CONCLUSIONS

DT and MNI were associated with HbA1c in T2DM patients.