• Journal of Oral Medicine and Pain
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• 제42권3호
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• pp.72-80
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• 2017

Purpose: Pilocarpine as a salivation stimulant in pill form has mostly been used to relieve oral dryness for xerostomic patients but its use may often be limited due to variable side effects from systemic absorption. Therefore, the purpose of this study was to investigate the effects of pilocarpine mouthwash on salivation according to the variable concentration and duration for healthy volunteers. Related adverse effects and subjective assessment on its effects on salivation were also examined. Methods: This study was performed as placebo-controlled, double-blind, randomized clinical trial. Thirty healthy volunteers (male=23, mean age=22.2 years) were randomly allocated to 6 groups with the different concentration of pilocarpine mouthwash (placebo, 0.1%, 0.5%, 1.0%, 1.5%, and 2.0%). The whole experiment consisted of 3 sessions according to the duration of mouthwash, i.e., 1, 3, and 5 minutes with the mean wash-out period ${\geq}2$ days between the sessions. Unstimulated whole saliva was collected before and after gargling with a mouthwash. Results: Salivation of the higher concentration groups ${\geq}1%$ significantly increased than those of lower concentration group. The application period of mouthwash did not cause any changes of salivary flow rate at the higher concentrations ${\geq}1.0%$. The lower concentrations of 0.5% and 0.1% had no effects on salivation even after 5-minute mouthwash. There was no significant difference between blood pressure and pulse rate before and after use of mouthwash. Conclusions: From the results of the current study, pilocarpine mouthwash with at least 1.0% concentration more than a minute might be clinically effective in salivation without any serious side effects. Dose of mouthwash rather than duration seems to be a critical factor to salivation.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.77-80
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• 2016

Oral squamous cell carcinoma (OSCC) is one of the ten most common causes of cancer death worldwide. Assessment of molecular changes can help detect and control lesions. The aim of this study was evaluation of salivary levels of ErbB2 and CEA in OSCC patients. In this case-control study, 27 OSCC patients and 26 healthy controls participated. After obtaining consent and filling out a questionnaire, unstimulated saliva samples were collected from people in the morning for measurement of the two markers using ELISA. Data were analyzed using Mann Whitney U test in SPSS 19 software with P<0.05 considered significant. Subjects were in the age range of 40 to 65 years. \Salivary level CEA was elevated in OSCC samples ($42.6{\pm}21.1ng/ml$) as compared to those of controls ($22.6{\pm}22.1ng/ml$) (p< 0.01), but no significant variation was noted for ErbB2 ($5.2{\pm}1.8ng/ml$ and $4.93{\pm}2.14ng/ml$, p=0.28). The role of ErbB2 as a tumor marker in patients with OSCC must still be regarded as controversial and needs further studies to clarify any significance for early detection or screening. In contrast the salivary level of CEA may find application for early detection of patients.

• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.10-16
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• 2015

Purpose: Pilocarpine has the effects on improvement of salivary flow and subjective symptoms for xerostomic patients. Because of unwanted side effects following its systemic administration, topical pilocarpine has been paid attention as an alternative. This study aimed to investigate effects of pilocarpine solution as mouthwash on salivary flow and adverse effects compared to systemic administration of 5 mg pilocarpine tablet in healthy subjects. Methods: The study was a double blind, placebo-controlled, crossover clinical trial. Five milligrams pilocarpine tablets, 4 mL of 2% pilocarpine solution and placebo solution were given to 12 healthy volunteers (6 males and 6 females) in a predetermined order with wash-out period of at least two days and unstimulated whole saliva was collected before and after administration of each drug. Blood pressure and pulse rate was also measured and subjective effect and potential side effects were evaluated by a self-administrated questionnaire. Results: Systemic (5 mg tablet) and topical (2% solution) use of pilocarpine significantly increased salivary flow rate in healthy subjects compared to placebo (p<0.001). In both the pilocarpine solution and tablet groups, salivary flow rates at 120 minutes after administration remained increased. Subjective effect on salivation was the largest in the pilocarpine tablet group, followed by the pilocarpine solution group (p<0.05). There was no significant difference in blood pressure and pulse rate after administration of all three drugs. Fewer side effects reported in the pilocarpine solution group than in the tablet group. Conclusions: Two percents pilocarpine solution as mouthwash increases salivary flow rate, definitely superior to placebo solution and comparable to pilocarpine tablet, with fewer side effects in healthy subjects. It indicates a possibility of pilocarpine solution as a useful alternative of pilocarpine tablets for the xerostomic patients with systemic diseases.

• Journal of Oral Medicine and Pain
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• 제44권1호
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• pp.25-30
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• 2019

Purpose: The exact causes of burning mouth syndrome (BMS) is unclear so far. There are many studies to elucidate the relation between oral disease and genetic predisposition. In this study, we first tried to investigate salivary exosomal genetic components that could play an important role for diagnosing and elucidating the progression of BMS. Methods: We compared salivary exosomal micro RNAs (miRNAs) of BMS Patients to those of control using next generation sequencing (NGS). Unstimulated whole saliva from 15 patients with BMS and 10 control subjects were divided into two sets. Isolated exosomes and their total RNAs were subject to NGS for the screening of miRNAs. Results: There were up-regulated 10 exosomal miRNAs (hsa-miR-1273h-5p, hsa-miR-1273a, hsa-miR-1304-3p, hsa-miR-4449, hsa-miR-1285-3p, hsa-miR-6802-5p, hsa-miR-1268a, hsa-miR-1273d, hsa-miR-1273f, and hsa-miR-423-5p) and down-regulated 18 exosomal miRNAs (hsa-miR-27b-3p, hsa-miR-16-5p, hsa-miR-186-5p, hsa-miR-142-3p, hsa-miR-141-3p, hsa-miR-150-5p, hsa-miR-374a-5p, hsa-miR-93-5p, hsa-miR-29c-3p, hsa-miR-29a-3p, hsa-miR-148a-3p, hsa-miR-22-3p, hsa-miR-27a-3p, hsa-miR-424-5p, hsa-miR-19b-3p, hsa-miR-99a-5p, hsa-miR-548d-3p, and hsa-miR-19a-3p) in BMS patients comparing with those of control subjects. Conclusions: We show that there are 28 differential expression of miRNAs between the patients with BMS and those of control subjects. The specific function of indicated miRNAs should be further elucidated.

• 대한한방내과학회지
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• 제43권1호
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• pp.53-67
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• 2022

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS. Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause-effect relationships were present between statistically significant values. Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment. Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.

• Journal of Oral Medicine and Pain
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• 제46권4호
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• pp.131-135
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• 2021

Purpose: Depression is a condition that weakens psychosocial functioning and reduces quality of life. In Korea, the prevalence of depression among the elderly is 29.2% and depression is a considerable public health concern for the elderly. Depression has a statistically significant relationship with oral conditions such as number of teeth and salivary flow rate. Oral health-related quality of life (OHRQoL) is the concept including subjective evaluations of psychological, physical and social aspects of oral health. Tooth loss and hyposalivation can affect mental health and quality of life. Our study was designed to identify the relationship among the number of teeth, salivation, OHRQoL, and depressive symptoms in the elderly in Korea. Methods: We recruited 100 participants, aged over 65 years, and assessed their number of teeth, unstimulated salivary flow rate. All participants filled out oral health impact profile 14 (OHIP-14) and Zung self-rating depression score (SDS) for checking OHRQoL and depressive symptoms. Statistical analysis was done by R program. Results: We found that the positive relationship between OHIP-14 and SDS after Mann-Whitney test (p=0.03). The lower SDS group had an OHIP-14 median score of 4. On the other hand, the higher SDS group had a median value of 7.5. The other factors (number of teeth and salivary flow rate) did not show correlations with OHIP-14 or SDS. Conclusions: OHRQoL and depressive symptoms have significant correlation.

• 대한소아치과학회지
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• 제26권2호
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• pp.427-436
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• 1999

치아탈구 발생시 사고 현장에서 쉽게 구할 수 있는 저장용액을 이용하여 치주인대세포의 생존율을 비교해보고자 치주인대세포를 10% FBS함유 ${\alpha}-MEM$에서 배양한 후 ${\alpha}-MEM$에서 저장한 군을 대조군으로 하고 동일한 조건하에서 저온살균된 우유군, 멸균된 생리적 식염수군, 비자극성 타액군, 건조된 상태로 방치한 군을 실험군으로 하여 $25^{\circ}C$ 실온에서 세포 배양 30, 60, 90, 120, 180분 후에 각 군에 대해 MTT assay를 시행하여 다음과 같은 결론을 얻었다. 1. 각 조사시점에서 실험군간의 비교에서는 모두 유의성있는 차이를 보였으며 저온살균된 우유군에서 치주인대세포의 생존율이 가장 높았고, 멸균된 생리적 식염수군, 비자극성 타액군, 건조된 상태로 방치한 군 순으로 점차 감소하였다(P<0.05). 2. 각 실험군내에서 조사시점간의 비교에서는 치주인대세포의 생존율이 시간이 경과함에 따라 유의성있게 감소하였으나(p<0.05), 저온살균된 우유군에서 90-120분 경과 사이, 멸균된 생리적 식염수군에서 60-90분과 120-180분 경과 사이에서는 유의성있는 차이는 없었다(P>0.05). 이상의 결론을 종합해볼 때 외상으로 인한 치아탈구 발생시 저장용액으로 HBSS가 추천되고 있으나 사고 현장에서 쉽게 구할 수 있고 치주인대세포의 생활력 보존에도 유리한 저온살균된 우유에 탈구된 치아를 담가오도록 추천할 수 있겠다.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.485-497
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• 2003

Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.

• Radiation Oncology Journal
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• 제22권2호
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• pp.106-114
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• 2004

목적 : 세기조절방사선치료(IMRT)를 시행받은 두경부암 환자군에서 구강건조증 지표들을 측정시점별로 비교분석 하고 이 지표들과 이하선에 조사된 방사선량과의 연관성을 분석하고자 하였다. 대상 및 방법 : 2003년 2월부터 10월까지 두경부암으로 IMRT를 시행받은 13명을 대상으로 하였다. IMRT군의 연령은 43$\~$77세(중앙값 57세)이었고, 구강건조증을 평가하는 주관적 지표로서 4항목으로 구성된 구강지표점수(xerostomia questionnaire score: XQS)와 객관적 지표로서 자극유무에 따른 saliva의 분비량(unstimulated & stimulated salivary flow rate: USFR & SSFR)을 측정하였고, 주관적 그리고 객관적 통합지표로서 LENT SOMA scale(LSC)을 측정하였다. 측정시점은 치료 전, 치료 후 1개월, 3개월이었다. IMRT군 내에서 전체 환자군과 전체이하선에 조사된 평균방사선량을 기준으로 나눈 두 군에서의 측정시점에 따른 지표들 간 변화유무를 보았고, 나아가, 구강건조증지표들과 타액분비량 간의 상관관계를 분석하였다. 결과: IMRT군 전체13명 내에서 치료 전과 치료 후 1개월, 3개월에 측정된 XQS, LSC, USFR & SSFR은 유의한 변화가 없어 구강건조증의 발현이 관찰되지 않았다. 전체이하선에 조사된 평균선량 3,500 cGy를 기준으로 환자군을 나누어 보았을 때, 3,500 cGy 미만 조사받은 8명의 환자군에서는 유의한 변화가 없었으나 3,500 cOy이상 조사받은 5명의 환자군에서는 XQS, LSC, SSFR그리고 USFR이 유의하게 증가되어 구강건조증의 발현이 관찰되었다. 또한, 각 지표들과 타액분비량 간의 상관관계를 보았을 때, 치료 후 1개월째에서 유의한 상관관계를 보이지 않았으나, 치료 후 3개월째에서 XQS, LSC가 커질수록 USFR, SSFR이 감소하는 유의한 상관관계를 보였다. 결론: 본 연구결과 IMRT는 구강건조증을 상당한 정도로 감소시킬 수 있는 것으로 나타났고, XQS와 LSC이 유용한 임상지표로서의 가능성을 보였음을 알 수 있었다. 삶의 질을 저하할 정도의 심한 구강건조증을 피하기 위해서는 양측 이하선 전체에 조사되는 평균선량을 가능한 한 3,500 cGy미만으로 조사되도록 하여야 할 것으로 생각한다. 향후, 충분한 환자를 대상으로 하여 전체이하선의 평균선량에 대한 신뢰할 수 있는 결과와 나아가 타액의 분비량을 대신할 수 있는 임상적지표를 선정하는 연구가 진행되어야 할 것이다.

• 한국산학기술학회논문지
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• 제17권6호
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• pp.537-545
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• 2016

본 연구는 구강환경요인을 살펴보고, 구강환경이 구강세균 검출에 미치는 위험요인 알아보고자 시행하였다. 연구기간은 2015년 2월 15일~ 2월 28일까지 성인 근로자 60명을 대상으로 조사하였다. 연구변수로는 안정시, 자극시 타액분비율, 타액완충능, 타액 pH, 설배와 설하 구강건조도, 구취 설태량을 측정하였다. 구강세균의 검출 유무를 확인하기 위하여 안정시 타액분비율의 gDNA를 추출하여 균을 검출하였다. 그 결과, S.mutans균은 흡연자 15배, 자극시, 안정시 타액분비율 1.3~1.6배 위험도가 더 높았으며, P.intermedia는 흡연자 13배, 설하 구강건조도 4.3배, 설태량 4배 TM7은 설하 구강건조도 5.5배 더 높은 위험도를 나타냈다. 구강 내 세균을 줄이기 위해서는 타액분비율을 촉진시키는 습관을 형성하고, 금연교육을 시행함이 중요하다고 본다. 또한 구강위생이 깨끗하고 관리가 잘되는 성인에서는 구강세균이 많이 줄어들고, 구강질환을 좀 더 예방할 수 있을 것이라 기대된다.