儿童饮用软饮料过程中唾液pH值的变化

对象和方法研究对象:病例组为30名4～10岁,患有可疑性牙酸蚀症的儿童。对照组为随机选择30名年龄、性别与病例组相匹配的、无临床龋损、且预防性充填的牙不超过两颗的个体。所有家长知情同意。实验所用均为全唾液,收集前2h禁止饮水。非刺激性唾液收集是将唾液吐入带刻度的试管中,每30s一次,将读数转换成流速;刺激性唾液收集前先咀嚼1g无味石蜡片1min。唾液pH值的测量采用pH测量器;缓冲能力的测量使用试纸。软饮料选用Coco-Cola、Sprite、ADESN、Cindor。每个儿童一周测试一种产品,喝完后测不同时间段的pH值、pH值的变化(△ph),以及处…     

胃食管反流病患者唾液腺功能的变化

目的探讨胃食管反流病（gastroesophageal reflux disease,GERD）患者的非刺激性唾液（unstimulated whole saliva,UWS）和刺激性唾液（stimulated whole saliva,SWS）初始pH值、唾液缓冲能力和唾液流率等唾液腺功能的改变。方法收集57例确诊的GERD住院患者和24名健康人的非刺激性唾液、刺激性唾液各2ml,测定唾液的pH值、唾液缓冲能力和唾液流率。结果①GERD组刺激性唾液的初始pH值极显著高于非刺激性唾液（P〈0.001）;②对照组非刺激性唾液的缓冲能力显著高于GERD组非刺激性唾液的缓冲能力（P〈0.01）,对照组刺激性唾液的缓冲能力高于GERD组刺激性唾液的缓冲能力（P〈0.05）;③对照组非刺激性唾液的流率极显著高于GERD组非刺激性唾液的流率（P〈0.001）,对照组刺激性唾液的流率显著高于GERD组刺激性唾液的流率（P〈0.01）。结论GERD患者唾液腺功能降低。     

006.影响儿童牙齿酸蚀症的唾液因素

[英]/O＇Sulli van EA…∥Caries Res.-2000,34.-82～87 本研究的目的是测量酸蚀症儿童的唾液流率、 缓冲力和变形链球菌的数目,并与同年龄、性别的无 龋和龋活跃个体比较,以确定酸蚀症的重要危险因 素. 材料和方法实验组选择3～16岁常规检查出 酸蚀症的103个儿童,对照组为年龄、性别匹配的儿 童组成的无龋组和龋活跃组.所有试验对象唾液收 集均在早晨及相对安静的环境中进行,采集前2 h 禁食禁饮,测定唾液变链菌数、菌斑pH值、唾液流 率和唾液pH值、缓冲力.变链菌用压舌板法采集 后接种于培养皿,以Joyce Loebel Magiscan分析系统 计数.非刺激性唾液收集时,儿童取坐位,低头流入 刻度管5 min;刺激性唾液收集时,儿童在咀嚼1 g石 蜡后吐入刻度管3 min.唾液流率、pH值、变链菌计 数的差异性用单因素方差分析,唾液缓冲力用卡方 检验.计算各因素的未校正概率,评估其危险性,大 于95%认为相关. 结果刺激性唾液流率增高,pH值增高(仅 有0.3个单位提高).试验组约一半刺激性唾液缓 冲力低.变链菌平均计数:试验组大于龋活跃组大 于无龋组(实验组与对照组比较P=0.05).无龋组 唾液流率最高,但与其他两组比较差异无显著性. pH值则无龋组大于龋活跃组大于试验组,差异有显 著性(P＜0.001).唾液缓冲力为试验组低缓冲力 的个体百分数最高,各组间差异有极显著性(P＜ 0.001).表明变链菌数、刺激性和非刺激性唾液的 pH值、缓冲力是酸蚀症的危险因素,非刺激性唾液 pH值低于6.5则酸蚀症易感性提高5倍,低缓冲力 可提高易感性2倍. [杨德琴摘刘天佳校]     

致龋菌、唾液缓冲能力与婴幼儿龋的相关性研究

目的探讨唾液中变形链球菌、乳酸杆菌和唾液pH值、缓冲能力与婴幼儿龋的关系。方法将178名42～54个月的儿童分为患龋组（患龋牙数≥5）87例和无龋组91人。吐唾法采集非刺激性唾液和嚼蜡法采集刺激性唾液各2ml，用选择性培养的方法检测刺激性唾液中变形链球菌、乳酸杆菌的检出率和计数水平；测定非刺激性及刺激性唾液的pH值和缓冲能力。结果患龋组唾液变形链球菌和乳酸杆菌的检出率分别为96．6％和79．3％，显著高于无龋组的63．7％和27．5％（P〈0．05）；患龋组两种细菌的计数水平比无龋组高近10倍。患龋组和无龋组刺激性唾液的初始pH值和对酸的缓冲能力均显著高于非刺激性唾液（P〈0．001）；患龋组刺激性和非刺激性唾液的初始pH值和缓冲能力均显著低于无龋组（P〈0．05）；无龋组中变形链球菌、乳酸杆菌和唾液pH值、缓冲能力之间无明显的相关性；患龋组刺激性唾液的缓冲能力与变形链球菌的计数水平显著相关（r=0．249，P〈0．05）。结论变形链球菌和乳酸杆菌是婴幼儿龋的重要致病菌；唾液的初始pH值和缓冲能力偏低可能是影响婴幼儿龋的重要因素。     

不同龋敏感人群唾液理化性质的比较

对不同龋敏感人群唾液的分泌率、pH值、缓冲能力、粘度进行了比较.发现无龋组唾液分泌率、缓冲能力显著高于高龋组(P<0.02),无龋组唾液的粘度显著低于高龋组(P<0.01),两组间唾液pH值无显著性差异(P>0.05).以上结果提示唾液理化性质可能是影响龋病发生的重要因素之一.     

终末期肾脏病病人的唾液流率、pH值和缓冲能力与龋病的关系

目的:调查行血液透析治疗的终末期肾脏病病人的龋病状况和唾液性质,并分析两者的关系。方法:比较病患组(76例)和对照组(76例)的龋病状况、唾液流率、pH值和缓冲能力;并通过Pearson相关性检验分析病患组龋失补指数值与其唾液性质的关系。结果:两组间的龋病指标值无显著差异(P>0.05),病患组的唾液流率显著低于对照组、pH值和缓冲能力显著高于对照组,差异均有统计学意义(P<0.05),同时病患组中的龋失补指数值与唾液流率和pH值呈负相关,但无显著性(P>0.05),与唾液缓冲能力呈显著负相关(r=-0.322,P=0.005)。结论:终末期肾脏病病人,唾液缓冲能力的增加可能是其患龋病率相对较低的重要因素。     

咀嚼刺激对儿童全唾液富酪蛋白浓度的影响

用高效液相色谱法及氨基酸组成分析法测定4～6 岁43 名儿童的非刺激性及刺激性全唾液富酪蛋白浓度.经咀嚼刺激后的全唾液富酪蛋白浓度高于非刺激性全唾液(P<0.01),但性别间及各年龄组间富酪蛋白浓度差异无显著性,提示咀嚼刺激可使唾液中富酪蛋白浓度升高.     

牙周炎患者非刺激性全唾液、龈沟液及血清中CD147的表达及意义

目的研究发现CD147可能参与调节牙周疾病的进展过程,因而评估牙周炎患者经牙周基础治疗前后和健康者的非刺激性全唾液、龈沟液及血清中CD147水平,探讨其与牙周炎的相关性以及作为牙周炎诊断及预后标志物的可能性。方法酶联免疫吸附试验(ELISA)检测20例牙周炎患者治疗前、后及20名健康人非刺激性全唾液、龈沟液及血清中CD147的水平,并记录牙周袋探诊深度(PD)、附着丧失(AL)和出血指数(BI)。结果经牙周基础治疗6周后,牙周炎患者的临床指标除AL外BI及PD均低于治疗前(P<0.05);治疗后非刺激性全唾液、龈沟液及血清中CD147水平明显降低,与治疗前相比差异具有统计学意义(P<0.05);除血清外,牙周炎患者治疗前、后的非刺激性全唾液和龈沟液中CD147水平仍高于健康对照组,其差异有统计学意义(P<0.05)。结论牙周炎患者、健康者的非刺激性全唾液及龈沟液中均有CD147表达,并随牙周炎症减轻CD147表达降低。     

非刺激性混合睡液对全口义齿着色影响的实验研究

目的:本研究通过检测牙列缺失的患者全口义齿配戴前后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子的浓度,探讨非刺激性混合唾液对全口义齿着色的影响.方法:按全口义齿着色程度的不同,将90例全口义齿配戴者分成轻、中、重度3组.对各组患者全口义齿配戴前和配戴3个月后非刺激性混合唾液的流率、pH值以及Ca2+、Na+、K+离子浓度进行检测.采用单因素方差分析和配对样本资料的t检验进行统计学分析.结果:(1)全口义齿配戴前与配戴后,轻度组的唾液流率以及pH值高于中度组和重度组,Ca2+、Na+、K+离子浓度则低于中度组和重度组,差别有统计学意义(P<0.01).(2)全口义齿配戴后唾液流率0.66±0.17mL/min高于配戴前0.50±0.20mL/min,配戴后pH值6.48±0.22低于配戴前6.71±0.18,Ca2+、Na+、K+离子浓度升高,差别均有统计学意义(P<0.01).结论:非刺激性混合唾液的流率、PH值以及Ca2+、Na+、K+离子浓度的变化影响全口义齿着色的严重程度;全口义齿修复前后唾液的分泌也有所改变.     

糖尿病患者胰岛素治疗前后唾液葡萄糖含量分析

目的:研究糖尿病患者胰岛素治疗前后唾液中葡萄糖含量的改变,并观察唾液糖与血糖的关系。方法:实验组为40例糖尿病患者。收集糖尿病患者胰岛素治疗前后清晨非刺激状态下自然分泌的全唾液,进行葡萄糖含量分析,同时行空腹血糖分析。结果:治疗前患者的唾液葡萄糖含量为(2.081±0.287)mmol/L,高于治疗后的(1.571±0.193)mmol/L,二者有显著性差异(P<0.01);治疗前患者的唾液葡萄糖含量与血糖浓度有显著直线相关性(P<0.05);治疗后患者的唾液葡萄糖含量与血糖浓度无显著直线相关性(P>0.05)。结论:糖尿病患者唾液中的葡萄糖含量明显增加,说明唾液腺分泌功能发生改变;良好的胰岛素治疗不仅可以达到良好的血糖控制,还可以控制减少唾液葡萄糖的分泌量。     

鼻咽癌放疗后唾液流率和pH值的变化

目的：研究鼻咽癌放疗对涎腺功能造成放射性损害，为尽量减少和预防鼻咽癌放疗后遗症寻求可能的途径。方法：对2002年收治的38例鼻咽癌患者进行分析，38例均为首次接受放疗的鼻咽癌患者，平均年龄41．4岁，分别在放疗前、后检测混合唾液流率和pH值。结果：放疗后多数患者出现口干，唾液流率显著减少，pH值稍微上升。结论：放射治疗使涎腺功能受到极大破坏，唾液的质和量有很大变化；精确设计放射野，改进放疗技术可以预防和减少放射性涎腺损伤。     

The pH change after HCl titration into resting and stimulated saliva for a buffering capacity test

BACKGROUND: Saliva collection can provide clinical information about individual patients. However, a correlation between ranking buffering capacity using resting and stimulated saliva is still unknown. The aim of this study was to evaluate the pH change after HCl titration into resting and stimulated saliva for a salivary buffering capacity test. METHODS: Resting and stimulated saliva (by chewing paraffin wax) were collected from 80 patients. After the pH of both saliva samples was measured using a hand-held pH meter, the saliva samples were titrated with 0.1N HCl to evaluate the buffering capacity. Correlations of ranking buffering capacity (high, medium, low) between stimulated saliva and resting saliva with 30 microL HCl titration and between stimulated saliva and resting saliva with 40 microL HCl titration were statistically analysed by Spearman Rank Correlation Test (p < 0.05). RESULTS: At 50 microL HCl titration, stimulated saliva buffering capacities were ranked into high (above pH 5.5), medium (pH from 5.5 to 4.5) and low (below pH 4.5). At 30-40 microL HCl titration, the resting saliva buffering capacities were ranked into the same categories. Spearman Rank Correlation indicated significant positive coefficients for the stimulated saliva and resting saliva buffering capacity at 30 microL titration and the stimulated saliva and resting saliva at 40 microL titration. CONCLUSION: Stimulated saliva is more resistant to variation in pH change during HCI titration than resting saliva. Stimulated saliva sampling is a good method to determine buffering capacity during a comprehensive oral health assessment.     

Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis.

OBJECTIVE: The aim of this study was to investigate oral manifestations and salivary changes in patients with end-stage renal disease undergoing hemodialysis. STUDY DESIGN: Eighty-two patients undergoing hemodialysis for renal insufficiency were examined; 22 of these patients were randomly selected for salivary tests. Unstimulated whole saliva and stimulated parotid saliva were collected, and flow rate, pH, and buffer capacity were examined. Twenty-two healthy volunteers were included as controls. RESULTS: Uremic odor, dry mouth, and taste change were common symptoms. Petechia and/or ecchymosis and increase of tongue coating were major signs. The flow rates of unstimulated whole and stimulated parotid saliva were decreased in the patient group. The pH and buffer capacity of unstimulated whole saliva were increased in the patient group, but stimulated parotid saliva did not show any significant differences. CONCLUSIONS: Patients with end-stage renal disease undergoing hemodialysis showed apparent oral and salivary changes. The results help us understand the relationship between oral changes and renal insufficiency.     

Salivary and microbial conditions in patients with orofacial discomfort complaints

Secretion rate, pH, and buffer capacity of paraffin-stimulated saliva and the prevalence of salivary Streptococcus mutans and lactobacilli were examined in 98 consecutive patients (22 men, 76 women) referred for orofacial discomfort complaints related to 'oral galvanism'. The results of this investigation were compared with those of a group of 100 patients without symptoms and complaints. The patients with orofacial symptoms and complaints had significantly fewer teeth with amalgam fillings than patients without, despite equal mean number of teeth in the two groups. Most patients had normal secretion rate and pH of saliva but somewhat low values of salivary buffer capacity. Determination of saliva conductivity showed values within a normal reference interval but lower than those from a group of subjects without orofacial symptoms and complaints. The salivary levels of cariogenic bacteria were low.     

Does the neuromotor abnormality type affect the salivary parameters in individuals with cerebral palsy?

J Oral Pathol Med (2010) 39 : 770–774 Background: Previous studies reported alterations in salivary flow rate and biochemical parameters of saliva in cerebral palsy (CP) individuals; however, none of these considered the type of neuromotor abnormality among CP individuals, thus it remains unclear whether the different anatomical and extended regions of the brain lesions responsible for the neurological damage in CP might include disruption of the regulatory mechanism of saliva secretion as part of the encephalopathy. The aim of this study was to evaluate salivary flow rate, pH and buffer capacity in saliva of individuals with CP, aged 3–16 years, with spastic neuromotor abnormality type and clinical patterns of involvement. Methods: Sixty‐seven individuals with CP spasticity movement disorder, were divided in two groups according to age (3–8‐ and 9–16‐years‐old) and compared with 35 sibling volunteers with no neurological damage, divided in two groups according to age (3–8‐ and 9–16‐years‐old). Whole saliva was collected under slight suction and pH and buffer capacity were determined using a digital pHmeter. Buffer capacity was measured by titration using 0.01N HCL, and flow rate was calculated in ml/min. Results: In both age groups studied, whole saliva flow rate, pH and buffer capacity were significantly lower in the spastic CP group (P < 0.05). The clinical patterns of involvement did not influence the studied parameters. Conclusion: These findings show that individuals with spastic cerebral palsy present lower salivary flow rate, pH and buffer capacity that can increase the risk of oral disease in this population.     

The effect of increased mastication by daily gum-chewing on salivary gland output and dental plaque acidogenicity.

The effect of increased mastication on plaque metabolism and salivary gland function was determined in 11 human subjects who chewed a sugarless gum for ten minutes of each waking hour for two weeks. Prior to and at the conclusion of the gum-chewing regimen, unstimulated whole saliva and 2% citric-acid-stimulated parotid saliva were collected. Flow rates, pH, and buffer capacity were determined on all saliva samples. In addition, parotid saliva was analyzed for protein concentration and the proteins further studied by SDS-PAGE. The plaque pH response to a 10% sucrose rinse was also measured before and after the regimen. Significant increases were observed in the pH and buffer capacity of unstimulated whole saliva as were similar increases in the flow rate, pH, and buffer capacity of stimulated parotid saliva. Protein concentrations and profiles remained unaffected. In addition, the resting plaque pH and minimum plaque pH reached after a sucrose challenge were both raised significantly, with a significant reduction in the cH area. The results of this study indicate that increased masticatory effort by frequent consumption of sugar-free chewing gum over a prolonged time period resulted in a functional increase in the output of stimulated parotid saliva, as well as in increases in pH and buffer capacity of whole and parotid saliva, which may help to reduce plaque acidogenicity.     

Changes in composition of whole saliva in patients with fissured tongue

Both resting and paraffin-stimulated whole saliva were studied in 25 patients with fissured tongue and in their age and sex-matched healthy controls. The groups did not differ in dental or periodontal health. No significant differences were found between the groups in the salivary secretion rate, pH and buffer capacity, or in the frequency of lactobacilli and yeasts in saliva samples and scrapings from tongue surface. In patients with fissured tongue, unstimulated whole saliva displayed significantly elevated levels of sodium, lysozyme, myeloperoxidase and all immunoglobulins (isotypes A, G and M) when compared with the controls. These changes most likely reflect the inflammation frequently seen in the biopsies of fissured tongue. No differences between the groups existed in the amounts of salivary potassium, calcium, inorganic phosphate, amylase and total protein. Our study shows that in patients with fissured tongue the salivary secretion and composition are normal. However, components from plasma and inflammatory cells are diagnostically elevated in the whole saliva samples of patients with fissured tongue when compared with the healthy controls.     

Changes in composition of whole saliva in patients with fissured tongue

Both resting and paraffin-stimulated whole saliva were studied in 25 patients with fissured tongue and in their age and sex-matched healthy controls. The groups did not differ in dental or periodontal health. No significant differences were found between the groups in the salivary secretion rate, pH and buffer capacity, or in the frequency of lactobacilli and yeasts in saliva samples and scrapings from tongue surface. In patients with fissured tongue, unstimulated whole saliva displayed significantly elevated levels of sodium, lysozyme, myeloperoxidase and all immunoglobulins (isotypes A, G and M) when compared with the controls. These changes most likely reflect the inflammation frequently seen in the biopsies of fissured tongue. No differences between the groups existed in the amounts of salivary potassium, calcium, inorganic phosphate, amylase and total protein. Our study shows that in patients with fissured tongue the salivary secretion and composition are normal. However, components from plasma and inflammatory cells are diagnostically elevated in the whole saliva samples of patients with fissured tongue when compared with the healthy controls.     

Oral clearance of an acidic drink in patients with erosive tooth wear compared with that in control subjects

PURPOSE: The aim of this study was to compare the clearance of an acidic drink in patients with tooth wear caused by regurgitation erosion to that in patients without tooth wear. MATERIALS AND METHODS: Oral clearance was measured using antimony electrodes at 4 soft tissue sites around the mouth in the patients with erosion caused by regurgitation and compared to a matched control group. The data were analyzed for pH at the resting state, the time below 5.5, and the lowest recorded pH. In addition, the resting hydration levels and viscosity of fluid from the minor salivary glands, the pH of resting saliva, and the flow rate and buffering capacity of stimulated saliva were compared between the 2 groups of patients. RESULTS: The pH recorded at the tip of the tongue reached a lower level in the controls than in those in the erosive tooth wear group (P < .05) and the time that the pH remained below 5.5 was longer in the controls than those with tooth wear (P < .05). The flow rate from the minor salivary glands (P < .05) and the viscosity of resting saliva appeared to differ between the two groups (P < .001). CONCLUSION: Oral clearance at the tip of the tongue, measured as a function of the lowest pH reached and the time below 5.5, was quicker in those with erosive tooth wear than the controls. It is suggested that this may be a result of a feedback mechanism from constant exposure of the oral environment to low pH.     

A prospective study of salivary gland function in patients undergoing radiotherapy for squamous cell carcinoma of the oropharynx

OBJECTIVE: We sought to investigate the impact of head and neck cancer treatment on salivary function. STUDY DESIGN: The study was conducted on 54 patients with advanced squamous cell carcinoma with confirmed (n = 50) or suspected (n = 4) primary oropharyngeal localization who were treated with radiation alone or in combination with surgery or chemotherapy, or both. The following groups were considered in the evaluation: 1, the entire pool of patients; 2, those undergoing surgery and those not undergoing surgery before radiation; 3, those undergoing resection and those not undergoing resection of the submandibular gland. The flow rates, pH, and buffering capacity were determined before, during, and up to 12 months after the completion of radiation. RESULTS: Head and neck surgery, particularly when submandibular gland resection was performed, had a negative impact on salivary flow rates but did not influence pH or buffering capacity. Nonetheless, the effect of surgery on salivary flow rates decreased progressively and disappeared at 3 to 6 months after radiotherapy. More than two thirds of the salivary output was lost during radiation treatment. All patients were experiencing salivary dysfunction at 1 year after completion of radiotherapy, with average decreases of 93% (P < .0001) and 95% (P < .0001) for whole resting salivary flow and whole stimulated salivary flow, respectively, compared with the preradiotherapy values. The buffering capacity decreased to 67% of its preradiotherapy value, and whole stimulated saliva became acidic. CONCLUSIONS: The result of this study confirms that cancer treatment involving full-dose radiotherapy (RTH) to all major salivary glands for locally advanced squamous cell carcinoma of the oropharynx induces severe hyposalivation with alteration of salivary pH and buffering capacity. Head and neck surgery has a negative impact on salivary flow rates, especially when the submandibular gland is removed. However, surgery before irradiation is not a factor aggravating hyposalivation when postoperative radiotherapy includes all the major salivary glands.