Search Results (207)

Objectives: Stomatitis is a broad term for oral mucosal inflammation, and oral candidiasis represents one of its common subtypes caused by fungal infection. This study aimed to investigate the relationship between oral candidiasis and reduced salivary flow in patients diagnosed with stomatitis and to identify clinical predictors of oral candidiasis. Methods: A total of 259 patients (mean age 59.77 ± 15.93 years; range 10–87 years; 201 females) with stomatitis were evaluated for oral candidiasis through Candida albicans culture testing. Clinical characteristics were compared between Candida-positive and Candida-negative groups. Unstimulated salivary flow rate (UFR) and stimulated salivary flow rate (SFR) were measured to assess xerostomia. Results: Among the 259 patients, 81 (31.3%) were diagnosed with oral candidiasis. Patients with candidiasis were significantly older (64.25 ± 14.66 years) than those without (57.73 ± 16.10 years; p = 0.002). Both UFR (0.36 ± 0.32 vs. 0.47 ± 0.28 mL/min, p = 0.006) and SFR (1.21 ± 0.68 vs. 1.41 ± 0.69 mL/min, p = 0.032) were significantly lower in the candidiasis group. The prevalence of xerostomia was significantly higher among Candida-positive patients, based on UFR ≤ 0.2 mL/min (49.4% vs. 18.5%, p < 0.001) and SFR ≤ 0.7 mL/min (27.2% vs. 10.7%, p < 0.001). The predictive accuracy for oral candidiasis was 62.2% based on age (AUC = 0.622; cutoff 64.50 years), 65.8% for UFR (AUC = 0.658; cutoff 0.335 mL/min), and 58.7% for SFR (AUC = 0.587; cutoff 1.150 mL/min). In the generalized linear model, xerostomia, as defined by UFR, was a significant predictor of oral candidiasis (B = 0.328, 95% CI: 0.177–0.480, p < 0.001). Conclusions: Oral candidiasis in patients with stomatitis was more strongly associated with decreased UFR than with aging alone. Among the factors assessed, reduced unstimulated salivary flow may serve as a useful clinical indicator for predicting oral candidiasis, particularly in elderly individuals. Full article

Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. Full article

Background: This study aimed to evaluate the effectiveness of a saliva-based screening method for periodontal disease among community-dwelling older adults in Japan. Methods: A total of 372 study participants (mean age: 73.1 years) with 20 or more remaining teeth were included in the study. Of the six parameters assessed by the Salivary Multi Test (SMT), this study focused on the three parameters related to periodontal disease: occult blood, leukocytes, and proteins. Periodontal tissue examinations were performed based on the Community Periodontal Index (CPI) using partial mouth recording. To evaluate screening accuracy, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each of the three markers: occult blood, leukocytes, and proteins. Receiver operating characteristic (ROC) analysis was performed for each SMT item, and area under the curve (AUC) was calculated. Logistic regression analysis was used to calculate the odds ratios for combinations of SMT markers, with the presence of periodontal pockets and gingival inflammation as the respective outcome variables. Results: Among the individual markers, occult blood showed the highest diagnostic performance for detecting both periodontal pockets and gingival inflammation. The combination of elevated occult blood and leukocyte levels yielded the highest odds ratios for both periodontal pockets and gingival inflammation. Conclusions: While several SMT markers showed associations with periodontal conditions, their utility for screening in older Japanese adults remains to be further validated. Combining markers may help improve diagnostic performance, but additional studies are warranted. Full article

Background/Objectives: Temporomandibular joint (TMJ) ankylosis, characterized by osseous–fibrous fusion, severely impairs mandibular function. While alloplastic total joint replacement (TJR) is the gold standard, long-term outcomes remain understudied. The aim of this study is to evaluate the long-term esthetic and functional outcomes of prosthetic replacement and to retrospectively analyze our 20-year experience. Methods: A retrospective observational study (2003–2024) was conducted at a tertiary referral center in Turin and enrolled patients who underwent alloplastic total joint replacement for TMJ ankylosis. Data collected included demographic variables, etiology, characteristics of the ankylosis, prosthesis type (stock/custom), surgical details, and outcomes (maximal interincisal opening [MIO], pain, quality of life, diet consistency, Helkimo index, complications). Results: Among 28 patients (61% female, mean age 51.8 years), etiologies included post-traumatic (39%), osteoarthritis (32%), congenital (25%) and neoplastic (4%) causes. Custom prostheses were used in 57% of cases. Median follow-up was 11.5 years. Significant improvements were observed in MIO (p = 0.001), pain level (p = 0.001), quality of life (p = 0.001), diet score (p = 0.002), and Helkimo index (p = 0.001). Complications included facial nerve dysfunction (32.1%), salivary leakage (14.3%), and one recurrence (2.2%). Conclusions: Alloplstic TJR provides durable functional and esthetic restoration for TMJ ankylosis, with custom prostheses excelling in complex anatomies. Long-term stability (>10 years) supports its role as a definitive solution. Full article

Background/Objectives: Pleomorphic adenomas (PAs) are the most common salivary gland tumors, with a known risk of recurrence, especially after inadequate surgical excision. Understanding how surgical approach influences recurrence remains essential to optimize management. This study aimed to synthesize recurrence rates of PAs based on different surgical techniques and to illustrate the implications of surgical strategy through a representative case of multifocal deep lobe recurrence. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. Three electronic databases (PubMed, Cochrane, and Google Scholar) were searched for studies published in the last ten years, reporting recurrence rates of PAs by surgical approach. Data were extracted on recurrence, complications, and tumor characteristics. Additionally, a complex clinical case of recurrent deep lobe PA (DLPA) was presented to contextualize the findings. Results: Fifteen studies were included, comprising a total of 2095 patients. Recurrence rates were 3.27% after extracapsular dissection (ED), 0.73% after partial superficial parotidectomy (PSP), and 2.41% after superficial parotidectomy (SP). Recurrent PA (RPA) is often multifocal and associated with increased risks of facial nerve palsy and positive surgical margins. The presented case involved five surgical procedures, with ultimate total parotidectomy and facial nerve preservation despite infiltrative recurrence in the prestyloid space. Conclusions: Techniques such as ED and PSP have demonstrated their efficacy and safety compared to more invasive approaches, although their application should be carefully evaluated based on tumor size and location. RPA remains a challenging entity to treat. Avoiding outdated techniques and ensuring evidence-based decision making may improve long-term outcomes in PA management. Full article

Background/Objectives: Obstructive salivary gland disorders—primarily sialolithiasis and ductal stenosis—remain a significant source of morbidity, often requiring surgical intervention. Sialendoscopy has emerged as a minimally invasive, gland-preserving technique for both diagnosis and treatment. This retrospective study aimed to evaluate diagnostic and interventional sialendoscopy outcomes in a Romanian patient cohort and to identify gland-specific considerations in the management of salivary gland obstruction; Methods: A total of 89 patients with confirmed obstructive salivary gland disease (parotid or submandibular) were included. The most common indications included lithiasis, ductal stenosis, sialadenitis, and mixed pathologies; two cases of juvenile recurrent parotitis (JRP) were also managed. All patients underwent clinical evaluation, imaging (ultrasound, CBCT, CT, MR sialography), and sialendoscopic treatment between 2021 and 2025 in two centers. Data on demographics, imaging, calculus size, procedural technique, anesthesia, and complications were collected and analyzed using descriptive and inferential statistics; Results: The submandibular gland was more frequently involved (70.8%), with larger calculi compared to the parotid (mean 7.6 mm vs. 5.1 mm; p = 0.004). Minimally invasive techniques were predominantly used: sialolithotomy and intracorporeal lithotripsy were each performed in 32.6% of cases. Submandibulectomy was required in only 5.6% of patients. Most procedures (93.3%) were conducted under local anesthesia. Complication rates were low and primarily minor and self-limiting; Conclusions: Sialendoscopy is a safe and effective gland-preserving approach in managing obstructive salivary gland disorders. Gland-specific anatomy influences diagnostic pathways and therapeutic choices. These findings support broader adoption of sialendoscopy in routine practice and highlight the need for tailored management protocols based on gland involvement and stone characteristics. However, the study is limited by the absence of standardized post-intervention quality-of-life assessments and structured follow-up data on symptom recurrence. Full article

Background/Objectives: Sialolithiasis is a common disorder of the major salivary glands characterized by the formation of salivary stones, known as sialoliths. It is predominantly observed in patients in their fourth to sixth decades of life. Several potential factors have been associated with the development of sialolithiasis, including obesity, smoking, medication use, and several systemic diseases such as dyslipidemia, hypertension, and diabetes mellitus. Despite extensive research into the pathogenesis of sialolithiasis, it remains elusive. Therefore, this study aims to explore the characteristics of sialolithiasis among patients residing in Saudi Arabia and to detect the possible role of systemic disorders in the development of sialolithiasis. Methods: This study included 375 patients with a confirmed diagnosis of sialolithiasis between 1 January 2016 and 31 December 2024, at the National Guard Health Affairs centers in Saudi Arabia. Demographic information, body mass index (BMI), presence of systemic disorders (hypertension, diabetes mellitus, dyslipidemia, asthma, cancer), and the age at diagnosis of each disease were collected for data analysis. Results: A total of 55.5% of the patients were male, with a mean age of 39.8 and a mean BMI of 28. Dyslipidemia represented the most prevalent systemic condition (32.9%), followed by diabetes mellitus (23.5%) and hypertension (20.3%). Moreover, 74.4% and 74.2% of the patients developed hypertension and diabetes mellitus before sialolithiasis, respectively. Furthermore, dyslipidemia was associated with a higher risk profile compared with diabetes mellitus and other systemic disorders. Conclusions: This exploratory study indicates that the incidence pattern of sialolithiasis among both genders likely depends on lifestyle factors and other underlying systemic conditions. Elevated BMI may be a contributing characteristic, and the development of systemic diseases such as diabetes mellitus could be linked to the formation of salivary stones. Furthermore, these findings support a multifactorial pathophysiology of sialolithiasis. The aforementioned factors may play a role in the formation of salivary stones through hyposalivation, whether disease-related or medication-induced hyposalivation, potentially serving as a common mechanism. Full article

Histatin peptides are a family of small histidine-rich cationic polypeptides produced by two genes, HTN1 and HTN3. They are found in salivary secretions from the parotid, sublingual, and submandibular salivary glands. These peptides undergo proteolytic cleavages to produce different histatin fragments which play multiple roles including wound healing, maintenance of enamel, and regulation of balance in the oral microbiome. In this review, we explored the expression, structural characteristics, and metal-ion-binding capacities of these peptides and how their functions are modulated by their structure. We also provide here an insight into the potential use of histatins as biomarkers and therapeutic peptides in the management of oral and non-oral diseases including cancer. Potential gaps in the current understanding of histatins that warrant further research have also been highlighted. Full article

Though a variety of methods are used to conduct West Nile virus (WNV) surveillance, accurate prediction and prevention of outbreaks remain a global challenge. Previous studies have established that the concentration of antibodies to mosquito saliva is directly related to the intensity of exposure to mosquito bites and can be a good proxy to determine risk of infection in human populations. To assess exposure characteristics and transmission dynamics among avian communities, we tested the levels of IgY antibodies against whole salivary glands of Aedes albopictus and Culex quinquefasciatus, as well as WNV antigen, in 300 Northern cardinals sampled from April 2019 to October 2019 in St. Tammany Parish, Louisiana. Though there were no significant differences in antibody responses among sex or age groups, exposure to Ae. albopictus bites was more positively associated with exposure to WNV compared with Cx. quinquefasciatus exposure (ρ = 0.2525, p < 0.001; ρ = 0.1752, p = 0.02437). This association was more pronounced among female birds (ρ = 0.3004, p = 0.0075), while no significant relationship existed between exposure to either mosquito vector and WNV among male birds in the study. In general, two seasonal trends in exposure were found, noting that exposure to Ae. albopictus becomes less intense throughout the season (ρ = −0.1529, p = 0.04984), while recaptured birds in the study were found to have increased exposure to Cx. quinquefasciatus by the end of the season (ρ = 0.277, p = 0.0468). Additionally, we report the identification of several immunogenic salivary proteins, including D7 family proteins, from both mosquito vectors among the birds. Our results suggest that Ae. albopictus may have a role in early-season transmission of WNV, particularly among brooding females and hatchling cardinals. However, bloodmeal analysis was not included in this work and further studies are needed to verify this assumption. Yet, broad circulation of WNV in nesting avian communities could enhance risk of infection among Cx. quinquefasciatus mosquitoes in the late season, with the potential to contribute to human disease incidence and epizootic spillover in the environment. Full article

Background: The management of salivary gland tumors (SGTs) during pregnancy is a subject that has received scant attention in the medical literature. While treatment recommendations for cancer therapy in pregnancy have been delineated, those for benign tumors remain unspecified. The present inquiry focuses on the number of women of reproductive age with SGTs and the optimal diagnostic and treatment strategies for tumors occurring during pregnancy. Materials and Methods: This was a retrospective multicenter cohort study based on data from the Polish Salivary Network Database, collected between 2018 and 2022. From a total of 2653 patients with salivary gland tumors (SGTs), we identified 1313 women, including 300 of reproductive age (16–42 years). Among them, six cases of SGTs diagnosed during pregnancy were included for detailed analysis. Ethical approval was obtained for this study. Results: Among the 300 women of reproductive age, 285 had benign SGTs and 15 had malignant SGTs. Six tumors were diagnosed during pregnancy: four benign (pleomorphic adenomas) and two malignant (salivary duct carcinoma and mucoepidermoid carcinoma). All benign tumors were monitored during pregnancy and surgically treated postpartum. One malignant tumor was resected postpartum, while the second showed a rapid progression in late pregnancy and required early intervention. Individual case details highlighted the diagnostic and therapeutic complexity in this population. Conclusions: A standard diagnostic protocol, incorporating ultrasounds and a fine-needle aspiration biopsy, is recommended during pregnancy. For cases in which the clinical and imaging characteristics suggest a benign origin, surveillance is proposed. Conversely, surgical resection is recommended for malignant SGTs, irrespective of the gestational stage. The potential for the malignant transformation of benign tumors during pregnancy in young women underscores the necessity for surgical intervention prior to planned conception. Full article

Early disease detection using biosensors is a significant challenge in modern medicine. This study aimed to investigate Lactobacillus rhamnosus GG (LGG) as a bacterial biosensor for biomarkers indicative of oral and systemic health conditions. For this purpose, LGG was cultured and then exposed to phosphate buffer, 10 wt.% sucrose solution, pH = 4.0, lactic acid, and filter-sterile saliva from five subjects. A total of 10 groups consisted of filter-sterile, freshly pooled saliva of subject 1 (SANT), subject 2 (SLAN), subject 3 (SLFU), subject 4 (SLPA), subject 5 (SLPO), phosphate buffer solution (pH = 7.4, BUF), and PBS with resin. Subsequently, the proteomic profiling of the samples was done by high-resolution mass spectrometry, focusing on the expression of bacterial proteins. The samples were evaluated for the biosensing capacity of LGG through its proteomic expression. Statistical comparisons were performed to outline proteomic changes, clustering upregulated and downregulated proteins relevant to stress response, metabolism, and environmental adaptation. The identification of key proteins associated with metabolic regulation, response to oxidative stress, and bacterial adaptation was possible using heatmaps and volcano plots. Each subject’s salivary composition also presented its unique, characteristic proteomic signature. Results showed a massive downregulation of proteins linked with stress under nutrient-rich conditions. In conclusion, the early detection of protein expression modifications related to environmental niche changes has shown that LGG can serve as a promising novel diagnostic tool, potentially overcoming many drawbacks of current physicochemical transducer-based biosensors. Full article

Background: According to the One Health concept, the physical proximity between pets and their owners facilitates the interspecies spread of bacteria including those that may harbor numerous antimicrobial resistance genes (ARGs). Methods: A shotgun sequencing metagenomic data-based bacteriome and resistome study of 1830 canine saliva samples was conducted considering the subsets of ARGs with higher public health risk, ESKAPE pathogen relatedness (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species), and survey results on the physical and behavioral characteristics of the participating dogs. Results: A total of 318 ARG types achieved sufficiently high detection rates. These ARGs can affect 31 antibiotic drug classes through various resistance mechanisms. ARGs against tetracyclines, cephalosporins, and, interestingly, peptides appeared in the highest number of samples. Other Critically Important Antimicrobials (CIAs, WHO), such as aminoglycosides, fluoroquinolones, or macrolides, were among the drug classes most frequently affected by ARGs of higher public health risk and ESKAPE pathogen-related ARGs of higher public health risk. Several characteristics, including coat color, sterilization status, size, activity, or aggressiveness, were associated with statistically significant differences in ARG occurrence rates (p < 0.0500). Conclusions: Although the oral microbiome of pet owners is unknown, the One Health and public health implications of the close human–pet bonds and the factors potentially underlying the increase in salivary ARG numbers should be considered, particularly in light of the presence of ARGs affecting critically important drugs for human medicine. Full article

Since the World Health Organization (WHO) issued guidelines for developing a non-sputum test for active tuberculosis (TB) diagnosis that exhibits similar performance characteristics to sputum-based diagnosis, salivary diagnostic techniques have gained prominence as potential screening tools or adjuncts to existing diagnostics. We searched online databases for studies that looked at salivary diagnostic techniques. Afterwards, duplicates were removed, titles and abstracts were screened, and full-text studies were assessed for eligibility based on inclusion and exclusion criteria. The studies chosen for final analysis underwent a rigorous quality assessment following a QUADAS-2 template, and data were extracted. The primary outcome assessed the difference in mean levels of interleukins between TB+ patients and TB-controls (Hedges’ g). We then conducted two subgroup analyses: the first segregated the control group into healthy patients, and those with other respiratory diseases (ORD), and the second addressed three different interleukins separately (IL-6, IL-5, IL-17). The secondary outcome involved comparing salivary molecular diagnostic assays to WHO guidelines. This study is registered with PROSPERO, CRD42024536884. A total of 17 studies, out of an initial 1010, were chosen for the final analysis, but one was then excluded for being of poor quality. Our meta-analyses for the primary outcome revealed minimal diagnostic potential for interleukins. Our first subgroup analysis showed that interleukins were incapable of differentiating active TB patients from both healthy controls and ORD patients. Our second subgroup analysis showed that IL-17 was reduced in active TB patients. Assessment of the secondary outcome revealed that most studies relied on a GeneXpert MTB/RIF assay on saliva, but none fulfilled WHO guidelines for a non-sputum test. Individual biomarkers currently lack sufficient discriminatory power to definitively distinguish active tuberculosis from healthy individuals or those with other respiratory diseases (ORD), reinforcing the need for multi-biomarker panels. Interleukins may be alternatively used as markers for prognosis, severity, or treatment response. Our findings also suggest that assays are unable to meet WHO guidelines. Full article

Background: Malignant tumors of minor salivary glands (MGSTs) are rare and exhibit significant heterogeneity in terms of etiology, histology and prognosis. Methods: This retrospective analysis of 48 resected MGSTs employed Receiver Operating Characteristic (ROC) curves and logistic regression models to evaluate the association between the systemic inflammatory response index (SIRI), the systemic immuno-inflammation index (SII), the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR) with overall survival (OS). Although these biomarkers showed some correlation with OS, none were statistically significant when considered individually. Results: Significant correlation was observed between the SIRI, SII, and NLR with overall survival (OS). Among these, SIRI was the most reliable predictor, with an area under the curve (AUC) of 0.713, 80% sensitivity, and 70% specificity. Conclusions: While these inflammatory biomarkers correlate with the prognosis and risk stratification of MGSTs, there is currently no clinical utility in decision making due to the lack of standardization and their limited application in clinical practice. Full article

Cortisol, known as the “stress hormone”, is vital for stress response, metabolism regulation, and immune function, and salivary cortisone reflects serum cortisol levels. The measurement of salivary cortisone levels has been proposed as an effective alternative method for estimating serum cortisol levels. Objective: This study aimed to evaluate the use of Fourier Transform Infrared Spectroscopy (FTIR) for salivary cortisone identification and quantification and to assess the impact of adding the surfactant TWEEN 80 to the analysis. Methods: Initially, cortisone was diluted in chloroform and methanol (5,000,000 µg/dL). FTIR spectra were obtained, and absorbance characteristics and peaks were identified. The spectrum of this initial dilution was processed using the Savitzky-Golay filter to evaluate peak heights at 1655 cm⁻¹ and 1700 cm⁻¹, and the effect of signal processing on these peaks was assessed. Additionally, two series of dilutions were performed by adding the surfactant TWEEN 80 at two different concentrations, and the effect of the surfactant on the cortisone spectra was evaluated to reduce noise and enhance the signal. Results: The spectra obtained from the cortisone solution were similar to those found in the literature for solid samples. The peak corresponding to the wavenumber range of 1600–1680 cm⁻¹, related to the stretching bands of C=C, was found to be reliable for use in cortisone quantification studies. The standard deviation between the spectra of the same sample was less than 0.01. It was not possible to detect cortisone when TWEEN 80 was added; however, with signal processing, TWEEN 80 could be detected in quantities as low as 0.0033% of the solution. Conclusions: FTIR demonstrates potential as a non-invasive method for cortisone analysis. While Tween 80 aids in the dilution of cortisone in water, it obscures its spectrum. Full article