Search Results (17)

Background: This randomized parallel-group clinical study evaluated salivary cortisol as a biomarker of perioperative stress response during surgical extraction of impacted mandibular third molars performed under local anesthesia administration of ropivacaine and dexamethasone. Methods: The trial was registered in the ISRCTN registry (ISRCTN87752106). Ninety patients undergoing impacted mandibular third molar surgery were randomly assigned (1:1:1; n = 30/group) to receive inferior alveolar nerve block with 0.5% ropivacaine plus dexamethasone (R+D group), 0.5% ropivacaine (R group), or 0.5% bupivacaine (B group). Salivary cortisol as the primary outcome was measured at 15 min before anesthesia, and 15 min and 24 h postoperatively. Preoperative psychological stress was assessed using the Revised Norman Corah Dental Anxiety Scale. Results: No significant differences were observed between groups in preoperative anxiety (p = 0.890) or baseline salivary cortisol levels (p = 0.984). Significant intergroup differences in cortisol levels were observed at 15 min (p = 0.002) and 24 h postoperatively (p = 0.001). Cortisol levels at 15 min postoperatively were significantly lower in the R+D group compared to the R (p = 0.001) and B groups (p = 0.004) and after 24 h (R+D vs. R: p = 0.005; R+D vs. B: p < 0.001). Conclusions: The ropivacaine–dexamethasone administration significantly reduced perioperative salivary cortisol levels compared to ropivacaine alone or bupivacaine alone during impacted mandibular third molar surgery. This modulation of the neuroendocrine response likely results from dexamethasone-induced suppression of hypothalamic–pituitary–adrenal axis and the improved analgesic effects of this combination. The observed results may contribute to improved physiological stability, postoperative recovery and the clinical benefit of this anesthetic approach in oral surgery. Full article

Background: Sleep hygiene protocols (SHPs) have been shown to improve sleep and stress regulation; however, the role of cortisol in shaping downstream physiological and performance adaptations remains unclear. This study primarily examined the effects of a short-term SHP on sleep duration and salivary cortisol responses across resting, pre-exercise, and post-exercise states in female collegiate soccer players and, secondarily, whether cortisol statistically mediated selected aerobic and anaerobic performance outcomes. Methods: Fourteen players (22.1 ± 3.3 y; 157.8 ± 6.0 cm; 53.5 ± 3.9 kg) completed a randomised, counterbalanced crossover study comparing habitual sleep (no sleep hygiene protocol; nSHP) with a comprehensive SHP incorporating environmental, behavioural, and educational strategies. Salivary cortisol was sampled one hour post-waking and 30 min pre- and 15 min post-exercise during standardised testing sessions. Performance outcomes included vertical jump, sprint performance (40 m and repeated sprints [RAST]), and the Yo-Yo Intermittent Recovery Test Level 1. Linear mixed-effects models assessed cortisol responses, and mediation analyses explored cortisol–performance relationships. Results: After SHP, perceived (7.87 h vs. 6.5 h; p = 0.002, ESg = 1.0) and calculated sleep duration (8.5 h vs. 6.9 h; p = 0.004, ESg = 0.95) increased significantly. Cortisol was markedly lower following SHP at selected timepoints, including before RAST (−43.05%, p = 0.006, ESg = 0.84), with additional timepoint-specific, condition-dependent differences post-anaerobic and post-aerobic exercise (Δ = 7.37 and 5.98 nmol·L⁻¹, respectively; p < 0.001). Vertical jump height demonstrated significant total (9.92 cm, p = 0.002) and direct effects (7.72 cm, p = 0.034), and peak repeated-sprint performance showed a significant direct effect (p = 0.026). Cortisol did not significantly mediate any performance outcomes (ACME p > 0.05). Conclusions: Short-term sleep hygiene is associated with increased sleep duration, timepoint-specific modulation of cortisol responses, and selected anaerobic performance benefits; however, these effects were not explained by measured cortisol responses and are unlikely to be sustained without ongoing reinforcement or support, particularly in athletic populations. Full article

Background: Adiponectin is an adipokine with insulin-sensitizing, anti-inflammatory, and cytoprotective properties that also plays a key role in metabolic adaptation to exercise. Although its regulation after resistance exercise has been extensively documented, less is known about its short-term modulation and its correlation with muscle damage markers following resistance training. Methods: Nine resistance-trained young men completed two sessions of total-body resistance exercise: (1) high time under tension (TUT) (5-1-2-1 cadence, to failure; ETS1) and (2) moderate TUT (2-1-2-1 cadence, two repetitions in reserve; ETS2). Plasma and saliva samples were collected before exercise and at 15 min, 24 h, and 48 h after exercise to assess total adiponectin by ELISA. Plasma creatine kinase (CK) and a Visual Analog Scale (VAS) were also measured for muscle soreness. Results: Plasma adiponectin significantly decreased from baseline to 48 h post-exercise in both sessions (p < 0.001), with no differences between the TUT conditions. Salivary adiponectin remained unchanged. Although a significant increase in CK and a decrease in adiponectin were observed at the group level, correlation analysis revealed no significant linear relationship between the magnitude of CK elevation and adiponectin reduction. Conclusions: Overall, these findings support the role of adiponectin as a marker of acute metabolic adaptation to resistance exercise. Acute resistance exercise elicited a time-dependent decrease in circulating adiponectin, irrespective of TUT. The temporal pattern of adiponectin decrease coincided with the rise in muscle damage markers, yet the lack of direct correlation suggests distinct regulatory mechanisms, while the lack of salivary changes underscores the complexity of adipokine regulation in vivo and suggests that saliva is not a reliable indicator of changes in circulating adiponectin. Full article

Background/Objectives: Orthodontic tooth movement is a biological process involving coordinated bone resorption and formation in response to mechanical stimulation. The aim of this study was to evaluate the temporal changes in C-terminal telopeptide of type I collagen (CTX), procollagen type I N-terminal propeptide (PINP), and vitamin D-binding protein (VDBP) levels in gingival crevicular fluid (GCF) and saliva during fixed orthodontic treatment, as well as to assess the relationships among these biomarkers. Methods: The study included a total of 27 systemically and periodontally healthy individuals comprising 14 males and 13 females. Clinical periodontal parameters were assessed at three time points: before treatment (T0), at 24–48 h (T1), and on day 40 (T2). GCF and saliva samples were collected at the same time points. Levels of CTX, PINP and VDBP in GCF and saliva were quantified using enzyme-linked immunosorbent assay. The data were analyzed using both parametric and non-parametric statistical tests. Temporal changes across the three time points were evaluated using mixed-effects models, differences between GCF and saliva biomarker levels were assessed using paired tests, and correlations were examined using Spearman correlation analysis. Results: GCF and salivary CTX levels demonstrated a significant increase from T0 to T1, while PINP levels exhibited a substantial rise from T1 to T2 (p < 0.001). Levels of VDBP in both GCF and saliva did not demonstrate significant temporal changes (p > 0.05). Higher VDBP levels in both fluids were found to be negatively associated with increases in CTX and positively associated with increases in PINP (p < 0.05). Furthermore, salivary CTX and VDBP levels exhibited a consistent increase compared to those measured in GCF at all time points (p < 0.05). Conclusions: Fixed orthodontic forces elicit sequential resorptive and formative responses in both GCF and saliva. The potential of VDBP to function as a local modulator is indicated, with the capacity to influence the balance between osteoclastic and osteoblastic activity. The evaluation of these biomarkers in non-invasive biological samples may offer a valuable approach for monitoring bone metabolism throughout orthodontic treatment. Full article

Background/Objectives: Streptococcus mutans (S. mutans) is a primary cariogenic bacterium contributing to biofilm acidogenicity and enamel demineralization. Conventional caries prevention relies mainly on mechanical plaque control and dietary modification, but probiotics have emerged as potential adjuncts for oral microbiota modulation. This pilot randomized controlled trial aimed to evaluate the short-term effects of a multi-strain probiotic containing Lactobacillus and Bifidobacterium on clinical and microbiological parameters associated with dental caries in children. Methods: A double-blind, randomized, placebo-controlled clinical trial was conducted in 40 children aged 6–14 years from a community setting. Participants were randomly allocated (1:1) to receive either probiotic or placebo lozenges for 30 days. Clinical assessments included the Gingival Index (GI), Plaque Index (PI), International Caries Detection and Assessment System (ICDAS), salivary pH, buffering capacity, and salivary S. mutans concentration. The study was preregistered (10.17605/OSF.IO/GKVUW) and ethically approved. Results: The intervention was well tolerated, with no adverse events reported and high participant acceptability. Despite there being no statistically significant differences in any clinical or microbiological parameter (p > 0.05), we found trends toward higher salivary pH, improved buffering capacity, and reduced S. mutans counts in the probiotic group. Conclusions: Short-term probiotic supplementation was safe and well accepted among children but did not produce statistically significant improvements in oral health parameters over 30 days. These findings highlight the feasibility of probiotic use in pediatric populations and support the need for larger, longer-term trials to clarify their potential role as adjuncts in caries prevention. Full article

Background/Objectives: Certain components of natural products help maintain the oral microbiota balance, thereby promoting oral health. This study aimed to identify natural components with anticariogenic properties by analyzing evidence from in vivo studies. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was performed across multiple databases and included English-language studies published between 2013 and 2025. The review included intervention and comparative studies that examined the effects of dietary habits involving natural components in participants of any age, with or without dental caries. Results: A total of 77 studies were included in the review, most of which were clinical trials conducted in pediatric populations. To assess the impact of the interventions, most studies measured outcomes such as Streptococcus mutans levels, dental caries incidence, and salivary pH, among other parameters. The most frequently studied components included probiotics, plant extracts, sugar substitutes, propolis, arginine, dairy products, among others. Significant effects were most reported on biological risk factors (72.8%). In addition, 16.9% of the studies reported a statistically significant reduction in clinically diagnosed dental caries. Conclusions: This review identified preliminary evidence suggesting that certain natural compounds may play a role in modulating cariogenic factors. However, further high-quality studies are needed to strengthen the evidence base and confirm these findings. The protocol for this review was registered on the Open Science Framework platform. Full article

Background: Salivary pH plays a critical role in oral health by influencing enamel demineralization, buffering capacity, and the ecology of oral microbiota. Essential oils such as Origanum vulgare (oregano) possess well-documented antimicrobial properties that may reduce acidogenic bacterial activity. However, the effects of edible delivery systems like jellies on salivary pH modulation and their potential interactions with hormonal states remain poorly understood. Methods: This study evaluated the in vitro antimicrobial activity of an oregano-oil-based jelly formulation against standard bacterial (Staphylococcus aureus, Streptococcus pyogenes, and Escherichia coli) and fungal (Candida albicans) strains using the Kirby–Bauer disc diffusion method. Additionally, a human trial (n = 91) measured salivary pH before and after administration of the oregano-oil jelly. Participants were characterized by age, smoking status, menopausal status, and presence of menstruation. Multiple linear regression was used to identify predictors of final salivary pH. Results: The oregano-oil jelly demonstrated strong in vitro antimicrobial activity, with inhibition zones up to 8 mm for E. coli and C. albicans. In vivo, mean unstimulated salivary pH increased from 6.94 to 7.07 overall, indicating a mild alkalinizing effect. However, menstruating participants showed a significant decrease in final pH (from 7.03 to 6.78). Multiple regression identified menstruation as a significant negative predictor (β = −0.377, p < 0.001) and initial pH as a positive predictor (β = +0.275, p = 0.002). Menopausal status was not a significant predictor, likely due to the small sample size. Conclusions: Oregano-oil jellies may represent a promising natural approach to support oral health by increasing salivary pH and providing strong antimicrobial activity. However, physiological states such as menstruation can significantly modulate this response, underscoring the importance of personalized or phase-aware oral care strategies. Further studies with larger, diverse cohorts and controlled hormonal assessments are needed to validate these findings and optimize product formulations. Full article

Physical exercise may affect drug use by balancing neurohormonal system mechanisms. Cortisol and β-endorphin, associated with stress, mood, and pleasure feelings, can be affected by exercise and act as regulators of withdrawal symptoms associated with drug use during short-term abstinence. The present study investigated the effect of a supervised, two-month moderate-intensity aerobic exercise program on salivary cortisol and β-endorphin levels in patients with an opioid use disorder (OUD) and on a substitution treatment during a short-term, 24–36 h withdrawal phase from methadone/buprenorphine medication. Ninety opioid users (41 females) in methadone and buprenorphine substitution treatment were randomly divided into four groups: (a) buprenorphine exercise (BEX) (n = 26; age (mean ± SD): 41.9 ± 6.1 yrs), (b) buprenorphine control (BCON) (n = 25; age: 41.9 ± 5.6 yrs), (c) methadone exercise (MEX) (n = 20; age: 46.7 ± 6.6 yrs), and (d) methadone control (MCON) (n = 19; age: 46.1 ± 7.5 yrs). The exercise intervention groups (BEX and MEX) followed a training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. The responses of cortisol and β-endorphin were measured before (t0) and immediately after an exercise session (t20) on different days (i.e., the 1st, 12th, and 24th session) corresponding to the beginning, middle, and end of the training program. A significant increase in β-endorphin levels was observed after the completion of the training intervention (24th exercise session) in both exercise groups (BEX before: 63.8 ± 33; BEX after: 185.6 ± 182.8 pg/mL; MEX before: 115 ± 211; MEX after: 262.3 ± 505.7 pg/mL), whereas β-endorphin was decreased in the control groups (BCON before: 34.7 ± 20.1; BCON after: 24.2 ± 8.8 pg/mL; MCON before: 129.7 ± 185.7; MCON after: 84.9 ± 104.3 pg/mL) (p < 0.05). Inversely, cortisol decreased in both exercise groups post-intervention (BEX before: 9.5 ± 5.9; BEX after: 2.8 ± 1.5 ng/mL; MEX before: 9.3 ± 6.6; MEX after: 3.1 ± 1.5 ng/mL) and increased in control groups (BCON before: 6.3 ± 2.5; BCON after: 10.1 ± 5.4 ng/mL; MCON before: 7.5 ± 3.2; MCON after: 12.5 ± 4.3 ng/mL) (p < 0.05). Moderate-intensity aerobic exercise can beneficially influence β-endorphin and cortisol levels in individuals undergoing treatment for OUD. By increasing endogenous opioid levels and reducing stress hormones, exercise emerges as a promising adjunctive strategy for alleviating withdrawal symptoms, enhancing emotional regulation, and potentially reducing the risk of relapse. The inverse relationship between β-endorphin and cortisol highlights the role of physical activity as a long-term modulator of neuroendocrine function in the context of substance use recovery. Future research should prioritize longitudinal studies extending beyond two months and involving larger, more diverse populations. Additionally, investigating the integration of exercise with non-pharmacological interventions—and its effects on relapse rates, mental health outcomes, and overall quality of life—would provide further insight into its therapeutic value in addiction recovery. Full article

Objectives: This clinical study aimed to evaluate the effects of two different sugar-free chewing gums on bacterial plaque reduction and salivary pH modulation in pediatric patients. Methods: This study retrospectively analyzed data from 100 children aged between 7 and 14 years who had previously participated in an investigation on plaque control and salivary pH. The Plaque Control Record Index (PCR) had been assessed in all participants using a plaque-disclosing agent, and salivary pH had been measured with a litmus test. The children had been randomly assigned into two groups: 50 had chewed a xylitol-containing gum, while the remaining 50 had chewed a maltitol-containing gum for five minutes. PCR and salivary pH values recorded immediately after chewing were reviewed for analysis. Results: Both chewing gums significantly reduced Plaque Control Record (PCR) values on dental surfaces (p < 0.001), indicating a statistically significant difference between pre- and post-treatment values. Salivary pH increased in both groups, suggesting a buffering effect associated with gum chewing. While the maltitol gum also reduced plaque accumulation, it showed greater variability in efficacy compared to the xylitol gum. No statistically significant differences were observed between the two gums in terms of salivary pH modulation. Conclusions: The findings highlight the beneficial effects of sugar-free chewing gums in reducing bacterial plaque and increasing salivary pH. These effects appear to be independent of the specific type of gum used, supporting their potential role as an adjunctive measure in oral hygiene maintenance. Full article

Background/Objectives: Tooth wear is a progressive and multifactorial condition influenced by mechanical and chemical factors. Saliva plays a crucial role in modulating erosive wear through its buffering capacity and remineralization potential. This study aimed to assess the prevalence and severity of erosive tooth wear among dental students and explore its correlation with salivary factors such as flow rate and pH. Methods: A cross-sectional study was conducted on 96 individuals from the Egas Moniz School of Health & Science. Erosive wear was evaluated using the Basic Erosive Wear Examination (BEWE) index. Unstimulated and stimulated saliva samples were collected to measure salivary flow rate and pH. Statistical analyses included Spearman’s correlation and multinomial logistic regression. Results: All individuals were classified as no risk (BEWE Score 0–2) or low risk (BEWE Score 3–8). The most affected teeth were the lower first molars and the 4th and 6th sextants. Salivary analysis showed a mean unstimulated flow rate of 0.5 mL/min and stimulated flow of 1.7 mL/min. A significant negative correlation (rho = −0.224, p = 0.029) was found between stimulated salivary pH and BEWE score, indicating that higher acidity contributes to greater erosive wear. Conclusions: This study highlights the impact of salivary properties on erosive tooth wear, emphasizing the protective role of higher salivary pH. Regular monitoring of saliva and preventive strategies should be integrated into early diagnosis and management of erosive wear in young adults. Full article

This review aims to provide a comprehensive overview of the literature on the oral side effects caused by radiotherapy for head and neck cancers. Various treatments are examined to mitigate these sequelae, and a protocol is proposed for dentists and dental hygienists to manage oncological patients. A literature search was conducted to select relevant articles addressing the effects of radiotherapy treatments on the oral cavity, with a particular focus on the development of mucositis, candidiasis, changes in salivary pH, trismus, fibrosis, and alterations in the oral biofilm. PubMed and MedLine were used as search engines, with keyword combinations including: head and neck cancer, mucositis, candida, dental care, dental hygiene, epidemiology, oral microbiome, biofilm, trismus, fibrosis, and salivary pH. A total of 226 articles were identified, spanning the period from 1998 to 2023. Articles deemed inappropriate or in languages other than English or Italian were excluded. A management protocol for oncological patients was proposed, divided into two phases: home-based and professional. Despite the advancements in intensity-modulated radiation therapy, it is impossible to completely avoid damage to healthy tissues. Preventive education and counseling in the dental chair, ongoing motivation, and education about oral hygiene are crucial to combine a good therapeutic outcome with an improved quality of life for the patient. Full article

Grape pomace is the main by-product generated during the winemaking process; since it is still rich in bioactive molecules, especially phenolic compounds with high antioxidant power, its transformation in beneficial and health-promoting foods is an innovative challenge to extend the grape life cycle. Hence, in this work, the phytochemicals still contained in the grape pomace were recovered by an enhanced ultrasound assisted extraction. The extract was incorporated in liposomes prepared with soy lecithin and in nutriosomes obtained combining soy lecithin and Nutriose FM06^®, which were further enriched with gelatin (gelatin-liposomes and gelatin-nutriosomes) to increase the samples’ stability in modulated pH values, as they were designed for yogurt fortification. The vesicles were sized ~100 nm, homogeneously dispersed (polydispersity index < 0.2) and maintained their characteristics when dispersed in fluids at different pH values (6.75, 1.20 and 7.00), simulating salivary, gastric and intestinal environments. The extract loaded vesicles were biocompatible and effectively protected Caco-2 cells against oxidative stress caused by hydrogen peroxide, to a better extent than the free extract in dispersion. The structural integrity of gelatin-nutriosomes, after dilution with milk whey was confirmed, and the addition of vesicles to the yogurt did not modify its appearance. The results pointed out the promising suitability of vesicles loading the phytocomplex obtained from the grape by-product to enrich the yogurt, offering a new and easy strategy for healthy and nutritional food development. Full article

Switching diets from forage to a high-grain (HG) diet increases the risk of rumen fermentation disorders in cattle. However, the effects of the duration of the HG feeding, after the diet switch, on animal behavior and health have received considerably less attention. This experiment primarily aimed to assess the effects of the duration of an HG diet on the chewing, eating, and lying behavior and salivation dynamics in a control group (CON) and a group of cows receiving a phytogenic feed supplement (TRT) at 0.04% (DM basis), which included L-menthol, thymol, eugenol, mint oil, and cloves powder. The experiment was a crossover design with nine non-lactating cows, and two experimental periods with an intermediate washout of four weeks. In each period, the cows were first fed a forage diet for a week to collect baseline measurements representing week 0; then, the diet was switched over a week to HG (65% concentrate), which was fed for four continuous weeks (week 1, week 2, week 3, and week 4 on an HG diet, respectively). The cows were divided in two groups of four and five animals and were randomly allocated to CON or TRT. The data analysis revealed that at the start of the HG feeding, the dry matter intake and the cows’ number of lying bouts increased, but the eating time, rumination time, and meal frequency decreased, resulting in a greater eating rate. We also found that an advanced duration on an HG diet further decreased the rumination time, total chewing time, chewing index, and sorting in favor of short feed particles, with the lowest values in week 4. The feed bolus size increased but feed the ensalivation decreased in week 4 compared to week 0. The dietary switch increased salivary lysozyme activity, and the advanced duration on the HG diet increased salivary pH, but salivary phosphate decreased in weeks 1 and 2 on the HG diet. Supplementation with TRT increased sorting in favor of physically effective NDF (peNDF) in week 2 and increased salivary pH in week 4 on an HG diet. Overall, the negative effects of the HG diet in cattle are more pronounced during the initial stage of the HG feeding. However, several detrimental effects were exacerbated with the cows’ advanced duration on feed, with host adaptive changes still observed after 3 and 4 weeks following the diet switch. The TRT mitigated some of the negative effects through the temporal improvement of the salivary properties and the intake of peNDF, which are known to modulate rumen fermentation. Full article

Engineering of the acquired enamel pellicle using salivary peptides has been shown to be a promising anticaries strategy. However, the mechanisms by which these peptides protect teeth against tooth decay are not fully understood. In this study, we evaluated the effect of the engineered salivary peptides DR9-DR9 and DR9-RR14 on enamel demineralization in two experimental conditions: (1) adsorbed onto the enamel surface forming the AEP, and (2) forming the AEP combined with their use to treat the biofilms 2×/day, using a validated cariogenic Streptococcus mutans in vitro biofilm model. Biofilms were grown for 144 h on enamel slabs and then collected to determine the bacterial viability (CFU/biofilm) and biofilm mass (mg protein/biofilm), and to extract cellular/extracellular proteins, which were characterized by mass spectrometry. The culture medium was changed 2×/day to fresh medium, and pH (indicator of biofilm acidogenicity) and calcium concentration (indicator of demineralization) was determined in used medium. DR9-RR14 peptide significantly reduced enamel demineralization (p < 0.0001) in both experimental conditions. However, this peptide did not have a significant effect on biofilm biomass (p > 0.05) nor did it modulate the expression of cellular and extracellular bacterial proteins involved in biofilm cariogenicity. These findings suggest that DR9-RR14 may control caries development mainly by a physicochemical mechanism. Full article

Since the modification of the proteinaceous components of the Acquired Enamel Pellicle (AEP) could influence the adhesion of Streptococcus mutans, the most cariogenic bacteria, to dental surfaces, we assessed if engineered salivary peptides would affect the adherence and modulate the bacterial proteome upon adherence. Single-component AEPs were formed onto hydroxyapatite (HAp) discs by incubating them with statherin, histatin-3, DR9, DR9-DR9, DR9-RR14, RR14, and parotid saliva. Then, the discs were inoculated with S. mutans UA159 and the bacteria were allowed to adhere for 2 h, 4 h, and 8 h (n = 12/treatment/time point). The number of bacteria adhered to the HAp discs was determined at each time point and analyzed by two-way ANOVA and Bonferroni tests. Cell-wall proteins were extracted from adhered, planktonic, and inoculum (baseline) bacteria and proteome profiles were obtained after a bottom-up proteomics approach. The number of adhered bacteria significantly increased over time, being the mean values obtained at 8 h, from highest to lowest, as follows: DR9-RR14 > statherin > RR14 = DR9-DR9 > DR9 = histatin3 > saliva (p < 0.05). Treatments modulated the bacterial proteome upon adherence. The findings suggested a potential use of our engineered peptide DR9-DR9 to control S. mutans biofilm development by reducing bacterial colonization. Full article