An analysis of parotid salivary gland function with desipramine and age in female NIA Fischer 344 rats.

Cyclic antidepressants are still a dominating group of psychotherapeutic drugs used in the treatment of depression. Dry mouth is one of their major side effects. In this study we analyzed the effects of the long-term administration of the tricyclic antidepressant desipramine and the reversibility of this treatment following a 15-day washout period on different parameters in parotid gland function in aging rats. We hypothesized that glandular function would be decreased, and recovery delayed with age. Drug treatment affected body weight, glandular weight, DNA synthesis, and the concentration of soluble and structural membrane proteins. Surprisingly, parotid flow rate was increased with desipramine in all ages. While the concentration of secreted proteins was generally decreased with treatment, total proteins secreted were quite stable. SDS/PAGE analysis revealed prominent changes with desipramine. Amylase activity was depressed with treatment, but only low residual cellular enzyme activity was detected in the glandular supernatant. Therefore, a secretory impairment with desipramine was excluded. The content of the antimicrobial proteins peroxidase and lysozyme was increased with desipramine in all age groups. Most parameters measured revealed delayed recovery with age. These data indicate that the tricyclic antidepressant desipramine has profound effects on parotid gland function, accented with age.

Desipramine changes salivary gland function, oral microbiota, and oral health in rats.

Tricyclic antidepressants are still a dominating group of psychotherapeutic drugs used in the treatment of depression. Oral dryness is one of their major side-effects, leading in humans to increased oral disease and dysfunction of speech, chewing, swallowing and taste. We previously reported that the tricyclic antidepressant desipramine desensitizes beta-adrenergic signal transduction in salivary glands. In this study, we evaluated the effects of this treatment on parotid and submandibular gland function, oral microbiota, and oral health in rats. Total protein secretion and salivary alpha-amylase was not affected by treatment, while cellular alpha-amylase and the content of epidermal growth factor was depressed. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed increased secretion for proline-rich proteins and glycoproteins. Surprisingly, flow rates were temporarily increased. These alterations in salivary gland function may partially explain the observed changes in oral microbiota and the increased incidence of gingivitis. Under other nutritional conditions, desipramine might have more severe impacts on oral health.

An analysis of submandibular salivary gland function with desipramine and age in female NIA Fischer 344 rats.

Dry mouth is one of the major side effects of cyclic antidepressants, which are still a dominating group of psychotherapeutic drugs used in the treatment of depression. In this study we analyzed the effects of 28 day tricyclic antidepressant administration and the reversibility of this treatment following a 15 day washout period on different parameters in submandibular gland function in aging rats. We postulated that desipramine would decrease gland function, accented with age, and delay recovery in senescent animals. In contrast to body weight, desipramine had no effect on glandular wet weight. While glandular DNA synthesis was changed with age and treatment, the concentration of total membrane and soluble proteins was not affected. Flow rate was significantly changed with age, but desipramine increased salivary flow in the youngest animals only. Neither age nor treatment influenced salivary protein concentrations, but the total amount of proteins secreted, revealed perturbation with age. SDS- polyacrylamide gel analysis revealed changes in protein expression with treatment and age. Desipramine decreased epidermal growth factor (EGF) levels in all age groups, but increased the secretion of peroxidase and lysozyme. Analysis of total RNA showed a pronounced decrease with age. These data indicate that desipramine has profound effects on submandibular salivary gland function.

Desipramine induced changes in salivary proteins, cultivable oral microbiota and gingival health in aging female NIA Fischer 344 rats.

Cyclic antidepressants are still a dominating group of psychotherapeutic drugs used in the treatment of depression. One of their major side effect is salivary gland dysfunction (oral dryness, xerostomia), leading in humans to increased oral disease and dysfunction of speech, chewing, swallowing and taste. The purpose of this study was to assess the effects of the long-term administration of the tricyclic antidepressant desipramine and the reversibility of this treatment following a 15 d washout period on specific salivary proteins, composition of oral microbiota, and oral health (gingivitis) of aging female F344 rats. Total salivary proteins showed decreased concentrations with age and desipramine. Similar SDS/PAGE protein profiles appeared in all phases but in different relative amounts with age and treatment. While certain proteins maintained steady levels (lactoferrin) or decreased with age and treatment (amylase), the synthesis of proline-rich proteins, high molecular weight mucin-type glycoproteins, and lysozyme was induced with desipramine and age. The oral microbiota was significantly changed with age and the administration of the antidepressant. The incidence of gingivitis with desipramine was highest in the oldest animals, For the different parameters measured, recovery was delayed with age. These data indicate, that desipramine has profound effects on salivary protein secretion. This may partially explain the changes in microbiota and the increased incidence of gingivitis.

[Geriatric dentistry: medical problems as well as disease- and therapy-induced oral disorders]. / Alterszahnmedizin: medizinische Problematik sowie krankheits- und therapieinduzierte orale Störungen.

As in pediatric dentistry, management of the oral problems in elderly patients does not depend on the development of new technical skills, but rather on the knowledge of: biological, psychological and social aspects of primary (physiological or age-related) and secondary (pathological or disease-related) aging; atypical presentations of disease; multiple pathological conditions (polymorbidity, polypathophysiology, polypharmacy); an underreporting of disease; the importance of functional status; the role of an interdisciplinary team; Geriatric medicine refers to social, psychological and clinical aspects of disease in older adults. Geriatric dentistry deals with the respective aspects concerning oral diseases. Chronic conditions as well as their treatment (e.g. medication) are more common with advancing age. They may have major implications for dental practice, leading to changes in oral health behavior and attitudes of the elderly patient with sometimes detrimental effects on oral health. Therefore, different concepts in prevention, diagnosis and therapy of oral diseases are required for the oral care of older adults. Two important consequences must be considered: Firstly, the medical education of the dentist and the dental team must be improved. The dental team must become a member of the group of health-care professionals caring for an aging population (geriatric medicine) to meet the heterogeneous needs of as much as 75% of our future patients. Secondly, there is great need for education of all health-care professionals dealing with elderly patients about possible negative impacts medicine can have on oral health. Identification and diagnosis of oral disease as well as preventive measures must be stressed.

HIV disease: medical and dental aspects and trends for the future. A literature review.

The pandemic dimension of HIV disease is a reality. The cases of acquired immunodeficiency syndrome (Aids) and of new infections with HIV continue to increase. Available antiretroviral therapy cannot halt the progress of the disease. However, because of early diagnosis and treatment, life expectancy has increased. Oral diseases in these patients have the potential to cause severe pain, discomfort, alter form and function and disseminate systemically. Comprehensive dental management may be complicated by complex medical problems. Nevertheless, as the epidemic grows, a higher number of infected individuals will need dental care. A comprehensive dental management concept of the HIV-seropositive individual still needs scientific investigation. There are several unresolved psychosocial issues concerning the willingness of dentists to treat HIV-infected patients. The possible transmission of the virus from a dentist to his patients in a dental office in Florida generated public and professional hysteria. Lack of knowledge about the disease contributed to this situation. This literature review presents the state-of-the-art information available on medical and dental aspects of HIV disease and trends for the future in dental research, education and patient care.

Desipramine desensitizes beta-adrenergic signal transduction in salivary glands: differential regulation with age.

We previously reported that the tricyclic antidepressant, desipramine desensitizes beta-adrenergic signal transduction in parotid and submandibular salivary glands. To determine the consequences of repeated desipramine administration on beta-adrenergic signal transduction in salivary glands from aged rats and whether the recovery after drug withdrawal is impaired, we assessed the effects of 28-day desipramine administration and the reversibility of this treatment following a 15-day washout period on beta-adrenoceptors and adenylyl cyclase activity in parotid and submandibular glands from F-344 rats of 6, 12 and 24 months of age. beta-Adrenoceptors were also assessed in the cerebral cortex. Desipramine administration down-regulated receptor number and attenuated isoproterenol-stimulated adenylyl cyclase activity in all three ages of rats. However, the reduction in isoproterenol-stimulated adenylyl cyclase activity was greater than the loss of receptor number. Desipramine administration attenuated the efficacy of NaF-stimulated activity with no change in forskolin-stimulated adenylyl cyclase activity. These data suggest that in addition to desensitizing beta-adrenergic-mediated signal transduction, desipramine impaired G-protein-mediated adenylyl cyclase stimulation. The recovery from desipramine desensitization was age dependent. beta-Adrenoceptor density recovered more slowly in the cerebral cortex and the submandibular gland in 24-month-old rats than in 6-month-old rats. In contrast, in 12-month-old rats, there was a receptor up-regulation and adenylyl cyclase supersensitivity. These data indicate that the capacity for receptor modulation is age dependent and suggest that desipramine treatment may down-regulate stimulatory G protein.

Desipramine desensitizes beta-adrenergic signal transduction in rat salivary glands.

The consequences of the tricyclic antidepressant drugs include sedation, orthostatic hypotension and salivary dysfunction. It was reported that administration of desipramine resulted in a decrease in the concentration of secreted salivary protein. Tricyclic antidepressants may indirectly alter salivary function as a result of their action on the central nervous system to decrease adrenergic neural transmission or, alternately, may act directly on salivary glands to modulate beta-adrenergic signal transduction. To investigate the latter possibility, the effects of administration of desipramine (DMI) for 28 days was assessed on beta-adrenergic and post-receptor signal transduction in the parotid and submandibular glands of the rat and the reversibility of this treatment following a washout period of 15 days. Both glands demonstrated desensitization of the isoproterenol-stimulated activity, and in the parotid gland treatment with DMI decreased the post-receptor signal transduction as well. The washout period of 15 days completely reversed the desensitization in the parotid gland and partially reversed the effects in the submandibular gland. These data suggest that desipramine-induced attenuation of beta-adrenergic signal transduction is not limited to the brain and that these direct effects on salivary glands may explain the salivary dysfunction observed after administration of desipramine.

A comparative study of two methods for the orientation of the occlusal plane and the determination of the vertical dimension of occlusion in edentulous patients.

The aim of this study was to compare two methods used to orientate the occlusal plane (OP) and to determine the vertical dimension of occlusion (VDO). In method A the VDO was established by means of the rest position, the minimal speaking distance, and the patient's profile. Method B used a newly developed registration pin assembly. The VDO was registered using a silicone occlusion rim and the swallowing technique. The results were compared to the values of the new dentures. Three standardized lateral radiographs were taken at the VDO obtained with methods A, B, and at that of the final dentures. On each radiograph the orientation of the OP to the Camper plane and the VDO were measured by two investigators independently. The results indicated no statistically significant differences between the mean VDO with method A and B compared with the new dentures (P greater than 0.05). With both methods it was not possible to orientate the OP parallel to the Camper plane. None of the occlusal planes of the new dentures were parallel either. Their OP diverged on average by 7 degrees dorso-caudally. The time spent with method B to orient the OP and to determine the VDO was significantly lower than with method A (17-50 min).

A new method for positioning the maxillary anterior arch, orienting the occlusal plane, and determining the vertical dimension of occlusion.

A new method for positioning the maxillary anterior arch, orienting the occlusal plane, and establishing the vertical dimension of occlusion in edentulous patients is described. The procedure uses a newly developed registration pin assembly that is fixed to the maxillary acrylic resin baseplate. The vertical dimension of occlusion is determined by having the patient swallow. This approach eliminates the tedious and time-consuming process of trimming the occlusion wax rims. The accuracy of the new method is currently being evaluated.

A biochemical analysis of parotid and submandibular salivary gland function with age after simultaneous stimulation with pilocarpine and isoproterenol in female NIA Fischer 344 rats.

This analysis of physiological, biochemical and molecular changes related to aging was made in 3-, 12- and 24-month-old rats. The salivary gland weight/body weight ratio and the structural membrane proteins did not change with age for either gland, but a significant age-related decline in DNA synthesis for both glands was detected, unrelated to the hormonal responsiveness at the level of the plasma membrane. There was a marked increase in the concentration of soluble proteins in adolescent parotid gland and, for the two older age groups, in submandibular gland. The saliva flow rate was different when expressed as volume per time, as volume per time and g glandular wet weight, and/or kg body weight. The concentration of secreted proteins was not affected by age in either gland. The total amount of proteins secreted over 30 min revealed no age-related perturbation for the parotid gland, but showed a significant age-related increase in submandibular saliva. Sodium dodecyl sulphate-polyacrylamide gel analysis revealed changes in the protein bands between 39 and 50 kDa in the Coomassie blue-stained gels from 12-month-old animals. Amylase showed an initial increase (12 months), followed by a marked decline in its activity in parotid saliva. The glandular supernatant had low residual cellular amylase activity after stimulation. Therefore, secretory impairment with age after pilocarpine-isoproterenol stimulation was excluded. Analysis of total RNA showed a pronounced decrease of amylase mRNA in the parotid gland between 12 and 24 months of age. No amylase mRNA was expressed in any of the submandibular samples. For epidermal growth factor, total saliva showed a decrease with age. It seemed that the submandibular gland followed the same picture with age as the parotid gland, with a specific decline in the biosynthesis of single secretory proteins.

Beta-adrenergic receptors and salivary gland secretion during aging.

Beta-adrenergic signal transduction is primarily responsible for the control of the protein secretions by salivary cells. To examine the relationship between beta-adrenergic signal transduction and beta-adrenergic agonist-stimulated salivary secretion, we simultaneously assessed beta-adrenergic receptor number and pilocarpine-isoproterenol-stimulated salivary flow and secreted proteins in parotid and submandibular glands from 3-, 12- and 24-month-old female NNIA F-344 rats. There were no age-related changes in the density of beta-adrenergic receptors in the parotid gland or in the submandibular gland. In the parotid gland there was a significant increase in saliva flow rate in the oldest age group and no changes in the amount of total proteins secreted over 30 min. However, when normalized to gland weight, flow rate was unchanged and the amount of total secreted proteins decreased with age. In the submandibular gland there were age-related increases in both absolute volume and total secreted protein, but when normalized to gland weight there were no longer changes with age. Changes in flow rate were paralleled by reciprocal changes in protein secretory function such that changes in the salivary protein concentrations for the most part were unchanged with age for both the parotid and the submandibular gland. These parameters were compared to our previous data on adenylate cyclase activity, and collectively, these data suggest that in the submandibular gland salivary secretory function does not correlate with changes in beta-adrenergic receptor density or isoproterenol-stimulated adenylate cyclase activity.

Regulation of cell-surface galactosyltransferase in isoproterenol-treated mouse parotid glands.

Chronic injection of isoproterenol into mice resulted in hypertrophy and hyperplasia of the parotid gland. As previously described for the rat, cell proliferation was accompanied by an increase in total membrane-associated galactosyltransferase. A plasma membrane localization was determined by fluorescence-activated sorting of intact cells. Co-administration of the galactosyltransferase modifier protein, alpha-lactalbumin, or the calmodulin inhibitor, trifluoperazine, blocked acinar cell proliferation by 96 h post-treatment but not at 24 h. While alpha-lactalbumin appeared to interfere with galactosyltransferase-substrate interactions, trifluoperazine prevented the appearance of cell-surface enzyme in isoproterenol-treated animals.

[Myoarthropathies of the masticatory system. Diagnosis]. / Myoartropathieen van het kauwstelsel. De weg tot de diagnose.

Guidelines are presented for the diagnosis of myoarthropathy of the masticatory system. Attention should especially be paid to the history of the patient and the importance of a careful clinical inspection.

[Myoarthropathies of the masticatory system. Primary treatment and occlusal therapy]. / Myoartropathieën van het kauwstelsel. Primaire behandeling en occlusale therapie.

An overview is presented of the etiology and treatment of myoarthropathies of the masticatory system. Emphasis is placed on the proper use of occlusal splints.

Ventricular enlargement in teenage patients with schizophrenia spectrum disorder.

Recent research has demonstrated statistically significant differences between the ventricular-brain ratios (VBRs) of schizophrenic patients and control subjects. In this study the VBRs of teenage schizophrenic/schizophreniform patients (N = 15) and borderline patients (N = 8) were measured and compared with those of controls of similar ages (N = 18). The schizophrenic group had significantly larger ventricles than the other two groups (p less than .0001). These findings support the hypothesis of previous investigators that ventricular enlargement is present early in the course of schizophrenia.