Oral mucosa and salivary findings in non-diabetic patients with chronic kidney disease.

INTRODUCTION: Chronic kidney disease (CKD) and dialysis treatment could affect oral mucosa and cause qualitative or quantitative changes of saliva. OBJECTIVE: The aim of the study was to investigate oral manifestations, unstimulated salivary flow rate (USFR), salivary pH value and biochemical composition of saliva in non-diabetic patients with CKD. DESIGN: The study group (PD) consisted of 50 pre-dialysis patients diagnosed with CKD, positive control group (HD) of 25 haemodialysis patients and negative control (H) of 25 age and gender-matched healthy persons. Creatinine clearance rate (CrCl) was calculated from the blood creatinine using the Cockcroft-Gault formula. After a detailed intraoral examination, whole unstimulated saliva samples were collected to determine salivary pH value, and biochemical composition using a spectrophotometric method. RESULTS: Statistical analysis revealed that PD subjects had more oral lesions (p < 0.05) and symptoms (p < 0.001) than controls. The mean CrCl was significantly lower (p < 0.05) in CKD subjects with pale mucosa, xerostomia, dysgeusia, and uremic odour, comparing to those without listed symptoms. PD subjects had significantly decreased USFR and increased pH, urea and creatinine than H controls (p < 0.05). A moderately strong positive correlation between serum and salivary creatinine in both PD (p < 0.05) and HD (p < 0.05) groups was found. CONCLUSION: This study confirmed that xerostomia and dysgeusia are major symptoms among pre-dialysis patients. Their presence along with uremic odour and pale mucosa is directly related to decreased kidney function. On the diagnostic point, decreased USFR, especially hyposalivation and increased salivary creatinine, should be considered a significant indicator of CKD in stages before dialysis therapy.

The Effect of Zinc Gluconate Supplementation on Symptoms and Tongue Epithelium Regeneration in Non-psoriatic Patients with Migratory Glossitis.

The aim of this study was to evaluate zinc gluconate as a treatment option in patients with symptomatic migratory glossitis (MG). Using simple random sampling, 28 non-psoriatic patients with symptomatic MG were divided into a test and control group. The test group took 20 mg/day of chelated zinc gluconate for one month, and was put on a diet rich in zinc. The control group was only put on a diet rich in zinc. Changes in the size of red atrophied areas (width and length) and the intensity of symptoms were evaluated as primary and secondary outcomes, respectively, at baseline, after therapy, and one month later. In the test group, the mean value of the red atrophy area width and length displayed some significant reduction as a primary outcome. There were no significant changes in the size of red patches in the control group. Secondary outcome showed that the intensity of subjective symptoms in the test group significantly decreased (P=0.042) compared with controls. The filiform papillae had partially or completely regenerated in 85.7% of cases in the test group and in 23.1% of the controls (P=0.001). Red patches with raised keratotic rims may have healed spontaneously and reappeared in constantly changing patterns that are typical for MG. This phenomenon was not observed in patients supplemented with zinc, and new atrophy areas occurred in only one case. Low-dose zinc gluconate.

Is denture stomatitis always related with candida infection? A case control study.

AIM: To examine the oral mucosa under the denture base and to determine the influence of local factors that contribute to denture stomatitis. METHODS: In this prospective, case control study 30 patients with palatal inflammatory lesions were evaluated. A degree of palatal inflammation was scored. Swab samples were taken from tongue and palatal mucosa for microbiological examination. Denture plaque index, data of night wearing dentures, pH values of tongue and palatal mucosa were determined for all subjects. RESULTS: Significantly higher incidence of poor denture cleanliness index (p=0.01) and night wearing of dentures (p=0.009) were found in patients with denture stomatitis. There were significant differences between the groups in relation to the pH value of the tongue and palatal mucosa (p=0.016 and p=0.035, respectively). No significant association was found between denture stomatitis and microbiological findings, dentures age, type of dentures, presence of previous prosthesis, frequency or manner of dentures hygiene and smoking habits. CONCLUSION: Poor denture hygiene, overnight wearing of dentures and oral mucosa pH less than 6.5 are predominant local etiologycal factors that contribute to denture stomatitis development.