Abstract
Background: The aim of this in vitro study was to assess the morphological characteristics and stability of dental composites immersed in saliva collected from patients with leukemia. Material and Methods: A total number of five patients without systemic disease and 20 patients with leukemia (acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML)) were included for saliva sampling. Composite disks were immersed in the leukemia, control, and artificial environments for 7 days. At the end of the experiment, atomic force microscopy (AFM), color stability (ΔE), and saliva elements analysis were performed. Statistical significance was considered for a p-value under 0.05. Results: The most changed surface resulted for ALL with a roughness that was almost double that of the untreated sample and was significantly increased compared to the healthy saliva. The effect of CLL was not as intense as observed for acute leukemia, but was significantly over the control. ALL seemed to modify structural components of the saliva, which were able to deteriorate the surface of the composite. ALL saliva promoted a significant dissolution of the initial feature of the samples and promoted nano-particle clusterization. All dental composites showed clinically acceptable color change values (ΔE < 3.3) in all four-leukemia salivas; CLL and CML showed large color differences for all composites. The total concentrations of P, Na, and K showed wide ranges of variations, while the coefficient of variation in Fe, Cu, and Mg showed narrow variations between the salvias’ investigated. The salivary concentration of zinc decreased considerably in the CLL and CML environments compared to the ALL and AML environments. Fe and Cu were significantly increased in the CML environment. Conclusions: Control and artificial salivas have a mild erosive effect on the surface of dental composites. The acute stage of the disease seems to deteriorate the surface roughness rather than its morphology, however, in the chronic stage, it is the surface morphology that mostly deteriorates.
Highlights
Leukemia represents a well-known malignant disease of uncontrolled proliferation of white and red blood cells [1,2]
atomic force microscopy (AFM) to fine observe the changes that occurred the surface morphology and the with roughness to observe the changes that occurred to the surface morphology and the roughness caused caused by exposure to saliva (Figure 1)
The effect of leukemia was followed by a complex by exposure to saliva
Summary
Leukemia represents a well-known malignant disease of uncontrolled proliferation of white and red blood cells [1,2]. Due to the impairment of the blood cells and the presence of immunosuppression, patients present with several oral complications such as cervical lymphadenopathy, petechiae, oral ulcers, and mucositis [1,2] Gingival bleeding is another common oral sign in patients with leukemia and some reports have stated that it is the initial oral sign in 17.7% of acute leukemia patients and 4.4% in patients with chronic leukemia [3]. Another research paper published by Hansen and coworkers indicated that a conservative dental approach resulted in low odontogenic complications in patients before starting hematopoietic stem cell transplantation (HSCT) [9]. The aim of this in vitro study was to assess the morphological characteristics and stability of dental composites immersed in saliva collected from patients with leukemia. The acute stage of the disease seems to deteriorate the surface roughness rather than its morphology, in the chronic stage, it is the surface morphology that mostly deteriorates
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