Salivary Nitric Oxide Research Articles

Possible Association between Behçet’s Disease and Periodontal diseases

AimThis study explores the connection between Behçet’s disease (BD), characterized by persistent oral and genital ulcers alongside iritis, and periodontal disease. It examines the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and nitric oxide (NO) in gingival crevicular fluid (GCF) and saliva.MethodsForty Behçet’s patients with gingivitis or periodontitis and 47 patients with either gingivitis or periodontitis but without BD were studied. Periodontal status was recorded with standard clinical indexes. GCF and saliva samples were obtained. NO, IL-1β and TNF-α levels were analysed. Current Behçet’s symptoms and medications usage were recorded.ResultsMean salivary IL-1β was elevated (p = .045), and mean NO level was decreased in BD patients with gingivitis compared to patients without BD (p = .000). In contrast, mean NO level in crevicular fluid was higher in Behçet’s patients with periodontitis than in patients without BD (p = .009). Furthermore, among Behçet’s patients, those with vascular involvement had lower salivary NO level compared to patients without vascular involvement (p = .000).ConclusionsBased on our findings, the elevated levels of IL-1β in the saliva of Behçet’s patients with gingivitis, along with the decreased NO level, indicate an altered inflammatory response in the oral cavity.

Correlation Between Blood Lactate and Salivary Biomarkers During Exercise in Women with Hypothyroidism Treated With L-Thyroxine

Background: Hypothyroidism reduces circulating levels of thyroid hormones metabolic enzymatic activities, and the skeletal muscle's work capacity and lactatemia increase during exertion. Objectives: To analyze salivary biomarkers and blood lactate obtained in exercise stages through exhaustion and investigate their correlation. Methods: Eight females attended the University Clinical Hospital who showed a condition of subclinical hypothyroidism. Before they began replacing with L-thyroxine, they were submitted to an ergometric test to check their tolerance to effort. Eight weeks after treatment, all volunteers were again submitted to lab and ergometric tests. Saliva and blood were collected to determine total protein, nitric oxide, IgA, lactate, and lipid profile. Results: The present study identified a correlation (0.8), so the behavior of the blood lactate could explain the behavior of the salivary of total proteins by 74.22% (R2 = 0.7422). Lactate production was minimized when women underwent L-thyroxine treatment in the first six stages of exercise. Still, total salivary proteins increased for pharmacotherapy between stages 1 and 8. While salivary nitric oxide had a percentage variation between pre- and post-exercise times of 96% before the start of treatment when the same exercise was performed after eight weeks of treatment with L-Thyroxine, this variation was 150%. Conclusion: The measurement of STP is an essential marker of stress, and it is highly correlated with the most used blood marker, lactate. Regarding treatment with L-Thyroxine in women with subclinical hypothyroidism, after eight weeks of this therapy, it was possible to observe a reduction in blood lactate production after the incremental load test on a cycle ergometer, accompanied by a reduction in the concentration of SA. SNO and SIgA tended to increase in women undergoing treatment, and this treatment should be considered in subsequent studies as causing a different effect on these markers.

Salivary Nitric Oxide Levels before and after Treating Caries in Children: A Comparative Study

Salivary Nitric Oxide Levels before and after Treating Caries in Children: A Comparative Study

Comparison of Low-Intensity and High-Intensity Exercise in Salivary Nitric Oxide Response: A Pilot Study

Background: Excessive production of salivary nitric oxide (s-NO) is a risk factor for oral diseases such as Sjögren syndrome and periodontal disease. Although s-NO is known to be affected by exercise, it is unclear how the difference in exercise intensities affects the s-NO response. Objectives: The purpose of this study was to investigate the acute effect of different exercise intensities (high vs. low intensity) on s-NO production using a cross-over design. Methods: Five healthy male young adults (21.6 ± 0.9 years) performed two ergometer exercises for 30 min at different exercise intensities: 50% heart rate (HR)reserve (low-intensity condition) and 80% HRreserve (high-intensity condition). Saliva samples were collected before (pre) and after (post 0-h and post 1-h) exercises. Results: The s-NO concentration significantly increased (P < 0.05) after the high-intensity exercise (∆changes in post 0-h; +244 ± 53 µmol/L, post 1-h; +352 ± 58 µmol/L), but the s-NO concentration did not change after the low-intensity exercise (∆changes in post 0-h; +11 ± 37 µmol/L, post 1-h; +64 ± 69 µmol/L). Conclusions: This study reveals that s-NO production is dependent on exercise intensities, suggesting that low-intensity exercise can be possible without increasing the risk of oral diseases.

Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment

BackgroundTaking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective.MethodsThis was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month).ResultsIn the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166).ConclusionsThe results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD.Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.

Effects of S-Allylcysteine-Rich Garlic Extract and Dietary Inorganic Nitrate Formula on Blood Pressure and Salivary Nitric Oxide: An Open-Label Clinical Trial Among Hypertensive Subjects.

The conversion of dietary inorganic nitrate(NO3-) to nitric oxide (NO) is a non-canonical pathway that plays an important role in NObiology, especially under pathological conditions. Inorganic NO3-supplementation is a proven method for controlling mild hypertension. Recent reports have suggested that another gaseous transmitter, hydrogen sulfide (H2S), influences NO biosynthesis and metabolism. Here, data are presented from an open-label clinical trial examining the effect of an encapsulated formulation (Vascanox® HP) that combines dietary sources of inorganic NO3- and S-allylcysteine (SAC), a source of H2S from garlic, on NO bioavailability and blood pressure in subjects experiencing elevated blood pressure or mild hypertension. An open-label clinical trial was conducted among patients with hypertension. Participants took Vascanox® for four weeks. Blood pressure was measured at baseline, two weeks, and four weeks. Salivary nitrite (NO2-), a surrogate of NO bioavailability, and NO3- were assessed prior to and two, six, and 24 hours after dosing on the first day of the study and prior to and two hours after dosing at subsequent study visits using saliva NO test strips. Changes in study outcomes over time were evaluated via analysis of variance (ANOVA) and paired t-tests. Twelve participants completed the clinical trial. Vascanox® HP decreased systolic blood pressure by ~11 mmHg (p < 0.001) at two weeks and persisted beyond four weeks with daily supplementation. It also decreased the diastolic blood pressure of hypertensive subjects but not normotensive ones. The magnitude of the decrease was 11 mmHg (p < 0.01) at four weeks of study. Measurements of salivary concentrations of NO2- revealed high peak levels (743 uM) at two hours post-administration and a slow decay to elevated levels (348 uM) at 24 hours. NO2- salivary concentrations, a surrogate biomarker of NO bioavailability, remained above baseline for the duration of the study. Vascanox® HP was shown to be a safe, effective, quick-acting, and long-lasting dietary supplement for controlling mild hypertension.

Clinical Evaluation of the Effects of Probiotics on Salivary Nitric Oxide Levels in Chronic Gingivitis Subjects during Orthodontic Treatment: A Clinico - Biochemical Study

Aim: To evaluate and compare salivary levels of nitric oxide in chronic gingivitis patients undergoing orthodontic treatment. Objective: To clinically evaluate the efficacy of probiotics on salivary levels of nitric oxide in chronic gingivitis patients undergoing orthodontic treatment. Materials and Methods: Unstimulated whole salivary samples were collected from a total of 20 subjects with chronic gingivitis undergoing fixed orthodontic treatment. Patients were divided into 2 groups. Group I patients were treated with non-surgical periodontal therapy i.e. Scaling and root planning (SRP) alone and Group II patients were treated with non-surgical periodontal therapy i.e. Scaling and root planning (SRP) and a Lactobacillus reuteri containing probiotic supplement. The clinical parameters of gingivitis were assessed using Modified Gingival Index (MGI), Sulcus Bleeding Index (SBI) and Plaque Index (PI). The biochemical analysis of salivary nitric oxide levels of subjects was conducted at baseline and 21 days. Statistical analysis was done using Mann-Whitney Test. Results: Group II patients showed a significant difference (p&lt;0.05) as compared to Group I patients in terms of Salivary Nitric Oxide levels, Modified Gingival Index (MGI), Sulcus Bleeding Index (SBI) and Plaque Index (PI). The use of probiotics in combination with SRP in the treatment of chronic gingivitis during active orthodontic treatment phase showed better results when compared to SRP alone. Conclusion: Salivary Nitric Oxide proves to be a significant marker of gingival inflammation and the adjunctive use probiotics along with NSPT can be recommended to reduce the severity of gingival inflammation and plaque formation during ongoing orthodontic treatment phase.

The Probiotic Streptococcus salivarius M18 Increases Plasma Nitrite but Does Not Alter Blood Pressure: A Pilot Randomised Controlled Trial

Some species of oral bacteria can reduce dietary nitrate to nitrite, which can later be converted to nitric oxide in the nitrate—nitrite—nitic oxide pathway. Increasing nitric oxide availability can reduce blood pressure (BP) and improve exercise performance. Streptococcus salivarius M18 (Streptococcus salivarius M18) is a bacteriocin-producing probiotic that is known to improve oral health by inhibiting pathogenic oral bacteria. However, it is presently unclear whether probiotic-induced alterations to the oral microbiome will influence circulating levels of nitric oxide metabolites and BP. Purpose: To determine the effects of Streptococcus salivarius M18 supplementation on plasma and salivary nitrate and nitrite levels and BP. Methods: Ten healthy males (age 32 ± 8 y, body mass 88.2 ± 15.1 kg) completed 2 × 14-day supplementation phases in a randomized order at least 14 days apart. In one phase, participants consumed Streptococcus salivarius M18 probiotic lozenges (2.5 billion colony-forming units/dose) once per day, and in the other, they ingested water (placebo). The abundance of bacteria on the tongue was assessed via Illumina 16S rRNA gene sequencing, unstimulated saliva, and venous blood samples were collected, and BP was measured pre and post each phase. Saliva and plasma were analysed for nitrate and nitrite using chemiluminescence, and pH was measured in saliva. The change in each outcome from pre- to post-supplementation was compared between phases using repeated measures ANOVA. Results: Plasma nitrite increased from baseline following probiotic supplementation (from 173 ± 39 to 223 ± 63 nM, p = 0.003, 95% CI 192–250 nM). In comparison, there was no change in the placebo phase or between baselines (all p &gt; 0.05). The abundance of nitrite-producing bacteria was not altered, salivary nitric oxide metabolites and pH did not change, and the increase in plasma nitrite did not result in reductions in BP (all p &gt; 0.05). Conclusions: Supplementation with Streptococcus salivarius M18 increased plasma nitrite, a key marker of NO availability. Despite this, Streptococcus salivarius M18 did not lower BP in these healthy normotensive participants. Additionally, the increase in plasma nitrite was not associated with abundance changes in bacteria thought important to NO generation. Further research is required to determine the mechanism behind the increase in plasma nitrite and the potential therapeutic and ergogenic benefits of Streptococcus salivarius M18 supplementation.

Salivary Nitric Oxide Levels in Adults with Different DMFT Scores in a Selected Iranian Population: A Cross-Sectional Study.

Due to the emphasis on the protective and antimicrobial role of Nitric Oxide against gastrointestinal diseases, investigating its relationship with dental caries is a right topic. Therefore, this research has investigated the amount of saliva Nitric Oxide in different volumes of DMFT indicator in adults. In this descriptive- analytical cross-sectional study, 80 participants (20-35 years old), without a history of systemic disease and drug use participated as research samples, (53.8% of the participants in the study were women). Participants were selected from patients who had visited dental Department. The participants were divided in four groups based on DMFT (DMFT=0, 1≤DMFT≤3, 3<DMFT<10, DMFT≥10). Non-stimulating saliva was collected from all participants between 9-11 am in a calibrated tube. Saliva Nitric Oxide was measured using a Nitrous Oxide test, based on the Griess reaction. We used a correlation test to analyze quantitative variables, and t-test or ANOVA for qualitative and quantitative variables. A significant relationship between DMFT and age was identified. At different levels of DMFT, significant relationship between DMFT and sex was not found. In different groups of DMFT, no significant relationship between Nitric Oxide and DMFT exist. The level of Nitric Oxide saliva was not affected by the amount of DMFT.

The relationship between salivary alpha-amylase, nitric oxide, pain and anxiety-induced stress in patients during dental treatment.

Pain and anxiety are the most reported negative effect of orthodontic treatment which can influence the quality of life and are responsible for the discontinuation of treatment. These unpleasant experiences raise the stress levels reflected by the increase in the concentration of salivary alpha-amylase and nitric oxide. These can be assessed through various subjective methods which have limited value as it depends on the patient's honesty, assessing whether using objective methods are reliable. To assess pain and anxiety-induced stress levels using both physiological (Salivary alpha-amylase and Salivary nitric oxide) and psychological testing instruments (Visual analog scale and State Trait Anxiety Inventory Y6) during the initial phases of fixed orthodontic treatment. A total of 30 patients were included. Pain and anxiety instruments were applied and saliva samples were collected from patients before and after separator placement, before and 48 h after archwire insertion and 1 month after archwire insertion. The mean values of alpha-amylase (235.3600), nitric oxide levels (2.060) and pain scores (7.8667) were higher 48 h after archwire insertion (T3) which are statistically significant, P = 0.00. Anxiety scores (57.7000) were high before separator placement (T0). No statistically significant correlation was found among pain and alpha-amylase, anxiety and nitric oxide levels. Initial alignment phases of fixed orthodontic treatment affect patients' anxiety and stress levels. The findings could be a result of the psychological stress due to procedures in the initial phases of the treatment.

Levels of nitric oxide in smokers and nonsmokers with chronic periodontitis before and after nonsurgical periodontal treatment.

The purpose of this study was to determine the level of nitric oxide (NO) in both serum and saliva of smokers and nonsmokers with chronic periodontitis before and after scaling and root planing, as well as to compare the same (NO levels) with the severity of periodontitis. Sixty people took part in the study and were divided into three groups. The control group (Group I) involved 20 patients who were nonsmokers with healthy periodontium. The other two groups included 20 patients each, where Group II was nonsmokers with chronic periodontitis and Group III was smokers with chronic periodontitis. In addition, NO generation was quantified indirectly in this study using the Griess reaction to determine the nitrite level in serum and saliva. The mean value of salivary and serum NO was higher in Group III than in Group II, and NO decreased considerably (P < 0.01) in both Groups II and III after treatment compared to before treatment. Serum and salivary NO levels can be used as a good predictor of the inflammatory condition of the periodontium in smokers.

Quantification of Salivary Nitric Oxide in Patients with Fixed Orthodontic Treatment

Nitric oxide (NO) is considered a regulator of bone response to mechanical stress that mediates adaptive bone formation, the pathological effects of lipopolysaccharides (LPS), tumour necrosis factor (TNF), interleukin 1 (IL-1) and other cytokines; regulates leukocytes and epithelial cell adhesion; inhibits T cell proliferation; and enhances natural killer (NK) cell activity, as well as other immune-related processes. The aim of the current study was to test the potential use of salivary NO as a biomarker of bone response that is specific and sensitive to local changes, following the application of different types of dental appliances. Material and methods: Salivary NO was determined in 30 patients divided into three groups with 10 participants each: control (C), fixed metal braces group (M), and aligners group (A). Salivary NO was determined four times in each group (before the procedure, at 2 weeks, 30 days, and 60 days after the procedure) using ELISA and rapid semi-quantitative assay with Nitric Oxide Saliva Test Strips (Berkeley, CA, USA). The mean results were compared with the ANOVA test, and the Pearson correlation index was calculated. The results show a significant increase in salivary NO levels by both methods only in the metal braces group, which is suggestive of oxidative damage, increased invasiveness, and bone response to metal braces. In conclusion, our study showed that metal brackets lead to a significant temporary increase in oral oxidative stress as an adaptive reaction to the presence of foreign bodies in the oral cavity. The subsequent concentration decrease at 60 days suggests a normalization of the body’s response to foreign bodies.

EFFECT OF CURCUMIN AS AN ADJUNCT TO SCALING AND ROOT PLANING, AND ITS THERAPEUTIC EFFECT ON SALIVARY NITRIC OXIDE LEVELS IN PATIENTS WITH CHRONIC PERIODONTITIS – A CLINICO – BIOCHEMICAL STUDY

Context (Background): Periodontitis is an infectious inflammatory disease with increase in salivary Nitric oxide levels and Curcumin is known to inhibit inflammatory mediators and neutralize nitric oxide which is expressed in salivary glands. To evaluate and compare the possible improvement in parameters of periodontal disease and salivaryAim: nitric oxide levels in patients undergoing scaling and root planing (SRP) alone and scaling and root planing (SRP) with systemic curcumin administration. In one group, systemic curcumin will be administered along withSettings &amp; Design: SRP &amp; in another group only SRP will be performed. In Group A, SRP along with systemicMethods &amp; Materials: curcumin was administered, and in Group B only SRP was performed. In both the groups, periodontal parameters such as the plaque Index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), presence or absence of bleeding on probing (BOP) and salivary nitric oxide (NO) levels by spectrophotometer were assessed at baseline and after three month. Chi-Square-test was used so as to evaluate and compare theStatistical Analysis used: possible improvement in parameters of periodontal disease and salivary nitric oxide levels in patients undergoing scaling and root planing (SRP) alone and scaling and root planing (SRP) with systemic curcumin administration. Results &amp; Conclusions: Clinically significant results with improvement in clinical parameters and reduction in salivary NO levels were noticed in both the groups, although test group showed more reduction in the salivary NO levels when compared to the control group thus concluding that administration of systemic curcumin is effective against salivary NO levels and can be used as an adjunct to SRP.

Investigation of the relationship between periodontal and systemic inflammation in children with Sickle Cell Disease: A case- control study.

Periodontal diseases are chronic inflammatory diseases and tissue destruction increases with oxidative stress in periodontal tissues. Periodontal diseases are associated with systemic diseases such as diabetes, cardio-vascular diseases and rheumatoid arthritis by means of systemic inflammation. Sickle cell disease (SCD) is a chronic inflammatory disease in which vaso-occlusive crisis and endothelial dysfunction are present. It is not known whether the chronic systemic inflammation seen in SCD affect periodontal tissues. The aim of this study was to investigate the relationship between periodontal and systemic inflammation in children with SCD. Forty-three children with SCD and 43 healthy children were included in the study. Physical, dental and periodontal statuses were examined, blood and saliva samples were taken. Levels of pro-inflammatory and oxidative stress mediators in serum and saliva were evaluated. The periodontal findings of the groups were similar. The majority of the subjects in both groups had gingival inflammation. In SCD group, significantly higher serum high sensitive C-reactive protein (Hs-CRP), interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, total oxidant status (TOS), nitric oxide (NO) and salivary IL-6 were observed (p<0.05). There were positive correlations between salivary IL-6 levels and serum Hs-CRP levels (r=0.303, p<0.05). In addition; it was determined that salivary IL-6, TNF-α and NO levels were increased 3-6 times in children with a history of painful crisis or acute chest syndrome compared to children who had never had a painful crisis or acute chest syndrome. Although, observed oral health status was similar in both groups, salivary cytokine levels were increased in children with SCD. The higher salivary cytokine levels may be associated with chronic systemic inflammation and vaso-occlusion observed in children with SCD.

Nitric Oxide, Oxidative Stress and Streptococcus mutans and Lactobacillus Bacterial Loads in Saliva during the Different Stages of Pregnancy: A Longitudinal Study.

Hormonal changes associated with pregnancy promote oral bacterial growth, which may affect salivary nitric oxide (NO) levels, oxidative stress (OS), and antioxidant capacity (AC). We hypothesized that caries-related bacterial load, NO level, and OS in the saliva change with advancing gestation. The aim of this study was to investigate longitudinal changes in salivary NO, OS, and AC during pregnancy and correlate them with Streptococcus mutans (SM) and Lactobacillus (LB) colonization at different stages of pregnancy. We assessed NO level by Griess method, OS by measuring malondialdehyde (MDA), AC by ABTS radicals and bacterial load by culturing SM and LB in the saliva of pregnant women (n = 96) and compared with non-pregnant women (n = 50) as well as between different stages of pregnancy. Compared with non-pregnant women, NO was 77% higher (4.73 ± 2.87 vs. 2.67 ± 1.55 µM; p < 0.001), MDA was 13% higher (0.96 ± 0.27 vs. 0.85 ± 0.22 nM; p = 0.0055), and AC was 34% lower (60.35 ± 14.33 vs. 80.82 ± 11.60%; p < 0.001) in the late third trimester. NO increased with advancing gestation, but AC and OS did not change significantly during pregnancy. SM were more abundant in pregnant women compared with non-pregnant (p = 0.0012). Pregnancy appears to have an adverse impact on oral health emphasizing the importance optimal oral healthcare during pregnancy.

Comparison of Oxidant Stress Levels among Healthy, Chronic Periodontitis, and Ischemic Heart Disease Subjects with Presence or Absence of Chronic Periodontitis.

Objective:To investigate the total oxidant levels in healthy, chronic periodontitis (CP), and ischemic heart disease (IHD) and to check for any correlation among them.Materials and Methods:A sample of 80 were split into four groups of healthy subjects (Group I), CP subjects (Group II), IHD subjects (Group III), and IHD subjects having periodontitis (Group IV). The serum and saliva samples collected were analyzed for levels of hydrogen peroxide (H2O2), hydroxyl radical (OH-), nitric oxide (NO), and superoxide radical (O2-).Results:There were significant (P < 0.05) variances in the mean serum and salivary levels of hydrogen peroxide, hydroxyl radical, NO, and superoxide within the 4 groups. Oxidant levels of both serum and saliva were lower in disease groups of Group II, III, and IV as compared to healthy controls, with different patterns.Conclusion:The oxidant levels (H2O2, OH-, NO, and O2-) are significantly hampered in periodontitis and IHD subjects as compared to healthy subjects. The oxidants, whether serum or salivary, did not always show the proportional change as a result of change in oxidant stress due to disease as positive correlation was observed only in the serum H2O2 and salivary NO radical levels and between serum superoxide dismutase radical and salivary H2O2 in Group I. In Group III, there was a positive correlation between serum NO radical and salivary H2O2.

Stress and its contribution to the development of depression symptoms are reduced in caregivers of elderly with higher educational level

Caregivers of elderly people with neurodegenerative diseases are highly vulnerable to stressful situations and mood disorders due to their work conditions. Stress has been associated with an increased risk of developing depression, and studies have supported that caffeine consumption can act as an independent protective factor for disorder. This study investigated indexes of stress and depression symptoms in caregivers of the elderly with neurodegenerative diseases, their caffeine intake and the association between stress and depressive symptoms with the salivary biomarkers cortisol, nitric oxide and DNA damage. Participants (n = 81) were recruited from the community between July 2018 and April 2019. Stress was assessed using Lipp’s Inventory of Stress Symptoms, and depressive symptoms were measured using the Hamilton Depressive Rating Scale. Participants provided a 72-hour recall of their diet to measure caffeine intake. Saliva samples were used to measure cortisol and nitric oxide. DNA damage was measured through micronuclei frequency after swabbing on the buccal mucosa. The majority of caregivers displayed stress and depressive symptoms. Stress was associated with educational level, tobacco use and total DNA damage. The indexes found in this population were not associated with caffeine intake or other salivary biomarkers, indicating that only some salivary molecules could be used as biomarkers for stress-related disorders. Caregivers of the elderly are exposed to stressful situations daily, however, we observed that educational level can reduce the psychological symptoms of stress and thus reduce the negative impact on quality of life.

Serum and Salivary Sialic Acid and Nitric Oxide Levels Estimation and Comparison after Nonsurgical Periodontal Therapy in Generalised Chronic Periodontitis Patients

Introduction: An exigency for a biomarker arises to expeditiously detect the periodontal disease evolution and to advocate more robust therapy efficacy measurements. Nitric oxide and sialic acid have been proved to be potential inflammatory markers. Hence, the evaluation of the involvement of nitric oxide and sialic acid in periodontal disease will enable us to assimilate the aspect of the complex process of periodontal disease progression. Aim: To estimate and compare the effect of nonsurgical periodontal therapy on serum and salivary sialic acid and nitric oxide levels in generalised chronic periodontitis patients. Materials and Methods: This study was a case-control as well as an interventional study. The subjects for this study were recruited from the Meenakshi Ammal Dental College and Hospital, Chennai from April 2017 to October 2018. Hundred patients were selected for this study. Control group consisted of 50 periodontally healthy subjects and test group consisted of 50 generalised chronic periodontitis subjects. After blood and saliva sample collection for determination of salivary and serum sialic acid and nitric oxide levels, evaluation of periodontal parameters like plaque index, probing pocket depth and Clinical Attachment Level (CAL) was done. Then the test group subjects underwent nonsurgical periodontal therapy and on 90th day post SRP parameters were re-evaluated. The collected data were analysed with IBM SPSS Statistics software, Version 23.0. In the above statistical tool the probability value 0.05 was considered as significant level. Results: The mean difference of plaque index, probing pocket depth, CAL, serum sialic acid, salivary sialic acid, serum Nitric Oxide (NO) and salivary nitric oxide: between the control and test group at baseline was -2.05, -5.01 mm, -5.56 mm, -12.515 mg/dL, -11.97 mg/dL, -129.762 μMol/L and -78.978 μMol/L respectively; for the test group at baseline and 90 days after nonsurgical periodontal therapy was 1.332, 3.15 mm, 3.285 mm, 14.206 mg/dL, 12.76 mg/dL, 130.082 μMol/L, 82.004 μMol/L, respectively. All the values were statistically significant with p-value &lt;0.001. Conclusion: Nonsurgical periodontal therapy led to a decrease in the serum and salivary sialic acid and nitric oxide levels in subjects with generalised chronic periodontitis. A decrease in biochemical parameters was associated with a reduction in probing pocket depth and gain in attachment level.

Relationship Between Salivary Nitric Oxide Concentration and Dental Caries in Children: A Systematic Review and Meta-analysis

Context: Conflicting results have been reported in the literature concerning the relationship between salivary nitrous oxide concentration and dental caries in children. Metaanalysis studies aim to combine different studies and reduce the difference between the parameters by increasing the number of studies involved in the analysis process. Objectives: Accordingly, this meta-analysis study aimed at determining the relationship between salivary nitrous oxide concentration and dental caries in children. Methods: Databases were searched using the keywords “nitric oxide”, “salivary”, “Caries”, “DMFT Index”, “children”, “early childhood caries” and OR, AND and NOT operators. Quality assessment was then performed based on the Newcastle-Ottawa scale (NOS) checklist. The standardized mean difference (SMD) of DMFT, dmft, and salivary nitric oxide (NO) concentration was estimated. Results: Seven studies made a comparison between the mean salivary NO concentration in children with dental caries and that in the control group. In four studies, the mean salivary NO concentration in children with dental caries was lower, as compared to that in the control group. This difference was significant in all four studies. Also, the mean standardized difference of the salivary NO index was also estimated to be -0.11 (CI 95%: -1.77, 1.55). Conclusions: This meta-analysis study demonstrated that salivary NO concentration was not significantly related to dental caries. Moreover, since salivary NO concentration is affected by various factors, it is not sufficient to determine the likelihood of the incidence of caries.

Association between hypertension, oral microbiome and salivary nitric oxide: A case-control study

BackgroundNitric oxide (NO) produced in the oral cavity is a powerful resource for the human body, especially when NO-syntethase production is not adequate. The role of oral microbiome in determining blood pressure levels has been linked to the active role of some bacterial species involved in the nitro-reducing process. In the present study we investigated the correlation between selected oral microbiome characteristics, nitric oxide (NO) concentration in saliva and their association with hypertension. MethodsA case-control study including 48 (25 normotensive and 23 hypertensive subjects), subjects between 50 and 70 years old, was carried out at the dental clinic of an Italian teaching hospital. Characteristics of participants have been evaluated by means of a physical examination, and by an assisted interview. A real-time polymerase chain reaction in samples of saliva and plaque was used to detect Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, Porphyromonas gingivalis, Treponema denticola, Streptococcus mutans, Streptococcus sanguinis, Veillonella dispar and Neisseria subflava as well as total bacterial count. Nitric oxide in saliva was evaluated by the ELISA method. ResultsNormotensive subjects, compared with hypertensive subjects, had significantly higher concentration of NO (165.77 ± 61.7 vs 57.49 ± 19.61 μmol/l; p = 0.023), and higher bacterial concentration of the supragingival plaque (4.73E+07 ± 4.33+07 vs 4.02E+07 ± 4.00+07; p = 0.024). Bacterial species, usually associated to good oral health status, such as Neisseria subflava, were significantly more present in normotensive subjects than in hypertensive ones (9090.88 ± 5481.49 vs 4791.35 ± 4349.37; p < 0.001). considering the concentration of bacteria as a biomarker of the development of hypertension. ConclusionsThe results support the association between hypertension, oral microbiome and salivary nitric oxide, in fact do the results allow us to establish any biomarkers (microbial or biochemical, NO) that allow early therapeutic intervention.