Halitosis is a term that refers to an unpleasant or foul odour originating from the oral cavity that can be caused by either intra‐oral or extra‐oral factors. Despite the fact that halitosis has multifactorial aetiology, intra‐oral factors play a significant role in the majority of cases. This systematic review assesses halitosis's intra‐oral and extra‐oral associations. An electronic search through MEDLINE (PubMed), Google Scholar and the Wiley Online Library was conducted to identify relevant manuscripts. A keywords‐based search was performed, using the terms ‘halitosis’, ‘bad‐breath’, and ‘oral malodour causes and aetiology’. Articles published from January 2014 to December 2020 were included. We selected studies evaluating the intra‐oral and extra‐oral factors that induce oral malodour, as well as the factors associated with systemic diseases. Eighty to ninety percent of halitosis is caused by intra‐oral factors, with coated tongue, periodontal diseases and poor oral hygiene practices being the principal factors. Ten to twenty percent of halitosis is induced by extra‐oral factors associated with systemic diseases. Multiple factors can cause halitosis, but most of the aetiology is intra‐oral. Increased medical awareness is needed to determine the actual pathophysiological process of oral malodour in otherwise healthy individuals.
Introduction Matrix metalloproteinase‐8 (MMP‐8) is considered as one of the most promising diagnostic markers for periodontal disease. Androgen deprivation therapy (ADT) has been correlated with impaired collagen synthesis and an increase in periodontal tissue susceptibility to pathogenic microorganisms. Objective This study aims to investigate the impact of ADT on salivary MMP‐8 level and periodontal parameters, which might be useful in monitoring periodontal disease in prostate cancer patients undergoing ADT. Materials and Methods A total of 88 subjects were selected and were divided into two groups: Group I included n = 78 PC patients who have been undergoing ADT); Group II included n = 10 healthy individuals. Periodontal parameters such as plaque index (PI), gingival index (GI), periodontal probing depth (PPD), and clinical attachment level (CAL) were examined. The salivary MMP‐8 level was estimated by using the sandwich enzyme‐linked immunosorbent assay method. Results Significant differences in mean salivary MMP‐8 level were found between PC patients undergoing ADT and healthy individuals. Salivary MMP‐8 levels of all individuals were positively correlated with GI, PI, PPD, and CAL. Salivary MMP‐8 can distinguish between periodontitis and healthy individuals with an accuracy of about 80%. Conclusion Salivary MMP‐8 levels were found to be higher in prostate cancer patients undergoing ADT compared to healthy individuals.
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