Recent advancements in mass spectrometric proteomics provide a promising result in utilizing saliva to explore biomarkers for diagnostic purposes. However, the issues of specificity or redundancy of disease-associated salivary biomarkers have not been described. This systematic review was therefore aimed to define and summarize disease-related salivary biomarkers identified by mass spectrometry proteomics. Peer-reviewed articles published through July 2009 within three databases were reviewed. Out of 243 articles, 21 studies were selected in this systematic review with conditions including Sjö gren's syndrome, squamous cell carcinoma, dental caries, diabetes, breast cancer, periodontitis, gastric cancer, systemic sclerosis, oral lichen planus, bleeding oral cavity, and graft-versus-host disease. The sample size ranged from 3-41 in both diseased and control subjects, with no consensus on sample collection protocol. One hundred eighty biomarkers were identified in total; 87 upregulated, 63 downregulated, and 30 varying based on disease. Except for Sjö gren's syndrome, the majority of studies with the same disease produce inconsistent biomarkers. Larger sample size and standardization of sample collection/treatment protocol may improve future studies.

Purpose Multifactorial etiological factors contribute to denture stomatitis (DS), a type of oral candidiasis; however, unlike other oral candidiasis, DS can occur in a healthy person wearing a denture. In this study, we therefore attempt to explore the association between candida, denture, and mucosal tissue using 1) exfoliative cytology, 2) the candidal levels present in saliva, on mucosal tissues and on denture surfaces, and 3) the salivary flow rate and xerostomic symptoms. Materials and Methods A cross-sectional study enrolled 32 edentulous participants, 17 without DS as controls and 15 with DS (Newton’s classification type II and III). Participants with systemic or other known oral conditions were excluded. Participants completed a xerostomia questionnaire, and salivary flow rates were measured. Samples of unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected. UWS was used for fungal culturing. Periodic acid-Schiff (PAS) stain and quantitative exfoliative cytology were performed on samples from affected and unaffected mucosa from each participant. Levels of Candida species (albicans and non-albicans) were determined in salivary samples (expressed as colony-forming units, CFU), as well as from swab samples obtained from denture fitting surfaces, in addition to affected and unaffected mucosa. Results There were no significant differences in salivary flow rates, mucosal wetness, or frequency of reported dry mouth comparing participants with and without DS. Exfoliative cytology of mucosal smears demonstrated significantly higher (P = 0.02) inflammatory cell counts in DS patients, as compared with smears of healthy denture-wearers. C. albicans was significantly more prevalent in saliva (P = 0.03) and on denture surfaces (P = 0.002) of DS participants, whereas mucosal candidal counts and the presence of cytological hyphae did not show significant difference comparing DS to healthy participants. Conclusions In this investigation, we presented a unique group of healthy edentulous patients. This population may reflect the general DS population without systemic or other oral diseases. The prominent etiological factor for DS in this population is the presence of candida in denture and saliva. We found that other factors such as saliva flow/xerostomia, fitting of the denture, and the presence of candida in the mucosa, are less important in this population. Therefore, DS treatments in healthy patients should first focus on sanitization of an existing denture and/or fabrication of a new denture.

BackgroundWhen implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval.Material and methodsTwenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten cemented crowns were removed at 48 hours after cementation as a short-term group (ST), while another 10 were removed 6 months after cementation as a long-term group (LT). To mimicking repetitive recementation and retrieval, the LT crowns were then recemented and removed after 48 hours as a long-term recemention (LTR) group. The LTR crowns were then again recemented and removed after 48 hours as a long-term repeated recemention (LTRR) group. Er:YAG laser was used to facilitate the retrieval of these crowns. recorded and analyzed using ANOVA and t-test. The surfaces of the crown and the abutment were further examined using light microscopy and scanning electron microscopy (SEM). Temperature changes of the abutment and crown upto 10 minutes were also measured and statistically analyzed (paired t-test).ResultsThe average times of crown removal from zirconia abutments were 4 minutes (min) and 42 second (sec) in LT to 3 min 24 sec in LTR, and 3 min 12 sec in LTRR and ST groups. LTR took the longest time to remove, statistically (ANOVA and t-test, p < .001). No statistical differences were observed among the removal times of LTR, LTRR, and ST groups (t-test, p = .246, .246 and 1). SEM examination of the material surface showed no visual surface damaging from treatment with Er:YAG laser. The temperatures during irradiation ranged from 18.4°C to 20°C and 22.2°C to 24.5°C (Paired t-test, p < .0001) for the abutment and the crown during irradiation from 1 min to 10 mins.ConclusionsLong-term cementation can increase time in lithium disilicate crown removal from zirconia abutment using Er:YAG. Er:YAG laser is a non-invasive tool to remove cement-retained implant prostheses and should be considered as a viable alternative to rotary instruments.

Type 2 diabetes and tooth loss are linked both epidemiologically and pathophysiologically. We applied label-free differential protein expression analysis using multidimensional liquid chromatography/tandem mass spectrometry (2D-LC-MS/MS) to explore the proteomic profile of saliva samples collected from selected type 2 diabetic edentulous patients and non-diabetic controls. Ninety-six peptides corresponding to 52 proteins were differentially expressed between the diabetic edentulous patients and controls (p < 0.05). Some diabetes-related inflammatory biomarkers including glyceraldehyde-3-phosphate dehydrogenase and serum amyloid A were detected with levels increased in diabetic samples. Other biomarkers including amylase, palate, lung and nasal epithelium associated protein (PLUNC), and serotransferrin levels were decreased in diabetic samples. In contrast with previous findings, salivary carbonic anhydrase 6 and alpha-2 macroglobulin levels, however, were decreased in this diabetic patient population. Cluster analysis and principle component analysis demonstrated a differential pattern of protein biomarker expression between diabetic and control subjects. Western blot analysis was completed to confirm the relatively lower expression level of two biomarkers, including PLUNC and amylase in the diabetic group compared to control subjects. The presence of salivary biomarkers specific for diabetes in edentulous subjects mimics those in serum, especially those related to inflammatory/lipid metabolism. While this exploratory study requires further validation with a larger population, it provides proof-of-principle for salivary proteomics for edentulous subjects with diabetes.

Purpose Removal of cement‐retained implant crowns can be difficult and often requires sectioning of the prosthesis by rotary instruments. This study aimed to measure how much time is required in crown removal and the temperature changes when erbium‐doped yttrium aluminum garnet (Er:YAG) laser was used to retrieve lithium disilicate crowns from titanium implant abutments luted with composite resin (CR) cement and resin‐modified glass ionomer (RMGI). Materials and Methods Forty identical lithium disilicate crowns were fabricated for prefabricated titanium abutments. CR and RMGI cements were used to lute the crowns, 20 specimens for each cement. Specimens were kept in 100% humidity for 48 hours. Er:YAG laser was then used to facilitate the crown retrieval. The retrieval time was recorded. The temperature changes at the abutment level for each type of cement were recorded during irradiation of 10 specimens for each type of cement from 1 to 10 minutes. Data were analyzed using t‐test (ɑ = 0.01) and paired t‐test (ɑ = 0.05). The surfaces of the crown and the abutment were further examined using scanning electron microscopy (SEM). Results The average times of crown removal from titanium abutments were 196.5 seconds for CR and 97.5 seconds for RMGI groups with statistical significance (p < 0.001). The temperatures measured from 1 to 10 minutes of irradiation ranged from 18° to 20.8° for CR and 18° to 23° for RMGI at the abutment surface, and 22.1° to 24.6° for CR and 22° to 24.8° for RMGI at the crown surface. No statistical differences were observed between temperature changes at the abutment or the crown for each cement (p = 0.63); however, there was a statistically significant difference between the temperatures at the abutment and crown for both cements (p < 0.001). SEM examination showed no visible damage caused by treatment with Er:YAG laser. Conclusions It is faster to remove lithium disilicate crowns from titanium implant abutments when luted with RMGI compared to CR cement. The temperature rise was higher in the crown compared to the abutment. The type of cement had no effects on temperature changes. Heat generated from Er:YAG irradiation does not appear to be high enough to have any adverse effect on implant osseointegration.