Nitric Oxide Concentration and Other Salivary Changes after Insertion of New Complete Dentures in Edentulous Subjects

Abstract

Objective. To assess changes in levels of salivary nitric oxide (NO) after insertion of new complete dentures and its association with clinical and salivary parameters. Methods. Nineteen fully edentulous subjects were included, mean age 64.4. Unstimulated whole saliva was collected before and after insertion of the dentures, at follow-up visits, and after 12 months. The concentration of the final stable NO product (nitrite) was measured by a colorimetric assay based on the Griess reaction. Clinical parameters were assessed during all clinical visits. Results. Functional adaptation to the dentures progressively improved, with no complaints at the long-term follow-up. NO concentration was not influenced by the level of functional adaptation, presence of injuries to the mucosa, salivary flow, and saliva viscosity. Pairwise comparison showed a reduction in NO concentration at the first follow-up compared to baseline values but differences were not statistically significant. Significant differences were observed in NO concentrations at the long-term follow-up when compared to the first (p = 0.024) and second (p = 0.027) visits. Conclusion. NO concentration reduced after denture insertion and returned to baseline levels in the long-term follow-up. This appears to be an autonomic response of the body and provides valuable complementary information for the management of the edentulous patient.

Evaluation of salivary stress biomarker changes after the insertion of complete dentures

“…In addition to that, another study reported a statistical significance of pH values before and after the CDs insertion [22]. Others, however, have not found significant changes in pH values [4,23]. Findings of our study are in correlation with previous findings that pH is significantly different before and after dentures insertion [24].…”

“…Stress may relate to usual transitory problems that arise after the insertion of new CDs, such as discomfort, functional difficulties, sore spots, injured mucosa and different levels of pain, thus extending the period of adaptation [4]. Introducing new CDs may also be a predisposing factor for the onset of salivary changes that affect oral homeostasis and oral mucosal health [4].…”

“…Patients first time CDs wearers are under various factors that influence their adaptation period. Those factors are not fully understood and are addressed as follows: quality of dentures, oral conditions, patient-dentist relationship, attitude toward dentures, patient's personality and socio-economic factors [4]. Mostly, clinical problems are, more or less, easily recognized, but the psychological discomfort during the adaptation period has not been fully explained.…”

Effectiveness of a simplified method for final impression in complete denture treatment: A pragmatic clinical trial

“…The levels of patient adaptation to the dentures and the presence of injuries in the mucosa were assessed and rated on a three‐point ordinal scale during the post‐insertion appointments . The level of patient adaptation to the dentures was rated as (a) report of favourable adaptation and continuous use of the dentures—absence of or minimal complaints; (b) report of difficult adaptation or intermittent use of the dentures—moderate to severe complaints; or (c) report of extreme difficulties and sporadic or no use of the dentures—severe complaints.…”

“…The levels of patient adaptation to the dentures and the presence of injuries in the mucosa were assessed and rated on a three-point ordinal scale during the post-insertion appointments. 20 The level of patient adaptation to the dentures was rated as (a) report of favourable adaptation and continuous use of the dentures-absence of or minimal complaints; (b) report of difficult adaptation or intermittent use of the dentures-moderate to severe complaints; or (c) report of extreme difficulties and sporadic or no use of the dentures-severe complaints. Injuries to the supporting mucosa were assessed and rated as follows: (a) absent; (b) one or two sore spots or ulceration evidenced by visual inspection, digital pressure or tissue compression with the denture; or (c) multiple sore spots or ulcerations evidenced by visual inspection, digital pressure or tissue compression with the denture.…”