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胃成形术对唾液特性、口腔健康状况和口腔感觉方面的影响:一项对照临床研究。

Impact of gastroplasty on salivary characteristics, dental health status and oral sensory aspects: A controlled clinical study.

机构信息

Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

MED-Mediterranean Institute for Agriculture, Environment and Development & CHANGE-Global Change and Sustainability Institute, University of Évora, Évora, Portugal.

出版信息

J Oral Rehabil. 2022 Oct;49(10):1002-1011. doi: 10.1111/joor.13353. Epub 2022 Jul 10.

Abstract

BACKGROUND

Saliva is a non-invasive source of biomarkers useful in the study of different pathophysiological conditions. The qualitative and quantitative study of saliva, as well as the assessment of oral health, can be particularly useful for a better understanding of obesity due to its importance in the food oral perception and ingestion.

OBJECTIVES

To evaluate the effect of treatment of morbid obesity (dietary counselling versus gastroplasty) on salivary characteristics, oral sensory perception and dental health in a controlled study.

METHODS

Seventy-three adults (60 females; 19-59 years) with morbid obesity were divided in: Control group (CG; n = 34) followed-up during a 6-months dietary programme, and Gastroplasty group (GG; n = 39) evaluated immediately before, 3 and 6 months after gastroplasty. Dietary habits, Oral Health Impact Profile and xerostomia complaints were investigated by interview. The clinical examination included anthropometric and caries experience evaluation. Salivary flow rate, buffering capacity, total protein and alpha-amylase levels, and sensitivity for the four basic tastes were assessed. Two-way mixed model and sign test were applied.

RESULTS

Physical and clinical aspects did not differ between groups in the beginning of the study, and GG showed a rapid weight loss after surgery (p < .001). An improvement in most of the dietary aspects was observed, especially in the GG. A worsening in the dental health status was observed over time in both groups, with an increase in the number of filled and decayed teeth. CG showed a better oral health-related quality of life, while xerostomia complains increased in GG after gastroplasty. Salivary flow rate remained stable in both groups, but a decrease in buffering capacity, total protein and alpha-amylase activity was observed in GG after 6-months; taste sensitivity increased from baseline to 6-months in GG (p < .05).

CONCLUSION

After 6-months of follow-up, patients undergoing gastroplasty presented an improvement in dietary habits and taste sensitivity. However, changes in saliva composition and a worsening in dental health status and xerostomia complaints were also observed.

摘要

背景

唾液是一种非侵入性的生物标志物来源,可用于研究不同的病理生理状况。唾液的定性和定量研究以及口腔健康评估对于更好地理解肥胖症特别有用,因为它在食物口腔感知和摄入中起着重要作用。

目的

在一项对照研究中,评估病态肥胖(饮食咨询与胃绕道手术)治疗对唾液特性、口腔感觉感知和牙齿健康的影响。

方法

73 名成年人(60 名女性;19-59 岁)患有病态肥胖症,分为对照组(CG;n=34),在 6 个月的饮食计划期间进行随访;胃绕道手术组(GG;n=39)在手术前、术后 3 个月和 6 个月进行评估。通过访谈调查饮食习惯、口腔健康影响概况和口干抱怨。临床检查包括人体测量和龋齿经历评估。评估唾液流率、缓冲能力、总蛋白和α-淀粉酶水平以及对四种基本味觉的敏感性。采用双向混合模型和符号检验。

结果

研究开始时两组的身体和临床方面没有差异,GG 手术后体重迅速下降(p<0.001)。观察到大多数饮食方面的改善,尤其是 GG。两组的牙齿健康状况随时间恶化,填充和龋齿的数量增加。CG 显示出更好的口腔健康相关生活质量,而 GG 手术后口干抱怨增加。两组唾液流率保持稳定,但 GG 组的缓冲能力、总蛋白和α-淀粉酶活性在 6 个月后下降;GG 组的味觉敏感性从基线到 6 个月增加(p<0.05)。

结论

在 6 个月的随访后,接受胃绕道手术的患者饮食习惯和味觉敏感性得到改善。然而,也观察到唾液成分的变化以及牙齿健康状况和口干抱怨的恶化。

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