CLINICAL AND EXPERIMENTAL SUBSTANTIATION OF THE CHOICE OF TOOTHPASTES ON THE BASIS OF MONITORING THE COMPOSITION OF THE ORAL FLUID IN THE INHABITANTS OF INDUSTRIAL AREAS
Abstract and keywords
Abstract (English):
The inhabitants of industrial areas are influenced by anthropogenic factors. Harmful chemicals enter the body from the air, drinking water, food and are found in the oral fluid, hard tooth tissues, dental deposits, biopsy of tissue structures and contribute to the development of caries and inflammatory periodontal diseases. Toothpastes and mouthwashes are used for prevention of major dental diseases. The toothpastes contain a variety of abrasives: silicon dioxide, calcium carbonate, titanium dioxide, calcium bicarbonate, hydroxyapatite, which can act as adsorbents of heavy metal compounds. Biomonitoring using inductively coupled plasma mass spectrometry (ICP-MS) allows to determine the micro-quantities of metals in blood, urine, human milk, hair and oral fluid. The study of oral hygiene products showed that toothpastes and mouthwashes, used by patients for prevention and treatment of inflammatory periodontal diseases, have an adsorption activity for metal ions. The article evaluates the adsorption efficiency of medical and preventive toothpaste relative to the metal ions (chromium, manganese, cadmium, lead, etc.) in the oral fluid of the inhabitants of industrial areas. The use of adsorption-effective toothpaste twice a day for two weeks showed a significant decrease in the concentration of metal ions in the mixed saliva of the inhabitants which are under the influence of unfavorable environmental factors. When using a toothpaste containing silicon and titanium oxides, the concentration of manganese, chromium, arsenic, lead and cadmium ions in the oral fluid decreases within 2 weeks. The modern method of ISP-MS is advisable to use for high-precision monitoring of the oral fluid ion composition in patients living in the industrial areas.

Keywords:
toothpaste, mouthwash, adsorption efficiency, monitoring, silicon oxide
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Introduction

The incidence and prevalence of dental diseases, such as dental caries and inflammatory periodontal disease are higher in people who are in direct contact with the factors of the industrial environment [1, 2, 6, 7, 13, 19, 20, 25], this indicates the need to improve the system of dental prevention. The inhabitants of industrial cities are also influenced by anthropogenic environmental factors, such as air containing heavy metal ions (lead, cadmium, chromium, arsenic, etc.). Harmful chemicals enter the body from the air, drinking water, food and are found in the oral fluid (OF), hard tooth tissues, dental deposits, biopsy of tissue structures and contribute to the development of caries and inflammatory periodontal diseases [1, 2, 6, 8, 9, 11, 13, 14]. Biomonitoring using inductively coupled plasma mass spectrometry (ICP-MS) allows to determine the micro-quantities of metals in blood, urine, human milk, hair and OF [8―12, 14―18, 21―24]. Monitoring data are used to adjust nutrition, to develop methods of treatment and prevention of diseases associated with the failure of metal-ligand homeostasis [8, 9, 16, 17]. Toothpastes (TP) and mouthwashes are used for prevention of major dental diseases [3―5, 7]. The toothpastes contain a variety of abrasives: silicon dioxide, calcium carbonate, titanium dioxide, calcium bicarbonate, hydroxyapatite, which can act as adsorbents of heavy metal compounds [6, 7]. The problem of choosing the oral hygiene products is relevant in the presence of heavy metal ions in the OF.

The purpose of research is ― to determine the effect of oral hygiene products on the variation in the concentration of heavy metal ions in the oral fluid in the inhabitants of industrial cities according to the results of monitoring.

                        Materials and methods of research

                        Clinical studies were conducted at the Department of Therapeutic Dentistry of the Ural State Medial University and included the analysis of complaints and medical history, visual examination, index assessment of oral hygiene (OHI - S, J. R. Green, J.R. Vermillion, 1969), hard tooth tissues (DMFT), periodontal tissues (PBI, Muhllemann, Saxer, 1965). The clinical study involved 27 somatically safe men, inhabitants of the industrialized city, aged 20 to 23 years, who signed a voluntary informed consent to participate in the study (mean age 21.40±1.59). The OF sampling was carried out in the morning, in the fasted state. Patients were trained in the rules of oral care, provided with medium toothbrushes, TP and mouthwash which are adsorption-effective against heavy metal ions [8, 9]; they brushed their teeth twice a day for two weeks. The laboratory measurements were carried out at the Institute of Geology and Geochemistry of UB RAS (Shared knowledge center "Geoanalyst", supported by the grant of the President of the Russian Federation for State support of leading schools of thought in the Russian Federation NSH-9723.2016.5). Using the method of ICP-MS according to NSAM № 480 - X, 46 elements were defined in the composition of the OF: manganese, arsenic, cadmium, lead, chromium. All laboratory measurements were carried out in the mode of quantitative analysis with plotting the calibration curves using multi-element standard solutions Perkin Elmer Instruments, 99,998 % argon [8, 9].

Statistical processing of the results was carried out using the application package MS Excel, Vortex 7.0. To compare the data, student's t-test was used; the confidence level was p ≤0,05 [3―6, 8].

Results

According to the clinical examination, the average DMFT was 8,83±2,07. As a result, the use of the suggested oral hygiene products contributed to the improvement of hygiene (reduction of OHI-S level by 52,0±3,5 %; p<0,05) and to the reduction of the degree of inflammation of periodontal tissues (reduction of PBI index by 58,2±10,1 %; p<0,05). As a result of the analysis of the OF ion composition, the increased value of chromium content was determined in 18,52 % of cases, manganese in 22,22 % of cases, arsenic in 7,40 % of cases, cadmium in 22,22 % of cases, lead in 11,11 % of cases. Moreover, 6 persons showed an increased concentration of one metal, and 1 person had an increased concentration of two metals, and in 4 persons there was an increased concentration of three or four metals.

As a result, all patients significantly decreased the content of manganese, arsenic, lead and cadmium in the oral fluid, p<0,05 (table 1).

 

Table  The examples of variations in the content of metal ions in the OF before and after (2―5 weeks after) the use of adsorption-effective oral hygiene products

Element

 

1.1

1.2

1.3

1.4

1.5

Element

 

2.1

2.2

2.3

2.4

Mn

μg /l

125.84

11.99

70.69

75.25

10.07

Cd

μg /l

4.19

0.3

<0.1

<0.1

 

 

2.1

2.2

2.3

2.4

 

 

 

3.3

3.1

3.2

 

Pb

μg /l

32.99

0.68

1.01

<0.2

 

 

μg /l

7.81

<0.1

<0.1

 

 

 

3.1

3.2

3.3

 

 

 

 

6.1

6.2

6.3

6.4

Mn

μg /l

296.46

82.89

53.32

 

 

 

μg /l

1.45

0.31

<0.1

<0.1

Pb

 

156.03

4.16

12.12

 

 

 

 

7.1

7.2

7.3

 

 

 

4.1

4.2

4.3

 

 

 

μg /l

<0.1

4.58

2.99

 

Mn

μg /l

281.98

126.44

72.6

 

 

 

 

8.1

8.2

8.3

 

 

 

5.1

5.2

5.3

 

 

 

μg /l

9.1

2.21

<0.1

 

Mn

μg /l

45.87

115.22

57.07

 

 

As

μg /l

46.7

36.55

5.08

 

 

 

8.1

8.2

8.3

 

 

 

 

 

 

 

 

Pb

μg /l

240.79

41.42

6.94

 

 

 

 

 

 

 

 

 

 

9.1

9.2

9.3

9.4

 

 

 

 

 

 

 

Mn

μg /l

280.23

28.87

70.24

60.53

 

 

 

 

 

 

 

The monitoring of the OF ion composition in the industrial areas allows us to personalize the approach when choosing the oral hygiene products which are adsorption-efficient relative to heavy metal ions present in mixed saliva, Reducing the level of contamination of the OF with heavy metal ions will increase the effectiveness of prevention and treatment of major dental diseases (dental caries and inflammatory periodontal diseases), due to the lack of additional negative effects of ecotoxicants on the organs and tissues of the oral cavity,

Conclusion

  1. The modern method of ISP-MS is advisable to use for high-precision monitoring of the OF ion composition in patients living in the industrial areas,
  2. When choosing the oral hygiene products for inhabitants of the industrial areas, a personalized approach should be used on the basis of the analysis of the OF ion composition, followed by monitoring of their effectiveness,
  3. When using a toothpaste containing silicon and titanium oxides, the concentration of manganese, chromium, arsenic, lead and cadmium ions in the OF decreases within 2 weeks.

ICP-MS studies are carried out in the UB RAS Geoanalytic Center for Collective Use and supported by АААА-А18-118053090045-8 topic of IGG UB RAS State Assignment.

References

1. Agafonov A.A., Blashkova S.L., Dautov F.F. Risk factors for the health of employees of power plant shops // Fundamental'nye issledovaniya. 2012. № 12-2. pp. 215 - 218. (In Russian)

2. Adrianovsky V.I. Carcinogenic hazard and nutritional ways to reduce it in the fire refining of copper: Summary of the thesis of the candidate of medical sciences / Ural State Medical University. Yekaterinburg, 2000. 26 p. (In Russian)

3. Elovikova T.M., Belokonova N.A. Molvinskykh V.S. Innovations of conservative periodontics: aspects of the hygienic phase of treatment of inflammatory periodontal diseases. IV all-Russian workshop on fundamental dentistry. International Congress "Dentistry Big Ural". Collected papers. Edited by Sc.D. Mandra Yu.V. Yekaterinburg: USMU, 2016. pp. 191-194. (In Russian)

4. Elovikova T.M., Molvinskikh V.S., Ermishina E.Yu. Analysis of the effect of therapeutic and prophylactic toothpaste with herbal extracts on the state of the oral cavity in patients with gingivitis // Voprosy Stomatologii. 2015. №2. P. 5-9. (In Russian)

5. Elovikova T.M., Ermishina E.Y., Mikheykina N.I. Mechanisms of the restorative action of the new treatment and prophylactic toothpaste // Stomatologia. 2016. Vol. 95. № 5. pp. 32-35. (In Russian)

6. Kabirova M.F. The program of treatment and prevention of dental diseases among workers of the petrochemical plant // Vestnik RUDN. Series: Medicine. 2009. №4. pp. 484-486. (In Russian)

7. Leskov A.S. Influence of chemical factors on the incidence and prevalence of dental caries // Institut stomatologii. 2012. № 1 (54). pp. 31–32. (In Russian)

8. Burguera J.L., Burguera M. Recent on-line processing procedures for biological samples for determination of trace elements by atomic spectrometric methods. / Spectrochimica Acta, Part B. 64 (2009), pp. 451–458.

9. Fernando Gila, Antonio F. Hernándeza, Claudia Márquez, Pedro Femiac, Pablo Olmedoa, Olga López-Guarnido, Antonio Pla. F. Gil et al. Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population. // Science of the Total Environment 409 (2011), pp. 1172–1180.

10. Karina Krzciuk. Intelligent Analysis of Samples by Semiquantitative Inductively Coupled Plasma Mass Spectrometry (ICP–MS) Technique: A Review. // Critical Reviews in Analytical Chemistry 46 (2016), pp. 284–290.

11. Yaprak E., Yolcubal I., Sinanoğlu A., Doğrul-Demiray A., Guzeldemir-Akcakanat E., Marakoğlu I. High levels of heavy metal accumulation in dental calculus of smokers: a pilot inductively coupled plasma mass spectrometry study. // Journal of Periodontal Research 52 (2016), pp. 83–88.

12. Yan Y., Han B., Zeng J., Zhou W., Zhang T., Zhang J., Chen W., Zhang C. A candidate reference method for serum potassium measurement by inductively coupled plasma mass spectrometry. // Clinical Chemistry and Laboratory Medicine 55 (2017), pp. 1517–1522.

13. Martín-Cameán A., Jos A, Calleja A, Gil F, Iglesias A, Solano E, Cameán A.M. Validation of a method to quantify titanium, vanadium and zirconium in oral mucosa cells by inductively coupled plasma-mass spectrometry (ICP-MS). // Talanta 118 (2014), pp. 238–244.

14. Mohr V., Miró M., Limbeck A. On-line dynamic extraction system hyphenated to inductively coupled plasma optical emission spectrometry for automatic determination of oral bioaccessible trace metal fractions in airborne particulate matter. // Analytical and Bioanalytical Chemistry 409 (2017), pp. 2747–2756.

15. Deng Z., Yang Z., Ma X., Tian X., Bi L., Guo B., Wen W., et al. Urinary metal and metalloid biomarker study of Henoch-Schonlein purpura nephritis using inductively coupled plasma orthogonal acceleration time-of-flight mass spectrometry. // Talanta 178 (2018), pp. 728–735.

16. Han B., Ge M., Zhao H., Yan Y., Zeng J., Zhang T., Zhou W., et al. Determination of serum calcium levels by 42Ca isotope dilution inductively coupled plasma mass spectrometry. // Clinical Chemistry and Laboratory Medicine 56 (2017), pp. 51–58.

17. Drobyshev E.J., Solovyev N.D., Ivanenko N.B., Kombarova M.Y., Ganeev A.A. Trace element biomonitoring in hair of school children from a polluted area by sector field inductively coupled plasma mass spectrometry. // Journal of Trace Elements in Medicine and Biology 37 (2017), pp. 14–20.

18. Fernández-Menéndez S., Fernández-Sánchez M.L., Fernández-Colomer B., de la Flor St Remy R.R., Cotallo G.D., Freire A.S., Braz B.F., et al. Total zinc quantification by inductively coupled plasma-mass spectrometry and its speciation by size exclusion chromatography-inductively coupled plasma-mass spectrometry in human milk and commercial formulas: Importance in infant nutrition. // Journal of Chromatography A 1428 (2016), pp. 246–254.

19. Morton J., Tan E., Suvarna S.K. Multi-elemental analysis of human lung samples using inductively coupled plasma mass spectrometry. // Journal of Trace Elements in Medicine and Biology 43 (2017), pp. 63–71.

20. Herman M., Golasik M,, Piekoszewski W., Walas S., Napierala M., Wyganowska-Swiatkowska M., Kurhanska-Flisykowska A., et al. Essential and Toxic Metals in Oral Fluid-a Potential Role in the Diagnosis of Periodontal Diseases. // Biological Trace Element Research 173 (2016), pp. 275–282.

21. Yan Y, Zhang C, Zhang J, Zhang T, Zhou W, Zeng J, Chen W. Measurement of Serum Sodium and Magnesium by Inductively Coupled Plasma Mass Spectrometry with Aluminum as Internal Standard // Clinical Laboratory 62 (2016), pp. 719–725.

22. Maoyong He, Hai Lu, Chongguang L., Tongxiang R. Determining trace metal elements in the tooth enamel from Hui and Han Ethnic groups in China using microwave digestion and inductively coupled plasma mass spectrometry (ICP-MS). // Microchemical Journal 127 (2016), pp. 142–144.

23. Cieslak W., Pap K., Bunch D.R., Reineks E., Jackson R., Steinle R., Wang S. Highly sensitive measurement of whole blood chromium by inductively coupled plasma mass spectrometry. // Clinical Biochemistry 46 (2013), pp. 266–270.

24. Lingott J., Lindner U., Telgmann L., Esteban-Fernández D., Jakubowski N., Panne U. Gadolinium-uptake by aquatic and terrestrial organisms-distribution determined by laser ablation inductively coupled plasma mass spectrometry. // Environmental Science: Processes & Impacts 18 (2016), pp. 200–207.

25. Sun X., Bernabé E., Liu X., Gallagher J.E., Zheng S. Do contextual factors have a role in periodontal disease? // Journal of Clinical Periodontology 44 (2016), pp. 13–21.


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