Saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia: a randomized controlled trial

Objectives Xerostomia is a prevalent sequelae among nasopharyngeal cancer (NPC) survivors; yet, effective treatment protocols have been elusive. This study was a prospective randomized clinical trial to compare the effects of saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia, between two treatment arms, conducted in a tertiary center. Materials and methods This study measured the effects within 4 weeks in relation to summated xerostomia inventory (SXI) and unstimulated whole saliva (UWS). Patients randomized into the interventional arm were prescribed an immunologically active saliva substitute (IASS), while patients in the control arm were prescribed a non-immunologically active mouthwash as placebo. Results The study population consisted of 94 patients. There was a significant difference in SXI difference (p < 0.0001) and UWS difference (p < 0.0001) between control and interventional arms. No harmful side effects associated with the use of either mouthwash encountered throughout the study duration. Conclusion IASS mouthwash significantly reduces subjective xerostomia scores measured using SXI and improves objective measurement of salivary flow using UWS among nasopharyngeal cancer survivors with xerostomia. Clinical relevance IASS is significantly more effective in improving subjective and objective xerostomia measurements compared to non-immunologically active mouthwash. Additionally, this treatment is very safe, with superior side effect profiles. Trial registration ClinicalTrials.gov Identifier: NCT04491435

Experimental Investigation of the Influence of Chlorhexidine Gel on the Implant-Abutment-Connection

Background The aim of this study was to determine the effect of chlorhexidine gel on removal torque of abutment prosthesis screws in vitro. Methods 60 implants (BEGO Semados ® S/RI 4.1, BEGO Implant Systems GmbH & Co. KG, Bremen, Germany) were embedded in acrylic resin for study set-up. The abutments (S/RI 4.1 SUB-TEC WI, BEGO Implant Systems GmbH & Co. KG, Bremen, Germany) were fixed with prothesis screws with 25 Ncm on the implants and were loaded for 10.000 cycles with 250N in a static material testing machine. The implemented study consisted of three groups (n=20). Group 1 (control group) were loaded under dry conditions. Group 2 was filled with a saliva substitute only (Sialin-Sigma solution, Sigmapharm Arzneimittel GmbH, Vienna, Austria), group 3 was filled with a saliva substitute and additional with chlorhexidine gel (Chlorhexamed 1% GEL, GlaxoSmithKline Consumer Healthcare GmbH & Co. KG, München, Germany). Statistical analysis was performed using ANOVA (significance level p<0.05). Results The control group showed the smallest range of removal torque (19.85 Ncm ± 1.42 Ncm) while group 2 showed 20.32 Ncm ± 2.61 Ncm and in group 3 was 19.74 Ncm ± 2.96 Ncm. No significant differences between the three groups were evaluated. Conclusions Within the limits of this in-vitro study, it can be concluded that the application of chlorhexidine gel did not show any significant effect on the removal torque on abutment screws after loading.