ARTICLE
Auteur(s) : Piotr Skomro1, Krystyna
Opalko1, Olga Bohdziewicz1, Iwona
Nocen2, Joanna
Janiszewska-Olszowska3
1Department of Propedeutics of Dentistry
and Dental Physiodiagnostics
2Department of Chemistry
3Department of Orthodontics, Pomeranian Medical
University of Szczecin, Poland
Saliva constitutes a natural environment for teeth, parodontium
and mucous membranes of the oral cavity and creates a
microenvironment, determining the proper course of many biochemical
and physical reactions [1]. Calcium and magnesium belong to the
mineral elements of saliva. They participate in building the enamel
and their altered content may lead to a pathology of hard tissue
and caries development. Ionized calcium helps the maintenance of
tooth mineral integrity by modulating mineralization and
demineralization [2]. Some authors assume that an elevated level of
calcium in saliva occurs in patients with periodontitis [3].
Magnesium is a component of organic matrix tooth enamel [4].
Some authors claim that the decreased content of magnesium ions in
saliva may lead to various changes and occurs most frequently in
people with periodontitis [5]. It has also been stated that
salivary magnesium concentrations are significantly higher in
patients with parotid malignant tumors [6].
Fluorides reveal their bacteriostatic properties by blocking the
activity of enzymes and inhibit the growth of dental plaque, which
in turn lowers its cariogenicity. The presence of fluoride reduces
enamel mineral loss by diminishing the solubility of dental
hydroxyapatite, which becomes more resistant to demineralization
[2].
Magnetic therapy provides a non-invasive, safe and easy method
to directly treat the site of injury, source of pain and
inflammation [7, 8]. The most effective clinical applications
relate to bone unification, pain reduction and soft tissue oedema
[7]. Magnetic fields have also proved to be effective in the
regeneration of periapical bone lesions [9, 10]. However, there is
no defined biological mechanism described, capable of explaining
the observed effects. It is obvious that cells (leukocytes,
platelets, keratinocytes, osteoblasts) and proteins (fibrin,
collagen, elastin and growth factors) exhibit alterations, when
exposed to magnetic field [5, 7, 11, 12].
No studies have been found concerning the influence of low
frequency magnetic fields of low induction on the content of
bioelements in saliva. The aim of the present investigation was
then to examine, if a magnetic field has any influence on the
content of calcium, magnesium and fluoride in saliva.
Subjects and methods
The study group comprised 62 patients referred for magnetic
stimulation treatment due to periapical osteolytic tooth lesions.
Magnetic stimulation by the Viofor JPS system (Med&Life,
Komorow, Poland) was carried out once a day, for 10 minutes, five
days a week (excluding Saturdays and Sundays) for 15 day period. An
elliptic applicator generating a low frequency magnetic field of
mean induction 3 μT at the first intervention and 4 μT at the
following ones was used.
The control group consisted of 62 patients, matching the study
group regarding to age, referred for dental treatment in which no
magnetic stimulation treatment was prescribed.
All the patients gave their consent for saliva sampling and
analysis of the mineral content. The principles outlined in the
Declaration of Helsinki were carefully followed.
Non-stimulated mixed saliva (2 mL) was sampled to a plastic
container once a week in every patient included in the study, in a
fasting state or at least two hours after a solid or liquid meal,
in a separate room and a comfortable sitting position. In the study
group saliva sampling was carried out before magnetostimulation and
after the 5th, 10th and 15th
magnetostimulation interventions. Patients from the control group
had saliva sampled three times before routine visits for dental
treatment.
The contents of calcium and magnesium ions were established by
means of atomic absorption spectrometry with the use of
spectrometer PU 9100X (Philips Scientific, Cambridge, UK). In order
to determine the content of calcium and magnesium, 0.5% lanthanum
solution (Lanthannitrat-Hexahydrat, Merck, Darmstadt, Germany) was
used as a ionization buffer. The analysis was carried out in an
oxygen acetylene flame (F-AAS). The reading was taken from the
curve traced on the basis of Titrisol (Merck, Darmstadt, Germany)
standards.
To determine the content of fluoride, an ion-selective electrode
was used to measure the potential value. The quantity of fluorides
in the solution examined was determined on the basis of the
potential difference before and after adding an appropriate
standard.
The data distribution of all variables was checked by using the
Shapiro-Wilk test. In order to compare data of normal distribution,
Wilcoxon paired test was used and for the latter – Student’s t
test.
Results
Distribution of ion concentrations (mmol/L) in saliva in the study
and control groups is presented in table
1. No statistically significant changes were found between
the calcium concentrations before magnetic stimulation and after 5,
10 and 15 interventions. In the control group, calcium ion
concentrations did not reveal any statistically significant changes
between the examinations.
The average concentration of magnesium ions in the saliva of
patients from the group examined showed a slight downward tendency,
however statistically significant differences were obtained only
for values between 10th and 15th
interventions (p < 0.03). No statistically significant
differences were found in the control group.
The average value of fluoride ion concentrations in saliva of
the patients treated with magnetic stimulation showed slight
fluctuations, but no statistically significant differences were
found between the interventions. However, in the control group, the
average values of fluoride ion concentrations revealed significant
changes. Highly statistically significant differences were obtained
for the values between: 1st and 2nd
examinations, 1st and 3rd examinations, and
2nd and 3rd examinations.
Table 1 Distribution of ion concentrations (mmol/L) in
the saliva of dental patients subjected to magnetic stimulation due
to periapical osteolytic lesions and matching control subjects.
|
Calcium
|
Study group, n = 62
|
Before magnetic stimulation
|
After 1st intervention
|
After 2nd intervention
|
After 3rd intervention
|
|
Mean
|
33.9
|
34.2
|
36.4
|
34.5
|
|
SD
|
11.2
|
11.0
|
11.9
|
12.1
|
|
Control group, n = 62
|
1st examination
|
2nd examination
|
3rd examination
|
|
|
Mean
|
33.9
|
33.2
|
32.5
|
|
|
SD
|
10.7
|
10.7
|
10.5
|
|
|
Magnesium
|
Study group, n = 62
|
Before magnetic stimulation
|
After 1st intervention
|
After 2nd intervention
|
After 3rd intervention
|
|
Mean
|
7.70
|
7.32
|
7.79
|
7.48
|
|
SD
|
3.65
|
3.61
|
3.25
|
3.35
|
|
Control group, n = 62
|
1st examination
|
2nd examination
|
3rd examination
|
|
|
Mean
|
7.00
|
9.63
|
8.19
|
|
|
SD
|
3.70
|
3.88
|
6.37
|
|
|
Fluoride
|
Study group, n = 62
|
Before magnetic stimulation
|
After 1st intervention
|
After 2nd intervention
|
After 3rd intervention
|
|
Mean
|
4.88
|
4.75
|
4.74
|
4.48
|
|
SD
|
1.94
|
1.77
|
1.65
|
1.64
|
|
Control group, n = 62
|
1st examination
|
2nd examination
|
3rd examination
|
|
|
Median
|
3.74
|
3.94
|
4.13
|
|
|
min-max
|
1.39-8.86
|
1.45-8.16
|
1.56-9.17
|
|
|
Q1 -Q3
|
2.91-5.59
|
3.11-5.57
|
3.19-5.49
|
|
Discussion
In available publications, no data concerning the influence of
electromagnetic fields on concentration of electrolytes in saliva
have been found. The mean calcium concentrations found in the
present study are similar to those reported by other authors [7,
13, 14], e.g. 1-4 mmol/ L (40-160 mg/L). The slight differences may
be due to the fact that the content of calcium ions is
characterized by regular fluctuations connected with food intake
and the time between the last meal and saliva sampling could be
different in the particular investigations.
Most studies describing the composition of saliva do not report
magnesium values due to its low content, but the concentrations of
magnesium are very similar to the values reported for healthy
individuals by Aps and Martens [15] e.g. 0.2 mmol/L (4 mg/L) as
well as Gradinaru et al. [6] e.g. 0.14 mmol/L.
It might be supposed that the concentration of fluoride in total
saliva is related to its consumption, depending on the fluoride
content in the environment, especially drinking water. Other
important sources of fluoride are products used in caries
prevention, especially toothpaste. The statistically significant
increase of fluoride concentration in the saliva of the control
group could be explained by its increasing supply. It is possible
that during dental treatment, with improving oral status, patients
were better motivated to maintain good oral hygiene and were
brushing their teeth more often and more carefully, especially just
before visiting the dentist, which resulted in the increase of
fluoride concentration in saliva. The patients subjected to
magnetic therapy did not have to show their teeth to the dental
professional during the procedure, because it was extraoral and
might not have had such a motivation factor.
Some authors notice that the effects depend on the parameters of
the magnetic field applied, including its type, intensity of
induction, localization and time of exposure [7, 8, 15, 16], thus
the results of the present study may not apply to different systems
and devices used for magnetic stimulation.
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