International Journal of Oral and Maxillofacial Surgery
Research PaperOral Medicine/TherapeuticsTrehalose inhibits oral dryness by protecting the cell membrane
Section snippets
Pilot study
To simulate the dryness associated with dental treatment or oral surgery, intraoral vacuum was applied for 5 min, followed by a saliva ejector for 5 min in seven healthy volunteers. The oral cavity was exposed to dryness for a total of 10 min. Trehalose (Hayashibara Biochemical Laboratories, Inc., Okayama, Japan) and distilled water (Otsuka Pharmaceutical Factory, Inc., Tokushima, Japan) were used to produce a 10% trehalose solution, and a control solution was prepared from distilled water. The pH
Trehalose suppresses oral dryness caused by applying vacuum
With the control solution, the surface area of the fungiform papillae shrank by more than 40% to the ratio of 0.560 after 10 min. Less shrinkage was achieved after trehalose solution spray with a surface area ratio of 0.942 (Fig. 1B). The trehalose solution caused higher moisture retention, the moisture content score was 26.2 after 5 min and 23.5 after 10 min. The moisture content score with the control solution went down quickly to 13.8 after 5 min and 14.0 after 10 min (Fig. 1C).
VAS measurements
For trehalose spray, post-stimulatory levels of dryness and pain intensity were about 30 and 20 mm, respectively. These values were significantly lower than those of the control group, compared with pre-stimulatory levels (Fig. 2B).
Atrophic changes
The mean clinical score of atrophic change was 0.85 in the trehalose treatment group, which was significantly lower than that in the control group 1.75 (p < 0.01) (Fig. 2C). In the trehalose group, the appearance of the tongue did not change after treatment (atrophic change score 0.5). In the control group, the clinical appearance markedly changed (atrophic change score 2) (Fig. 2D).
Trehalose protects cells from dryness-related damages in vitro
To verify the protective ability of trehalose against dryness, human oral cancer cell line Ca9-22 cells were treated with or without 7.5% trehalose for 15 min and cells were left to dry for 0, 40 or 50 min. The authors measured the percentage of live and dead cells using a LIVE/DEAD viability/cytotoxicity kit (Fig. 3A) and observed the morphological changes in cells after drying for 0 or 40 min (Fig. 3C). Treatment with trehalose markedly retained cell viability and suppressed cell death due to
Discussion
In the oral mucosa, the tongue is most frequently affected by oral dryness10. ‘Xerostomia’ occurs when the salivary glands do not operate properly. Many drugs and chronic diseases, such as diabetes and Sjögren's syndrome, can affect the salivary glands. Other causes of dry mouth include certain cancer treatments and damage to the nerves of the salivary glands. ‘Dryness due to oral vacuum’ occurs when saliva is removed from patients’ mouths using the aspirator, which can desiccate the oral
Competing interests
None declared.
Ethical approval
The institutional review board of the University of Tokyo (No. 1740).
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