Federica Romano

Salivary gland dysfunction is an underestimated oral late effect of chemotherapy in childhood cancer survivors (CCS). Therefore, the aim of this cross-sectional study was to assess the salivary functioning and dental caries experience in Italian CSSs and age- and gender-matched healthy children. A total of 32 children (15 females and 17 males, age range 6–14 years) in remission from hematological malignancy and 32 healthy controls were compared for salivary parameters (stimulated whole salivary flow rate, pH, and buffer capacity) and presence of carious lesions in the primary and permanent dentition using the dmft/DMFT indexes. Significantly lower stimulated whole saliva (SWS) and pH were observed in CSS than in healthy pediatric patients (both p < 0.001), together with a higher prevalence of carious lesions on both the deciduous (p = 0.002) and permanent teeth (p = 0.015). SWS was more severely impaired in children treated with chemotherapy before 5 years of age (p < 0.001) and, in spite of the tendency to improve over time, low SWS was still observed after 5–9 years of disease remission. According to the present data, chemotherapy has a detrimental effect on salivary gland functioning, which would seem to maintain up to 9 years after antineoplastic treatment.

Identification of biomarkers could help in assessing periodontal health status and monitoring treatment outcomes. Therefore, the aim of this cross-sectional study was to identify potential innovative salivary biomarkers for the diagnosis of periodontitis using an untargeted proteomic approach. Forty-five healthy non-smoker participants diagnosed as having periodontally healthy conditions (H), severe periodontitis (P), and healthy but reduced periodontium after active periodontal treatment (T) were consecutively enrolled (15 per each group) in the study. A higher number of spots were identified in the proteome of unstimulated whole saliva collected from H and T subjects compared with P group, mainly within the range of 8–40 kDa. Protein spots of interest were analysed by MALDI-TOF-MS, allowing the identification of cystatin SN (CST1) isoform, as confirmed by Western blot. CST1 was markedly expressed in the H group, while it was absent in most P samples (p < 0.001). Interestingly, a distinct CST1 expression was observed in saliva from T patients. CST1 was negatively correlated with the percentage of pathological sites (p < 0.001) and was effective in discriminating active periodontitis from healthy periodontal status (whether H or T). Therefore, salivary CST1 may be a promising non-invasive biomarker for periodontal disease diagnosis and monitoring.