Sialendoscopy for sialolithiasis in children: 4-8 years follow up

Sialolithiasis is rare in children, there are no guidelines for its treatment, and there are few, if any, long term follow-up studies. We report a retrospective review of medical records of children who were treated for sialolithiasis by sialendoscopy between 1 January 2007 and 31 December 2011, and who have been followed up for 4-8 years. Personal and clinical details, including age, sex, symptoms, whether the lithiasis was parotid or submandibular, the technique of sialendoscopy and complications, were recorded. Twenty-six children (30 sides) were successfully treated by sialendoscopy between 2007 and 2011 (mean (range) age 12 (3-17) years). Stones were removed from the parotid gland in four patients and the submandibular gland in 22. The main indication for sialendoscopy was swelling of the salivary gland during meals. Twenty-six procedures were done endoscopically. Twelve were treated with a wire basket alone, 10 by the combined approach, and laser was used in eight. Four patients developed complications, but without long-term effects. During follow-up of 4-8 years there were no recurrent swellings. We conclude that endoscopic treatment of stones in childhood is an efficient and conservative option for salivary glands, has few complications and no clinical recurrence at medium to long-term follow-up.     

Studies on immunologic and inflammatory factors in saliva in patients with asthma and in patients with periodontitis

Abstract To study the salivary response in asthma and periodontitis, calcium and phosphorus concentrations were determined from parotid and whole saliva. The IgE and histamine concentrations and the activities of lysozyme and arginine aminopeptidases were assayed from whole saliva. The values were compared with those obtained from matched healthy controls (n = 20 in each group). In whole saliva the phosphorus concentrations were elevated in the asthma group and the calcium concentrations in the periodontitis group. Regarding parotid saliva no significant differences between the group? were observed. The results indicate that in patients with asthma the IgE concentrations in whole saliva were elevated, while in patients with periodontitis and in healthy controls no detectable values were obtained. Both histamine and lysozyme concentrations seemed to increase in the asthma and periodontitis groups. A slight increase was also observed in the arginine aminopeptidase activities in the saliva of patients with asthma and patients with periodontitis.     

Admission level and students' performance at a Norwegian dental school

Data on students' performance at the Oslo Dental Faculty for 1977-86 were divided in two 5-year periods and analyzed in accordance with admission levels, largely on the basis of academic performance in junior college. During these years admission level decreased considerably, whereas the frequency of ‘not passed’, ‘dropouts’, and candidates using prolonged student time increased. The dental school grade average and the distribution of high-and low-performance candidates varied with the admission level. This trend was visible most clearly in the first 5-year period, when the admission point range included a considerable number of high admission level students. However, the admission level was not a good predictor of students' performance in the large middle or low admission level groups prominent in the second 5-year period. Poor preclinical results were not compensated for by clinical skills. All comparison of students' performance gave results in favor of the female students, but no sex-related differences were statistically significant. Most dropouts left dental school during the 1st year without visible examination difficulties. Students with several ‘not passed’ tended to repeat examinations, dropping out at a later stage or graduating after prolonged student time with poor results. With low interest in odontology, selection of students on the basis of minute differences in academic performance in the lower admission point scale is of limited value as a predictor of students' performance. □ Academic achievement; denial education; grades     

The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy

This study aimed to assess the value of cone beam computed tomography (CBCT) in the detection of salivary stones in patients with signs and symptoms of salivary gland obstruction. A total of 142 major salivary glands were analysed in a cohort of 127 patients with signs and symptoms of salivary gland obstruction. CBCT scans were performed in order to determine the presence of one or more salivary stones. All glands were also investigated by sialendoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for the submandibular gland, the parotid gland, and the whole group, based on the observers’ abilities to diagnose the presence or absence of calculi in the CBCT scan using the sialendoscopy data as the gold standard. Fifty salivary stones were detected in the CBCT scans of the 142 glands analysed: 34 in the submandibular gland and 16 in the parotid gland. The sensitivity (94%), specificity (90%), positive predictive value (84%), and negative predictive value (97%) for the whole group were good to excellent, with an overall accuracy of 92%. CBCT appears to be an ideal first-line imaging modality for patients with signs and symptoms of obstructed major salivary glands.     

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目的结合文献探讨涎腺导管癌（salivary duct carcinoma,SDC）的临床、病理特点、治疗及预后,以提高临床诊疗水平。方法回顾性分析中国人民解放军第148医院口腔颌面外科2010年1月至2011年12月收治的3例SDC患者临床资料,结合临床及病理特点、治疗方法及预后情况进行分析,并进行相关文献复习。结果SDC好发于男性,以腮腺导管癌多见,肿瘤生长迅速,浸润性强,易侵犯神经导致面瘫。讨论SDC是一类恶性程度很高的恶性肿瘤,诊断主要靠术后病理及免疫组化检查,治疗以局部广泛切除＋颈淋巴清扫术为主,术后给予放疗。关键词：涎腺;肿瘤;涎腺导管癌     

鼻咽癌放疗后唾液流率和pH值的变化

目的：研究鼻咽癌放疗对涎腺功能造成放射性损害,为尽量减少和预防鼻咽癌放疗后遗症寻求可能的途径。方法：对2002年收治的38例鼻咽癌患者进行分析,38例均为首次接受放疗的鼻咽癌患者,平均年龄41．4岁,分别在放疗前、后检测混合唾液流率和pH值。结果：放疗后多数患者出现口干,唾液流率显著减少,pH值稍微上升。结论：放射治疗使涎腺功能受到极大破坏,唾液的质和量有很大变化;精确设计放射野,改进放疗技术可以预防和减少放射性涎腺损伤。     

Crystalloid architecture of a sialolith in a minor salivary gland

A sialolith from a minor salivary gland of the mucosa of the upper lip was studied morphologically and analytically. Under stereoscopic microscopic visualisation, no core or any concentric laminar structure was found in the sialolith and it had a transparent glassy appearance. Scanning electron microscopy revealed differences between the internal structure of the sialolith and its external structure. No microbes were observed but some mineralized inclusion bodies were seen. X-ray diffraction indicated the absence of inorganic crystals in the sialolith, while energy dispersive x-ray microanalysis revealed a high content of S followed by Ca, Si and Na and little and scarce P on the fracture surface, with S, Na, Ca and P being distributed throughout the external coating of the sialolith. The results suggest that the sialolith was young and consisted of a crystalloid body with an incipient coating undergoing calcification.     

Salivary secretion in health and disease

Saliva is a complex fluid produced by 3 pairs of major salivary glands and by hundreds of minor salivary glands. It comprises a large variety of constituents and physicochemical properties, which are important for the maintenance of oral health. Saliva not only protects the teeth and the oropharyngeal mucosa, it also facilitates articulation of speech, and is imperative for mastication and swallowing. Furthermore, saliva plays an important role in maintaining a balanced microbiota. Thus, the multiple functions provided by saliva are essential for proper protection and functioning of the body as a whole and for the general health. A large number of diseases and medications can affect salivary secretion through different mechanisms, leading to salivary gland dysfunction and associated oral problems, including xerostomia, dental caries and fungal infections. The first part of this review article provides an updated insight into our understanding of salivary gland structure, the neural regulation of salivary gland secretion, the mechanisms underlying the formation of saliva, the various functions of saliva and factors that influence salivary secretion under normal physiological conditions. The second part focuses on how various diseases and medical treatment including commonly prescribed medications and cancer therapies can affect salivary gland structure and function. We also provide a brief insight into how to diagnose salivary gland dysfunction.     

人β-防御素-2在涎腺肿瘤及涎腺炎症中的表达及其意义

目的 研究涎腺良性肿瘤组织、恶性肿瘤组织和涎腺炎症中人β-防御素-2（HBD-2）mRNA和蛋白的表达特征。方法 对不同涎腺组织,采用聚合酶链反应（PCR）、实时聚合酶链反应（Real-Time PCR）和免疫组化检测HBD-2的表达,并分析HBD-2 mRNA和蛋白在涎腺良性肿瘤组织、恶性肿瘤组织、炎症组织和正常涎腺组织中的表达差异。结果 与涎腺正常组织比较,良性肿瘤组HBD-2 mRNA表达量为其6.468倍,显著高于涎腺正常组织组（P<0.05）;恶性肿瘤组为其0.334倍,显著低于涎腺正常组织组（P<0.05）;涎腺炎症组为其10.563倍,显著高于涎腺正常组织组（P<0.05）。HBD-2不仅在这些组织的细胞质中有表达,而且在恶性组织中的细胞核也有表达。结论 HBD-2在涎腺良性肿瘤组织及涎腺炎症组织中高表达,在涎腺恶性肿瘤组织中低表达,其蛋白发生核转移。     

Salivary interleukin-6 and tumor necrosis factor alpha in patients with drug-induced xerostomia

It is well known that cytokines are involved in the homeostasis of oral cavity and that altered levels of either serum and/or salivary cytokines have been found in certain oral/systemic diseases. So far, cytokines in connection with xerostomia have been investigated in patients with Sjögren's syndrome. We wanted to find out whether drugs themselves influence salivary glands, which would result in altered cytokine level or whether xerostomia itself of different causes leads to the changes in salivary cytokine levels. Therefore, the aim of this study was to evaluate levels of salivary interleukin‐6 (IL‐6) and tumor necrosis factor (TNF)‐α in 30 patients with drug‐induced xerostomia, age range 29–84 and mean 63.9 years. Control group consisted of 30 healthy participants, age range 30–82 years and mean age 65.2 years. Enzyme‐linked immunoassay was performed on commercially available kits. Statistical analysis was performed by use of Student's test. No significant differences in salivary IL‐6 and TNF‐α between patients with drug‐induced xerostomia when compared with the healthy controls were found (P < 0.05). We might conclude that drugs do not induce damage to the salivary glands which could be seen in altered salivary IL‐6 and TNF‐α levels and that xerostomia itself, induced by drugs does not alter levels of the investigated salivary cytokines.     

Fine needle aspiration cytology of salivary gland lesions

247 salivary gland lesions were subjected to fine needle aspiration (FNA) cytology; 179 were designated as neoplastic lesions and 68 as non-neoplastic. Based on cytomorphologic features, the neoplastic and non-neoplastic lesions were subcategorised. All but 36 of the neoplastic lesions were subjected to histopathologic study. The overall diagnostic accuracy of FNA cytology for neoplastic lesions was 91%. The sensitivity rate for detecting malignant tumours was 87.8% and the specificity 98.0%. There was 100% sensitivity for cytodiagnosis of benign tumours. The high sensitivity and specificity of cytodiagnosis makes FNA cytology a valuable diagnostic modality in the evaluation of salivary gland lesions.     

The flow rate of whole and submandibular/sublingual gland saliva in patients receiving replacement complete dentures

Provision of complete dentures to a new denture wearer increases the salivary flow rate is well known. The new dentures act as an additional mechanical stimulus to the salivary reflexes, thus increasing the flow rate. The purpose of this study was to determine whether replacing complete dentures would elicit the same response. Unstimulated and stimulated whole and submandibular/sublingual (SM/SL) saliva were collected before inserting complete replacement dentures and again after 2 days and after 3 weeks of denture wearing. Unstimulated whole salivary flow rate increased significantly 2 days after inserting replacement dentures, decreasing at 3 weeks but remaining significantly above the baseline. Stimulated whole salivary flow rate increased significantly after 2 days but decreased to normal after 3 weeks. Stimulated and unstimulated SM/SL salivary flow rate increased significantly after 2 days, decreasing at 3 weeks while remaining significantly above the values found before denture insertion.     

Electrostimulating device in the management of xerostomia

INTRODUCTION: The present study was undertaken to evaluate the safety and effectiveness of a recently developed electrostimulating device mounted on an individualized intra-oral removable appliance. MATERIALS AND METHODS: The device, containing electrodes, a wetness sensor, an electronic circuit and a power source, was tested on patients with xerostomia in a crossover, randomized, sham-controlled, double-blinded, multicenter study. Electrical stimulation and also sham were delivered during 10 min to the oral mucosa, in the mandibular third molar region. Oral dryness was measured by the sensor. As the primary outcome, sensor dryness and xerostomia symptom changes as a result of device wearing were assessed, and compared between active and sham modes. In addition, side-effects were recorded. RESULTS: Electrostimulation resulted in a significant decrease in sensor dryness, leading to a beneficial effect on patients' subjective condition. No significant side-effects were observed.     

涎腺黏液腺癌1例

黏液腺癌是一种少见的上皮性恶性肿瘤,好发于阑尾、胰腺、乳腺等部位,发生于涎腺者罕见。本文报道1例发生在涎腺的黏液腺癌,并对相关文献进行复习。     

A clinicopathologic study of 196 intraoral minor salivary gland tumours

We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128 malignant and 68 benign, diagnosed from 1954 to 1993 in the A.C. Camargo Hospital, São Paulo, Brazil. Sixty-five percent of the cases occurred in the palate, followed by tongue (9.7%) and retromolar area (6.1%). Pleomorphic adenoma was the most common benign tumour, and mucoepidermoid carcinoma was predominant among the malignant tumours. Surgery was the main treatment method and postoperative radiotherapy and radiotherapy alone were used in 40 and 15 patients, respectively. Local recurrence was observed in two patients with pleomorphic adenoma and in eight patients with malignant tumours. Regional lymph node metastases occurred in four cases and distant metastases in five. Forty-six of 47 patients with benigh tumours who were followed up from 1 to 7 years were alive without disease. Twenty-four of 79 patients with malignant tumours who were followed up for at least 5 years died due to the tumour and 47 were alive without disease.