口干症204例临床分析

目的 总结口干症的临床特点。方法 对204例口干症患者进行唾液白色念珠菌培养、泪腺流量测试、血细胞计数。结果 40岁以上年龄组发病率无明显区别,男女比例为1:5.57,口腔白色念珠菌感染75例,双侧泪腺流量异常16例,1侧异常28例,贫血32例。结论 贫血症、白色念珠菌感染与口干症有密切关系,更年期女性发病率最高。     

Comparison of salivary nitric oxide and oral health in diabetic patients with and without xerostomia

Background and objectiveDiabetes mellitus (DM) is a chronic multi-systemic metabolic disorder; diabetic patients are more prone to xerostomia and oral health problems than others. There are evidences that nitric oxide (NO) plays an important role in healthy salivary gland function, prevention of insulin resistance and progression of diabetes mellitus. The aim of this study was to compare the salivary NO level between type 2 diabetic (T2DM) patients with and without xerostomia.MethodsIn this case control study, 70 patients with T2DM, which were matched according to age, sex, type of disease control, were enrolled conveniently. The subjects based on abeslang test were allocated to the two groups; 35 patients with xerostomia and 35 patients without xerostomia. Unstimulated whole saliva was collected by spitting method. NO levels was measured by ELISA method using Griess reaction. Data was analyzed using t-test, ANOVA and logistic regression analysis to examine the association of salivary NO and xerostomia.ResultsThe mean and standard deviation of salivary NO in the diabetic subjects with xerostomia was significantly lower than diabetic subjects without xerostomia (138 ± 94.58 μmol/L vs. 356.61 ± 302.81 μmol/L (P-value = 0.001). In logistic regression analysis, salivary NO level was associated with 0.994 fold decreased risk of xerostomia in diabetic subjects after adjustment for age, gender, FBS and HbA1c.ConclusionsThe present study indicates salivary nitric oxide level was a predictor of xerostomia in diabetic patients. More longitudinal studies are necessary to understand the association of salivary NO level with diabetes-induced xerostomia.     

Effects of biodegradable hydrogel spacer injection on contralateral submandibular gland sparing in radiotherapy for head and neck cancers

Xerostomia is the most common late toxicity after head and neck radiation. We demonstrate injection of a hydrogel spacer anteriorly displacing the submandibular gland. This procedure enables reduced dose to the displaced submandibular gland in cadaveric models of oropharynx cancer treated with IMRT, with potential implications in reducing xerostomia risk.     

A case of oral recurrent ulcerative lesions in a patient with lipoid proteinosis (Urbach–Wiethe disease)

Lipoid proteinosis is a rare autosomal recessive genodermatosis characterized by deposition of amorphous hyaline material in different parts of the body, especially the skin, mucous membranes of the upper aerodigestive tract, and internal organs. A clinical manifestation of LP usually begins as a hoarseness and failure cry soon after birth or in the first years of life. However, other conditions may occasionally appear few years later. Oral cavity is most extensively affected area by the disease and the main oral abnormalities include diffusive infiltration of white pea-size plaques and stiffening of the tongue as well as inability to protrude it. In this report, we describe the case of a woman affected by LP presenting recurrent ulcerative lesions in mouth associated with xerostomia.     

Sjogren’s syndrome–An interesting case

ObjectiveTo present a case of Sjogren syndrome with pulmonary manifestations in an adult female and discuss its assessment and management.DesignCase Report.SettingTertiary care hospital.PatientOne.ResultsA 50 yrs female admitted with complaints of dryness of eyes with decreased salivation causing difficulty in swallowing since last 3 years, with persistent dry cough since 10–15 days and progressive dyspnea since 4–5 days. Anti-nuclear antibody (ANA) profile revealed Anti- Ro/SS-A and Anti- La/SS-B Positive. Also, sub-lingual excisional biopsy was done which was consistent with findings of Sjogren's syndrome. Patient showed significant improvement after starting oral glucocorticoids, systemic anti inflammatory agents (Tab. HCQS), artificial tear drops, oral iron supplements and other supportive treatment.ConclusionSjögren syndrome (SS) is a chronic inflammatory disorder characterized by diminished lacrimal and salivary gland function and associated with lymphocytic infiltration of exocrine glands, and can affect extraglandular organ systems including the skin, lung, heart, kidney, neural, and hematopoietic systems. We present a case of Sjogren syndrome in an adult female presenting with xerostomia and dyspnea and was diagnosed upon detection of anti-Ro and anti-La antibodies and confirmed by histopathological examination of lip biopsy. Patient was started on oral steroids and other supportive treatment, General condition improved significantly and is doing very well on regular follow-up.     

The effect of two artificial salivas on the adhesion of Candida albicans to heat-polymerized acrylic resin

PURPOSE

Xerostomia can diminish the quality of life, leads to changes in normal chemical composition of saliva and oral microbiata, and increases the risk for opportunistic infections, such as Candida albicans. Various artificial salivas have been considered for patients with xerostomia. However, the knowledge on the antifungal and antiadhesive activity of artificial saliva substitutes is limited. The aim of the present study was to evaluate influence of two artificial salivas on the adhesion of Candida albicans to the polymethylmethacrylate disc specimens.

MATERIALS AND METHODS

Two commercial artificial salivas (Saliva Orthana and Biotene Oral Balance Gel) were selected. 45 polymethylmethacrylate disc specimens were prepared and randomly allocated into 3 groups; Saliva Orthana, Biotene-Oral Balance gel and distilled water. Specimens were stored in the artificial saliva or in the sterile distilled water for 60 minutes at 37℃. Then they were exposed to yeast suspensions including Candida albicans. Yeast cells were counted using ×40 magnification under a light microscope and data were analysed.

RESULTS

Analysis of data indicated statistically significant difference in adhesion of Candida albicans among all experimental groups (P=.000). Findings indicated that Saliva Orthana had higher adhesion scores than the Biotene Oral Balance gel and distilled water (P<.05).

CONCLUSION

In comparison of Saliva Orthana, the use of Biotene Oral Balance Gel including lysozyme, lactoferrin and peroxidase may be an appropriate treatment method to prevent of adhesion of Candida albicans and related infections in patients with xerostomia.     

The cilical effects of electrostimulation on salivary function of Sjögren's syndrome patients

Summary A multi-center double-blind study of an electro-stimulator device was conducted to evaluate its ability to increase the production of saliva and reduce clinical symptomatology. A total of 77 Sjögren's syndrome patients at three centers were assigned to active devices (n=40) or to placebo devices (n=37). There were 2 male and 32 female patients assigned to active devices, and 1 male and 36 female patients assigned to placebo devices. The age range with the greatest number of patients was 60–69 years making up more than 31% of the study population. The selection criteria required the patients to have no greater than 0.2 g/min of whole salivary production (approximately 19% of normal salivary production). At the start of the study, the patients assigned the active device had a mean salivary production of 0.06 ml per min (6% of normal) and patients assigned placebo devices had a mean salivary production of 0.07 ml per min (7% of normal). There were three scheduled visits, 2 weeks apart, over a treatment period of 4 weeks. At all visits, the patients using active devices showed a statistically greater (P=0.005 to 0.02) increase in the production of saliva than placebo patients. The study also evaluated the reduction of patients symptoms associated with xerostomia. Patients showed significant improvement in (1) difficulty in swallowing and (2) burning tongue (P=0.008). Some patients on their initial visit had no response to the active device and did not show a significant response at subsequent visits. These results demonstrated that electrostimulation was effective in stimulating increased production of saliva and in reducing the symptoms of xerostomia in patients with xerostomia secondary to Sjögen's syndrome.

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