Índice de Placa Bacteriana, Índice Gingival y Prueba de Silometría en Pacientes con Síndrome de Sjögren Primario y Secundario / Bacterial Plate Index, Gingival Index, and Silometry Testing in Patients With Primary and Secondary Sjögren's Syndrome

El síndrome de Sjögren (SS) es una enfermedad crónica autoinmune presente en el 0.1 - 3.0 % de la población, en la que se encuentran involucradas las glándulas salivales, trayendo consigo manifestaciones orales como caries dental y enfermedad periodontal. El objetivo de este trabajo fue evaluar el índice de placa, el índice gingival y la prueba de sialometría en pacientes con síndrome de Sjögren primario y secundario. Fueron evaluados clínicamente 40 pacientes con SS primario (n=20) y SS secundario (n=20), ambos grupos diagnosticados con periodontitis crónica. Se registró el índice de placa de Quigley-Hein modificado por Turesky, el índice gingival de Löe y la prueba de silometría estimulada, recolectando saliva parotídea con el dispositivo Carlson-Crittenden. Los pacientes con SS primario tuvieron un índice de placa de (3,53±0,5954) e índice gingival (2,41±0,2608). En pacientes con SS secundario el índice de placa fue (1,62±0,3795) y el índice gingival (1,48±0,3994), con diferencia significativa (p=0,0001) entre ambos grupos. El flujo salival se elevó en pacientes con SS secundario. El presente estudio concluye que el índice de placa y el índice gingival fueron mayores en pacientes con SS primario comparados con pacientes con SS secundario. La prueba de sialometría fue mayor en pacientes con SS secundario.

Sjögren's syndrome (SS) is a chronic autoimmune disease present in 0.1 - 3.0 % of the population, in which the salivary glands are involved, bringing with it oral manifestations such as dental caries and periodontal disease. The aim of the present study was to evaluate the plaque index, gingival index and the sialometry test in patients with primary and secondary Sjögren's syndrome. Forty patients with primary SS (n = 20) and secondary SS (n = 20), both groups diagnosed with chronic periodontitis, were evaluated clinically. The Quigley-Hein plaque index modified by Turesky, the gingival index of Löe and stimulated sialometry test collected from parotid gland by using Carlson-Crittenden device were recorded. The patients with primary SS had plaque index (3.53 ± 0.5954) and gingival index (2.41 ± 0.2608). The patients with secondary SS had a plaque index (1.62 ± 0.3795) and gingival index (1.48 ± 0.3994), with significant difference between both groups. The present study concludes that plaque index and gingival index were higher in patients with primary SS than patients with secondary SS. Sialometry test were higher in patients with secondary SS.

Salivary rheumatoid factor in primary and secondary Sjögren's syndrome / Factor reumatoide salival en síndrome de Sjögren primario y secundario

Sjögren's syndrome is a chronic autoimmune disease, characterized by the presence of hyposalivation and xerophthalmia, which in addition to other factors is diagnosed by the presence of rheumatoid factor in blood. The objective of the present study is to evaluate the presence of rheumatoid factor (IgG-IgM) in the saliva of patients with primary and secondary Sjögren's syndrome. Materials and methods: Forty samples from patients with primary and secondary Sjögren's syndrome previously diagnosed by the Arthritis and Rheumatism Specialist Center of the Autonomous University of Nuevo Leon were analyzed. Samples were taken from the saliva using the Carlson-Crittenden device to evaluate the IgG-IgM immunocomplex using the ELISA method. Results: No significant difference was found between the presence of IgM in primary (0.099±0.016) and secondary Sjögren syndrome (0.098±0.017), however, a high presence of IgG was found in the group of patients with secondary Sjögren's syndrome (0.134±0.054). Conclusion: The search for diagnostic tools using salivary biomarkers has come with economic and clinical advantages, however, in the present study no significant changes were found in salivary rheumatoid factor between both groups.

El síndrome de Sjögren es una enfermedad autoinmune crónica, caracterizada por la presencia de hiposalivación y xeroftalmia, la cual además de otros factores es diagnosticada por la presencia del factor reumatoide en sangre. El objetivo del presente estudio es evaluar la presencia del factor reumatoide (IgG-IgM) en saliva parotídea de pacientes con síndrome de Sjögren primario y secundario. Materiales y métodos: Se analizaron 40 muestras de pacientes con síndrome de Sjögren primario y secundario previamente diagnosticados por el Centro de Especialistas en Artritis y Reumatismo de la Universidad Autónoma de Nuevo León, a los cuales se les tomó una muestra de saliva parotídea mediante el dispositivo Carlson-Crittenden para evaluar mediante el método ELISA el inmunocomplejo IgG-IgM. Resultados: No se encontró diferencia significativa entre la presencia de IgM en el síndrome de Sjögren primario (0.099±0.016) y secundario (0,098±0,017), sin embargo en cuanto a la presencia de la IgG se encontró elevada en el grupo de pacientes con síndrome de Sjögren secundario (0,134±0,054). Conclusión: La búsqueda de herramientas diagnósticas mediante biomarcadores salivales ha traído consigo ventajas económicas y clínicas, sin embargo en el presente estudio no se encontró un cambio significativo en el factor reumatoide salival entre ambos grupos.

Salivary stimulation by prolonged release of pilocarpine in sjõgren’ syndrome

Introduction: Prolonged drug delivery in the oral cavity offers many advantages, such as reducing adverse effects. Pilocarpine is an FDA-approved parasympathomimetic drug for the treatment of glandular hypofunction; however, its adverse effects limit its use. Objective: To evaluate the stimulation of salivary flow by the use of pilocarpine-releasing films, as well as their effects on the symptoms of xerostomia and adverse effects in patients with Sjõgren’s syndrome (SS). Materials and methods: Hydroxypropylmethylcellulose (Methocel K4MCR) films were prepared in 1 percent acetic acid and pilocarpine was added under magnetic stirring. The pH and thickness, as well as diffusion uniformity and kinetics of drug release per cm2 were evaluated by spectrophotometry. The films were tested sublingually in 40 patients with Sjõgren’s syndrome for a period of two weeks. Changes in their salivary flow were evaluated by analyzing samples of total saliva. Additionally, patients were screened for symptoms of xerostomia and adverse effects. Results: The films had a pH of 2.91 +/- 0.035, a thickness of 0.06866 +/- 0.00152μm, and a diffusion uniformity of 91 percent per cm2. Use of the films resulted in an increase in salivary flow in both primary and secondary Sjõgren’s syndrome, but this increase was only significant in primary SS. Conclusion: Films showed optimal physicochemical properties for their administration, and proved effective in stimulating salivary flow without causing adverse effects during their administration.