Evaluation of major salivary glands with ultrasonography in multiple sclerosis patients.

BACKGROUND: This study aimed to investigate the homogeneity of the major salivary glands in multiple sclerosis (MS) patients using ultrasonography (USG), assess DMFT indices, measure resting salivary flow rates, and compare these values with healthy individuals. METHODS: In this study, 20 individuals diagnosed with Relapsing-Remitting Multiple Sclerosis (RRMS) (mean age 36.15 ± 8.51) and 20 systemically healthy individuals (mean age 35.7 ± 9.22) were included. Oral and radiologic examinations were performed in all individuals. The parotid and submandibular salivary glands were examined using USG, and their homogeneity was assessed based on the scoring system recommended by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) study group. Resting salivary flow rates and DMFT indices were measured, and the obtained data were subjected to statistical analysis. RESULTS: The parotid glands exhibited more heterogeneity on USG within the MS patient group than the control group, with a statistically significant difference between the two groups (p = 0.015). A statistically significant correlation was observed in total homogeneity values between the patient and control groups (p = 0.021). Furthermore, the MS patient group exhibited higher DMFT indices and lower salivary flow rates than the control group. The difference between the DMFT indices and salivary flow rate between the patient groups was statistically significant (p = 0.004 and p = 0.002 respectively). CONCLUSIONS: The parenchyma of the major salivary glands in MS patients exhibited decreased homogeneity than the healthy controls. Additionally, the MS group showed a decrease in salivary flow rate and an increase in the DMFT index. Autonomic dysfunction and medications used for MS are thought to cause salivary gland hypofunction and dry mouth. It can be interpreted that hyposalivation and motor skill losses in MS patients lead to an increase in DMFT index.

A Rare Anatomical Finding: Bilateral Accessory Mental Foramen.

AIM: Accessory mental foramen (AMF) is a not common anatomical variation. During the surgical procedures involving the mandible such as implant surgery, periapical surgery, jaw surgeries, and periapical surgery and enucleation of pathologies at the mental region, obvious attention should be given to prevent postoperative sequelae. Case Report. Orthopantomograph (OPG) is routinely taken to visualize the maxillofacial region at a dental clinic. OPG shows exactly upper and lower jaw and teeth but superficially reveals some pathology or anatomic variation. It misses sometimes an anatomic landmark such as AMF. As the surgery is planned to a maxillofacial region, a detailed knowledge should be known before going into surgery to not interfere with anatomic landmarks. A 52-year-old male patient was referred to Kütahya Health Science University Dental Hospital, Turkey, to rehabilitate his bilateral partial edentulous lower jaw region. Implant surgery was planned in our patient. OPG was taken to evaluate the maxillofacial region but was unremarkable. Before the implant surgery, CBCT was obtained from our patient. CBCT and a three-dimensional reconstructed model of the male patient showed bilateral accessory mental foramen (AMF). CONCLUSION: Accessory mental foramen (AMF) carries additional innervation to the chin, mandibular anterior gingiva, and mental region. Reflection and protection of the AMF during the surgery can prevent hemorrhage and neurosensory disturbance at the mental region and can improve quality of life for the patient. CBCT has higher precision but also a higher price and radiation dose. Although anatomical variations are uncommon, they can be found on digital panoramic radiographs but in limited percentage.