[Effect of a gel-type denture adhesive on unstimulated whole saliva and minor salivary gland flow rates and on subjective orofacial sicca symptoms]. / A mufogsorragasztó hatása a nyugalmi kevert és a kis nyálmirigyek szekréciójára, valamint a szájszárazság érzetére teljes lemezes fogpótlást viselokben.

INTRODUCTION AND AIM: To determine whether the continuous use of gel-type denture adhesives influence the unstimulated whole saliva, the palatal and labial saliva flow rates, and to assess the possible changes of subjective orofacial sicca symptoms. METHOD: 28 maxillary complete denture wearing patients (average age: 70 ± 10 years) were investigated. A gel-type denture adhesive was administered to the patients for regular use during the 3 weeks of examination. A questionnaire of 16 questions was used to evaluate subjective orofacial sicca symptoms. Unstimulated whole saliva was determined by the spitting method, palatal and labial saliva flow rates were measured by the Periotron® device with filter paper discs at the initial, first, second and third weeks. STATISTICAL ANALYSIS: The following tests were used: subjective values - χ2-test; flow rates - ANOVA, paired Student's t-test. RESULTS: According to the questionnaire, the ratio or severity of xerostomia did not change. A significant increase in the subjective feeling of "saliva thickness" could be detected (p = 0.027), but the other subjective parameters remained unchanged. Palatal saliva flow rates decreased significantly by week 3 (week 0: 4.21 ± 3.96 µl/cm2/min; week 3: 2.21 ± 2.30 µl/cm2/min; p = 0.024). On the other hand, there was no significant change in the unstimulated whole saliva (week 0: 0.37 ± 0.36 ml/min; week 3: 0.39 ± 0.35 ml/min) and labial saliva (week 0: 3.99 ± 3.75 µl/cm2/min; week 3: 2.58 ± 3.39 µl/cm2/min) flow rates. CONCLUSIONS: The regular use of denture adhesives did not influence xerostomia and the majority of subjective orofacial sicca symptoms, but may cause a subjective feeling of "increased saliva thickness" and reduce palatal minor salivary gland flow rates among complete maxillary denture wearers. Orv Hetil. 2018; 159(40): 1637-1644.

Denture adhesives' effect on retention of prostheses in patients with xerostomia.

BACKGROUND: Patients with xerostomia have difficulties using dentures. Application of denture adhesives (DAs) can improve the stabilization of prostheses. OBJECTIVES: The aim of the study was to determine the retention capability of complete maxillary dentures in patients with xerostomia, determined with and without the use of prosthetic DAs. MATERIAL AND METHODS: This study evaluated the retention force of prostheses in a group of 60 patients diagnosed with xerostomia. Completely edentulous patients were classified into groups and all used the same kind of DAs during the study. The evaluation was performed 1, 3 and 6 h after application. RESULTS: All patients had poor retention of maxillary dentures without DAs. Maxillary denture retention was much better when DAs were used. The majority of the DAs used were most effective in terms of retention after 1 h. Denture adhesives in the form of glue had the best retention in this study of patients with xerostomia. CONCLUSIONS: The results of the present study revealed the impact of DAs on average retention forces in complete maxillary denture patients with xerostomia. Patients affected by a reduced secretion of saliva have difficulties using prosthetics. In some cases, such use becomes impossible because of a complete lack of retention. The application of DAs could be a solution in these cases. Denture adhesives in glue form had the best retention during the study for patients with xerostomia.

Minor salivary glands function is decreased in hyposalivation-related diseases.

OBJECTIVES: The aim of this cross-sectional study was to investigate the relationship between minor salivary gland (MSG) flow rates and oral dryness degrees in patients with xerostomia induced by primary Sjögren's syndrome (pSS), IgG4-related sialadenitis (IgG4-RS), radiation therapy-induced dry mouth (RTDM), or Steven-Johnson syndrome (SJS). DESIGN: 160 patients with pSS, IgG4-RS, RTDM, or SJS and their age- and sex-matched healthy control subjects were enrolled. The whole saliva flow rates and MSG flow rates were measured in four locations, including the upper labial, lower labial, buccal, and palatal mucosae. The degree of oral dryness was assessed in patient groups using the summated xerostomia inventory (SXI). RESULTS: The flow rates of whole saliva and most MSGs in patient groups were significantly lower than the flow rates in healthy control groups (P<0.05). The mean relative percentage of decrease in saliva flow rates was smaller in MSGs than in whole saliva in patient groups (P<0.05), indicating that these disorders have less impact on MSGs. Among the four MSG locations (the upper labial, lower labial, buccal, and palatal), buccal glands showed the highest flow rates in patient groups (P<0.05). SXI scores were significantly higher in pSS and RTDM patients than in IgG4-RS and SJS patients (P<0.05). The degree of xerostomia varied among different patient groups (P<0.05) and there was no clear correlation between MSG flow rates and SXI scores (P>0.05). CONCLUSIONS: MSG function is significantly reduced in pSS, RTDM, IgG4-RS, and SJS patients, but this reduction is more pronounced in the major salivary glands.

Involvement of minor salivary glands in the pathogenesis of peritonsillar abscess.

OBJECTIVES: To study the relationship between peritonsillar abscess (PTA) and minor salivary glands surrounding the palatine tonsils. STUDY DESIGN: Prospective population-based study. SETTINGS: Tertiary care university hospital. SUBJECTS AND METHOD: Prospective study including 41 patients with PTA and 6 patients with a neck abscess. Amylase levels of the pus and serum were measured and compared between the 2 groups. Clinical data regarding hospitalization length and recurrence rate were also collected. RESULTS: Of the 41 patients with PTA, 7 suffered from recurrent PTA. Average level of amylase in the pus of the PTA group was 3841 U/L versus 7.7 U/L in the neck abscess group (P < .001; median, 62 vs 9.5). Serum amylase was higher in the PTA group (49.3 U/L vs 37.3 U/L; P = .008). There were no recurrences in PTA patients with amylase greater than 65 U/dL in the pus in 0 of 20 (0%) versus 7 of 21 (33%) for amylase lower than 65 U/L (P = .01). CONCLUSION: High amylase in the pus lends further support for involvement of minor salivary glands. However, high recurrence rates related to low amylase in the pus imply an additional pathogenesis possibly related to tonsillar infection. It is possible that both minor salivary glands as well as tonsillar infection play a role in the pathogenesis of peritonsillar infections.

The expression of APRIL in Sjogren's syndrome: aberrant expression of APRIL in the salivary gland.

OBJECTIVE: A proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) are B-cell-related mediators and may play a role in the pathogenesis in SS. In this descriptive study we assessed the expression of APRIL and BAFF in the minor salivary gland and serum from SS patients. METHODS: Paraffin-embedded minor salivary gland sections from SS patients, non-SS controls and healthy volunteers were analysed by immunohistochemistry. Digital image quantification was performed to evaluate the expression of BAFF, APRIL and transmembrane activator and CAML interactor. Furthermore, serum was analysed for soluble BAFF and APRIL levels by ELISA. All the data were also analysed for subjects with decreased and normal stimulated salivary flow independent of the classification. RESULTS: APRIL expression was lower in minor salivary gland biopsies from SS patients compared with healthy volunteers and to a lesser extent non-SS controls, whereas BAFF expression was similar in all groups. Soluble APRIL levels in serum were increased in SS patients and in subjects with decreased salivary flow independent of the classification. CONCLUSION: APRIL salivary gland tissue levels are decreased, suggesting that targeting this cytokine locally in the salivary glands would not benefit SS patients. Moreover, the discrepancy between local and systemic levels is striking and future research should assess this in more detail.

Classification criteria for Sjogren's syndrome: a critical review.

Over the years, several different criteria sets have been proposed for the classification of Sjögren's syndrome (SS), but none of them has been widely adopted by the scientific community until the publication of the 1993 Preliminary European Classification criteria. These Classification criteria have been largely employed both in clinical practice and in observational and interventional studies for many years. In 2002 the Preliminary European Criteria were re-examined by a joint American and European Committee. The result of this revision were the American and European Consensus Group classification criteria (AECG-criteria) which introduced more clearly defined rules for classifying patients with primary or secondary SS, and provided more precise exclusion criteria. These AECG-criteria set is now considered to be valid to ensure a specific diagnosis of SS by the vast majority of the expert in the field. To date, the AECG-criteria have been cited more than 1.304 in literature and have been used to estimate the point prevalence of the disease in several studies conducted in Greece, UK, Turkey and Norway. However, when employed in epidemiologic studies or in daily practice, the AECG-criteria have demonstrated a higher specificity (75%), but a lesser sensitivity (65.7%) in comparison to the previous Preliminary European criteria, indicating an average prevalence of pSS at ~ 0.2% in the adult population, which is far lower than previously reported. In this paper we will critically analyse the "pro and cons" of the current AECG-criteria and of the potential usefulness of some potential revisions.

Clinical significance and diagnostic usefulness of anti-centromere antibody in Sjögren's syndrome.

Anti-SS-A/Ro antibody (SS-A) and anti-SS-B/La antibody (SS-B) are important serologic markers in the diagnostic criteria for Primary Sjögren's syndrome (SS). Although anti-centromere antibody (ACA)-positive SS is frequently experienced, ACA is not included in these criteria. The purpose of this study was to identify the clinical features of ACA-positive SS and discuss the usefulness of ACA in diagnosing SS. Forty-five patients with SS were divided into the following three groups: SS-A only-positive group (n = 17), SS-A and SS-B both-positive group (n = 18), and ACA only-positive group (n = 10). As a control, 54 patients without SS who were negative for antinuclear antibodies were also evaluated. The following items were compared among groups: Saxon's test, unstimulated whole salivary flow (UWSF), salivary gland scintigraphy (SGS), histopathologic examination of the minor salivary glands, Schirmer's test, and fluorescein staining of the cornea. In the ACA only-positive group, Saxon's test was 0.21 ± 0.26 g/2 min (mean ± SD) and UWSF was 0.16 ± 0.25 ml/10 min (mean ± SD), showing a significant decrease in salivary secretion (p < 0.05; vs. non-SS). On SGS, accumulation and disappearance of (99m)TcO (4) (-) were significantly decreased (p < 0.05; vs. non-SS). Histopathologic examination showed moderate or severe lymphocytic infiltration and tissue destruction in all cases, similar to that in the SS-A- and/or SS-B-positive groups. Schirmer's test and fluorescein staining were positive in 60% and 80%, respectively. Impaired lacrimal secretion and keratoconjunctivitis sicca were similar to those in SS-A- and/or SS-B-positive groups. These results suggest that ACA is an autoantibody reflecting impairment in the salivary and lacrimal glands and may be a useful serologic marker for SS.

Mucus extravasation and retention phenomena: a 24-year study.

BACKGROUND: Mucoceles are benign lesions related to the minor salivary glands and their respective ducts frequently affecting oral structures which are generally asymptomatic. Mucoceles are generally characterized by swollen nodular lesions preferentially located on the lower lip and differ from the so-called ranulas, which are lesions located on the floor of the mouth and related to the sublingual or submandibular glands. METHODS: The objective of the present study was to analyze data such as age, gender, race and site of the lesion of 173 mucocele cases diagnosed at the Discipline of Stomatology, São José dos Campos Dental School, UNESP, over a period of 24 years (April 1980 to February 2003). RESULTS: Of the 173 cases analyzed, 104 (60.12%) were females and 69 (39.88%) were males. Age ranged from 4 to 70 years (mean +/- SD: 17 +/- 9.53) and most patients were in the second decade of life (n = 86, 49.42%); white (n = 124, 71.68%). The lower lip was the site most frequently affected by the lesions (n = 135, 78.03%), whereas the lowest prevalence was observed for the soft palate, buccal mucosa, and lingual frenum. CONCLUSION: In this study, mucoceles predominated in white female subjects in the second decade of life, with the lower lip being the most frequently affected site.

Exocrine function in primary Sjögren syndrome: natural course and prognostic factors.

OBJECTIVES: Few studies have addressed the natural course of, or prognostic factors for the salivary and lacrimal function in primary Sjögren syndrome (SS). Except for the early stages, glandular function has been seemingly stable, and SS A antigen (SSA) seropositivity and hypocomplementemia may predict a decline in the van Bijsterveld score. The aim of the present study was to assess the natural course of the exocrine function in a larger cohort based on the American-European consensus criteria for SS, and to address possible predictive factors for a declining exocrine function. METHODS: We performed a retrospective cohort study. A total of 141 patients were investigated with the Schirmer I test and unstimulated whole saliva (UWS). Historical data regarding these tests and focus score were collected from the files of 111 patients. Median time from diagnosis to follow-up investigation was 5.0 years. RESULTS: Median UWS was unchanged during follow-up. Median Schirmer I test improved from 5.0 to 7.0 mm/5 min (p<0.05). Present Schirmer I test was associated with historical high IgG and IgA, positive SSA and SS B antigen (SSB) tests and high focus score, and present UWS with historical low C3/C4. Logistic regression identified high focus scores (odds ratio (OR) = 1.343), and low UWS (OR = 0.692) as factors predicting a 30% or more worsening of the Schirmer I test. High focus scores (OR = 1.488) predicted a 30% or more worsening of the UWS. CONCLUSION: We confirmed previous studies showing a stable or slightly improved exocrine function over time. High focus scores and low UWS were identified as independent predictors of a worsened exocrine function.

[Flow rate of minor salivary glands in elderly patients wearing complete dentures]. / Idoskorú, teljes fogpótlást viselok kisnyálmirigy szekréciójának vizsgálata.

Minor salivary glands show diverse levels of secretion in different regions of the oral cavity. The smallest production can be measured at the palatal glands, the highest in the buccal and the lingual glands. The labial glands show an intermediate value between the palatal and the buccal flow rate. According to the literature, secretion of the minor salivary glands decreases with age, yet only few data are available regarding the influence of removable dentures on the flow rate. The aim of this study was to assess the influence of complete dentures on the palatal, the labial and the whole saliva flow rate on elderly patients. A further aim was to compare the results obtained by the two measuring methods (weighing method and the PERIOTRON method), used to determine the flow rates of the minor salivary glands. According to the results of this study neither whole resting saliva flow rate nor the flow rate of the minor salivary glands (palatal, buccal) was influenced by long term removable denture wearing (denture wearers and controls -- weighing method: palatal: right side 2.4 +/- 3.3 microl/min/cm2, left side 1 +/- 3.8 microl/min/cm2 and labial: 1.4 +/- 2.6 microl/min/cm2; controls: right side 3.7 +/- 5.2 microl/min/cm2, left side 1.4 +/- 2.5 microl/min/cm2 and labial 1.8 +/- 3.9 microl/min/cm whole resting saliva flow: 0.32 +/- 0.26 ml/min and 0.29 +/- 0.24 ml/min respectively) (The data of denture wearers and controls -- PERIOTRON method: palatal right side 4 +/- 4.6 microl/min/cm2, palatal left side 3.5 +/- 3.6 microl/min/cm2 and labial 0.9 +/- 0.6 microl/min/cm2; controls: palatal right side 2.2 +/- 3.1 microl/min/cm2, palatal left side 1.8 +/- 1.8 microl/min/cm2 and labial 1.9 +/- 3 microl/min/cm2). Authors could not show difference between the weighing method and the PERIOTRON method applied in the measurement of the saliva flow rate of the minor glands.

The feasibility of using infrared thermography to evaluate minor salivary gland function in euhydrated, dehydrated and rehydrated subjects.

BACKGROUND: Infrared thermography technique (IRT) is utilized by a growing number of disciplines within medicine and dentistry. However, IRT has not been employed in the evaluation of salivary gland dysfunction. The purpose of this study was to examine the feasibility of using thermographic imaging in the evaluation of minor labial salivary gland function in subjects during euhydration, dehydration, and rehydration states. METHODS: Ten subjects were studied. Upper labial minor salivary gland secretion was quantified whilst simultaneously visualizing lower minor salivary gland output thermographically during each state. RESULTS: A significant difference was observed in the minor labial salivary flow among euhydrated, dehydrated and rehydrated, states. Despite the lack of statistical difference in the thermographic findings, IRT images reflected noticeable differences among the three hydration states. CONCLUSION: The overall results of this study suggest that IRT could potentially provide a valuable non-invasive tool for evaluating the relationship between minor labial salivary gland function and hydration status.

Rituximab treatment in patients with primary Sjögren's syndrome: an open-label phase II study.

OBJECTIVE: To investigate the safety and efficacy of B cell depletion treatment of patients with active primary Sjögren's syndrome of short duration (early primary SS) and patients with primary SS and mucosa-associated lymphoid tissue (MALT)-type lymphoma (MALT/primary SS). METHODS: Fifteen patients with primary SS were included in this phase II trial. Inclusion criteria for the early primary SS group were B cell hyperactivity (IgG >15 gm/liter), presence of autoantibodies (IgM rheumatoid factor, anti-SSA/SSB), and short disease duration (<4 years). Inclusion criteria for the MALT/primary SS group were primary SS and an associated MALT-type lymphoma (Ann Arbor stage IE) localized in the parotid gland. Patients were treated with 4 infusions of rituximab (375 mg/m2) given weekly after pretreatment with prednisone (25 mg) and clemastine. Patients were evaluated, using immunologic, salivary/lacrimal function, and subjective parameters, at baseline and at 5 and 12 weeks after the first infusion. RESULTS: Significant improvement of subjective symptoms and an increase in salivary gland function was observed in patients with residual salivary gland function. Immunologic analysis showed a rapid decrease of peripheral B cells and stable levels of IgG. Human anti-chimeric antibodies (HACAs) developed in 4 of 15 patients (27%), all with early primary SS. Three of these patients developed a serum sickness-like disorder. Of the 7 patients with MALT/primary SS, complete remission was achieved in 3, and disease was stable in 3 and progressive in 1. CONCLUSION: Findings of this phase II study suggest that rituximab is effective in the treatment of primary SS. The high incidence of HACAs and associated side effects observed in this study needs further evaluation.

Minor gland saliva flow rate and proteins in subjects with hyposalivation due to Sjogren's syndrome and radiation therapy.

In this study, the secretion rate and IgA, albumin and lactoferrin concentrations in minor labial and buccal gland saliva were investigated in individuals with hyposalivation due to primary Sjogren's syndrome (pSS; 10 subjects) or head and neck radiation therapy (RT; 10 subjects) and in their matched controls. Whole saliva was similarly examined. The minor gland saliva flow was measured using the Periotron method. IgA, albumin and lactoferrin concentrations were analysed by ELISA techniques. A general finding was that the flow rate and protein concentrations were lower in labial than in buccal gland saliva. In both hyposalivation groups, the labial minor gland saliva secretion rate was lowered compared to their respective controls. The buccal gland saliva flow rate was significantly reduced in the RT group only. IgA and albumin concentrations were not different from the controls in the labial secretions. The concentration of lactoferrin was increased in the RT group. In buccal saliva, the concentrations of all proteins examined but pSS IgA, were increased compared to the controls. Reduced flow rate and increased protein concentrations were seen for whole saliva where the lactoferrin concentration was higher in RT than in pSS subjects. Thus, our findings suggested that minor gland saliva flow rate and protein concentrations are affected in RT and pSS subjects and to highest extent in the former.

Evaluation of unstimulated flow rates of whole and palatal saliva in healthy patients wearing complete dentures and in patients with Sjogren's syndrome.

STATEMENT OF PROBLEM: The palate and upper lip are the regions of oral mucosa covered with the least amount of saliva. These areas are important for maxillary denture retention and stability. Thus, patients with xerostomia or hyposalivation may have problems with the stability of maxillary complete dentures. PURPOSE: The purpose of this study was to compare the unstimulated whole saliva (UWS) and palatal saliva (PS) flow rates of healthy patients wearing complete dentures and patients with Sjogren's syndrome (SS) and to determine whether xerostomia or hyposalivation has a negative influence on maxillary complete denture stability. A further aim was to determine the influence of new complete dentures on UWS and PS flow rates in healthy individuals. MATERIAL AND METHODS: Thirty-five complete denture wearers, 24 healthy individuals (controls) and 11 patients who fulfilled the diagnostic criteria for primary Sjogren's syndrome (as proposed by the European Community Study Group) were investigated. All participants were questioned about possible subjective oral complaints (xerostomia or instability of the dentures) through use of a standardized questionnaire. In the first part of the study, UWS and PS flow rates of the healthy subjects (controls) and of the SS patients were measured at the initial visit. The flow rate of UWS (mL/min) was collected by the "spitting" method; saliva was collected into preweighed vessels for 5 minutes while subjects were seated in an upright position. Patients were asked to refrain from smoking, eating, and drinking for 2 hours prior to the test session, to avoid swallowing, and to make as few movements as possible during the procedure. The PS flow rate (microL/min/cm2) was measured using previously weighed filter paper discs placed bilaterally in the region of the maxillary second molars, 15 mm palatally from the edentulous ridge, for 30 seconds. The measuring vessels and paper discs were weighed before and after each collection. In the second part of the study, new complete dentures were fabricated for healthy patients. Flow rates of UWS and PS were measured 7 days after the insertion to compare data with prefabrication values. Mann-Whitney and Wilcoxon rank sum tests and chi-square test were used to analyze the data (alpha=.05). RESULTS: The UWS flow rates were significantly lower in SS patients compared to healthy controls (0.36 +/- 0.33 vs 0.09 +/- 0.11 mL/min, P<.05), yet the PS flow rate for both groups was not significantly different. Although every SS patient had xerostomia, and 8 out of 11 had hyposalivation, no patient complained about denture instability. Neither UWS flow rate (0.36 +/- 0.33 mL/min and 0.39 +/- 0.35 mL/min) nor PS flow rate (1.66 +/- 0.99 microL/cm2/min and 1.86 +/- 0.45 microL/cm2/min) was different from the preinsertion values after 1 week of new denture insertion in healthy patients. CONCLUSION: Palatal mucous saliva may help stabilize the maxillary complete denture in patients with hyposalivation. The results suggest that neither UWS or PS flow rate are influenced by the placement of new dentures in complete denture wearers.

Adenoma Pleomórfico de glândula salivar menor do palato / Palate Pleomorphic Adenoma of mirror salivary gland

O objetivo deste estudo histológico da lesão exofítica de forma ovóide, bem delimitada e de consistência dura localizada no palato duro foi comparar os achados histológicos da lesão com os citados na literatura pesquisada. A lesão foi excisionada e incluída em parafina histológica e os cortes histológicos foram corados pela hematoxilina e eosina (H.E.) e, analisados em microscopia de luz comum. Os cortes histológicos analisados apresentavam um parênquima tumoral ricamente celularizado por células epiteliais dispostas em lençol, cordões e ilhotas isoladas e áreas com múltiplos ductos de células mioepiteliais. O estroma é formado por uma quantidade variável de material condróide que muitas vezes está entremeado por células epiteliais. A lesão é circunscrita por uma cápsula de tecido conjuntivo fibroso. Analisando estes aspectos histológicos com os da literatura estudada concluímos que a lesão do palato se trata de um tumor denominado de adenoma pleomórfico de glândula salivar menor

A simple method to estimate the secretion of saliva from minor salivary glands using iodine-starch reaction.

OBJECTIVE/HYPOTHESIS: This study was undertaken to detect the faculty of secretion of saliva from minor salivary glands by analyzing a color reaction on a test tape containing iodine and starch that was applied on the lower lip. STUDY DESIGN: A study involving 63 patients with oral dryness, 7 patients with Sjogren syndrome, and 70 healthy individuals was performed. METHODS: A test tape (1 x 1 cm) containing iodine and starch was set on the mucosal area anterior to the labia frenulum for 30 seconds. Because the number of blue spots was considered to correspond to the number of ostia of the salivary gland on the lower lip that was examined, the number of blue spots occurring as a reaction of iodine and starch on the test tape was counted and was compared among three groups. In addition, the relationship between the histopathological findings and the number of spots was analyzed. RESULTS: The average number of spots in the patients with oral dryness (4.52+/-3.18 [mean +/- SD]) was lower than that in healthy individuals (9.49+/-2.52, P <.01), and that in the patients with Sjögren syndrome (2.14+/-1.35) was the lowest among all groups in the study. Moreover, this reduction in the number of spots in those patients was accompanied by histopathological changes of the minor salivary glands. CONCLUSION: These findings suggest that this simple, noninvasive method can be successfully used for the estimation of the faculty of secretion of saliva from the minor salivary glands.

Significance of saliva for the denture-wearing population.

UNLABELLED: This paper summarises a series of studies already published in German and presents new data related to the aetiology of the 'dry mouth' and its associated problems. AIMS: To study factors affecting mucous and serous salivary gland secretion, the aetiology of the 'dry mouth' and its associated problems, causative factors for hyposalivation and it's treatment. SETTING: Two university dental hospitals. SUBJECTS: 587 denture wearers and 521 control subjects, and autopsy material. INTERVENTIONS: Exercise, chewing, water, oestrogen, pilocarpine, and anetholtrithion therapy, biopsy of the minor glands. MAIN OUTCOME MEASURES: Palatal secretion (PAL, microL/cm2/min) and parotid salivary flow (PAR), subjective complaints and clinical findings. RESULTS: Resting flow rates for PAL between 0 and 65 microliters/cm2/min were seen in every age group. The flow rates of PAR (0 to 3.7 ml/10 min) were not correlated with PAL. Most patients with a resting flow rate of PAL < or = 6.0 microliters/cm2 suffer from a 'dry mouth' and Burning Mouth Syndrome (BMS) or oral dysaesthesia (OD) with or without chronic lesions of the oral mucosa. Etiological factors for the incidence of reduced PAL and associated problems include xerostomic drugs, oestrogen deficiency, radiotherapy, thyroid dysfunction, smoking or continuous wearing of complete upper dentures. PAL also correlated with the retention of upper complete dentures. PAL was correlated with the water content of epithelial tissues. PAL and PAR were both increased by drinking ample fluid, improving their circulation by physical exercises, chewing intensively, or taking oestrogens, pilocarpine, anetholtrithion. CONCLUSIONS: Variation in palatal salivary secretion occurs and is clinically important.

[The functional activity of the minor salivary glands of the lips in allergic cheilitis]. / Funktsional'naia aktivnost' malykh sliunnykh zhelez gub pri allergicheskom kheilite.

Functional activity of minor salivary glands is studied in 289 children, 52 of these without signs of cheilitis and 237 with allergic cheilitis at different stages. Three variants of secretion are distinguished: fast, medium, and slow. The ratio of these variants changed in exacerbation of disease in comparison with that in health or remission. The activity of the glands depends on clinical manifestations of cheilitis. Changes in the activity of minor salivary glands determine the clinical picture, localization, and type of involvement in cheilitis.

Sindrome de Sjogren (SS) / Sjogren syndrome (SS)

Atendiendo a la ineludible responsabilidad del odontólogo de profundizar en el conocimiento de aquellas enfermedades cuya manifestación clínica se evidencie en el complejo maxilofacial. El presente artículo recoge, en apretada síntesis, una visión integradora del sindrome de Sjogren (SS), abordando aspectos históricos, definición, características clínicas, epidemiología y aspectos hísticos e inmunopatológicos de las alteraciones en glándulas salivales menores. Se plantea la participación del odontólogo en el diagnóstico de la enfermedad, atendiendo al conjunto de agresiones que pueden provocar alteraciones en el parénquima de las glándulas salivales menores, lo que puede ser de gran valor en la justa evaluación clínica de estos pacientes. Desde el punto de vista inmunopatológico, existe coincidencia al plantear que las células predominatnes en el infiltrado linfocítico de las glándulas salivales accesorias son las T-colaboradoras (CD4+) de 3-4:1. Las células B, constituyen aproximadamente el 20 por ciento del total de la población involucrada, mientras que las NK son las menos frecuentes (5 por ciento)

Remoçäo cirúrgica de mucocele / Mucoceles: a clinical case report

Mucocele é um termo utilizado para diagnosticar clinicamente dois fenômenos que podem acometer as glândulas salivares menores, sendo eles: o fenômeno de extravasamento e o cisto de retençäo mucoso. Embora essas lesöes sejam muito freqüentes na cavidade bucal, existe ainda certa confusäo em relaçäo a esses termos. Os autores relatam um caso clínico de mucocele, discutindo a etiopatogenia e as características clínicas que levaram ao diagnóstico clínico da lesäo, bem como o prognóstico, o tratamento e as características histológicas da mesma