[Usefulness of pilocarpine in the prevention of xerostomia in patients with head and neck cancer treated with radiotherapy. Assessment with gammagraphy and salivary flow]. / Utilidad de la pilocarpina como profiláctico de xerostomía en pacientes con cáncer de cabeza y cuello tratados con radioterapia. Valoración mediante gammagrafía y flujo salivar.

AIM: To assess the utility of salivary gland scintigraphy and salivary flow to quantify salivary function and to evaluate the usefulness of pilocarpine in the treatment of radiation-induced xerestomia in head and neck cancer patients. METHOD: Thirty two patients with head and neck tumor treated with radiotherapy (RDT) were studied. Patients were classified into two groups: pilocarpine group (P), that received prophylactic pilocarpine before RDT and during the first year after treatment. No pilocarpine group (NP) that received RDT without pilocarpine. Salivary gland scintigraphy and salivary flow were performed before RDT and during one year after treatment. Parotid and submaxillary uptake and excretion were calculated. Salivary flow after stimulation during five minutes was also obtained. RESULTS: Uptake and excretion in both salivary glands decreased after RDT. There were no statistical differences comparing P and NP groups (p < 0.001). However, in group P a trend to recovery was observed in parotid uptake values at 12 months after treatment, but it was not statistically significant. In both groups the salivary flow decreased after RDT and a good correlation (r = 0.8) between salivary flow and submaxillary excretion and parotid excretion was found. CONCLUSIONS: Salivary gland scintigraphy and salivary flow could be useful to evaluate salivary gland function in patients with head and neck irradiated tumors. Although better results on the salivary uptake at 12 months were noted, pilocarpine did not significantly improve salivary gland function.

Depresión y drogodependencia: efectos sobre la salud dental / Depression and drug dependency: effects on dental health

Introducción: Los pacientes que reciben antidepresivos y los pacientes drogodependientes presentan xerostomía, lo que junto a la alteración de sus hábitos higiénicos lleva a un incremento en la aparición de caries dental. Este trabajo compara dos muestras de ambos grupos. Material y métodos: Se han tomado datos de 75 pacientes en tratamiento antidepresivo y 80 pacientes drogodependientes durante un periodo de cinco años, en el servicio de psiquiatría del Hospital Clínic Universitari de Barcelona. Los datos recogidos han sido número y gravedad de caries, piezas dentales ausentes y pH salival. Se han realizado las pruebas U de Mann-Whitney, t de Student y análisis de la varianza con el programa SPSS v. 11.5. Resultados: Con un intervalo de confianza del 99% se establece que el grupo de pacientes drogodependientes presenta más caries y más graves, así como un pH más ácido que el grupo de pacientes con antidepresivos ,aunque presentan menor ausencia de piezas dentales. Discusión: Nuestros resultados son similares a los publicados en diversas áreas geográficas en lo que respecta a la aparición de caries en estos grupos. En nuestra muestra la pertenencia al grupo de drogodependientes tiene más peso que factores como el pH salival, el sexo o la edad. En la literatura se intenta discernir el peso que la patología de base, la higiene oral o la propia medicación tienen sobre la salud dental, pero es difícil llegar a conclusiones determinantes (AU)

Introduction: Patients receiving antidepressants and drug dependent patients present xerostomy, which together with the alteration of their hygienic habits leads to an increase in the occurrence of dental caries. This study compares two samples of both groups. Materials and methods: Data were collected from 75 patients in antidepressant treatment and 80 drug addict patients during a period of five years in the psychiatric department of the Hospital Clínic Universitari from Barcelona. The data collected were number and severity of caries, number of missing teeth and salivary pH. Mann-Whitney U test, Student’s t test and analysis of variance were performed using SPSS v. 11.5. Results: Drug dependent patients present more caries and are more serious, and have a more acidic pH than the group of patients receiving antidepressants, but have less absence of teeth. This was established with a confidence interval of 99%. Discussion: Our results regarding caries in these groups are similar to those reported in different geographical areas. In our sample, being drug dependent has more weight than factors such as salivary pH, sex or age. Literature try to discern the weight that underlying pathology, oral hygiene or medication have on dental health, but it is difficult to obtain decisive conclusions (AU)