1
|
Yi KH, Kim SB, Hu H, An HS, Hidajat IJ, Lim TS, Kim HJ. Ultrasonographic Study of the Submandibular Gland for Botulinum Neurotoxin Injection. Dermatol Surg 2024; 50:834-837. [PMID: 38712848 DOI: 10.1097/dss.0000000000004208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND Hypertrophied submandibular glands provide a bulky contour to the lower face. Botulinum neurotoxin injection methods are commonly used for facial contouring; however, no studies have suggested injection points because of the lack of delicate anatomical information on the submandibular gland. OBJECTIVE The aim of this study was to determine the optimal injection site for botulinum neurotoxin injections in the submandibular gland. MATERIALS AND METHODS Anatomical considerations when injecting botulinum neurotoxin into the submandibular gland were determined using ultrasonography. The thickness of the submandibular gland, its depth from the skin surface, and the location of the vascular bundle were observed bilaterally in 42 participants. Two cadavers were dissected to measure the location of the submandibular gland corresponding to the ultrasonographic observation. RESULTS The thickest part of the submandibular gland measured 11.12 ± 2.46 in width with a depth of 4.63 ± 0.76. At the point where it crosses the line of the lateral canthus, it measured 5.53 ± 1.83 in width and 8.73 ± 1.64 in depth. CONCLUSION The authors suggest optimal injection sites based on external anatomical landmarks. These guidelines aim to maximize the effects of botulinum neurotoxin therapy by minimizing its deleterious effects, which can be useful in clinical settings.
Collapse
Affiliation(s)
- Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
- Maylin Clinic (Apgujeong), Seoul, Korea
| | - Soo-Bin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyewon Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyo-Sang An
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Inneke Jane Hidajat
- Department of Dermatology, Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
2
|
Lalla RV, Helgeson ES, Virk K, Lu H, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Brennan MT. Females have lower salivary flow than males, before and after radiation therapy for head/neck cancer. Oral Dis 2024. [PMID: 39005202 DOI: 10.1111/odi.15068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To compare salivary flow rates between females and males, before and after radiation therapy (RT) for head and neck cancer (HNC). METHODS Prospective observational multicenter cohort study (OraRad). Stimulated whole salivary flow was measured before RT and at 6 and 18 months after RT. RESULTS Mean (95% confidence interval) salivary flow in g/min before RT was 0.81 (0.71, 0.90) in females (n = 107) and 1.20 (1.15, 1.25) in males (n = 391) (p < 0.001); at 6 months was 0.34 (0.24, 0.44) in females and 0.50 (0.44, 0.55) in males (p = 0.01); at 18 months was 0.49 (0.38, 0.59) in females and 0.70 (0.64, 0.75) in males (p < 0.001). Median nadir salivary flow after RT was 0.22 in females and 0.35 in males (p < 0.001). A lower nadir salivary flow in females, but not males, was associated with an increased risk for tooth failure (p = 0.02). CONCLUSIONS Females with HNC have lower stimulated whole salivary flow than males, before and after RT. Low salivary flow after RT may be a risk factor for tooth failure among females. The lower pre-RT salivary flow rates in females, combined with prior literature in other populations, indicates that, in general, females have lower stimulated salivary flow than males.
Collapse
Affiliation(s)
- Rajesh V Lalla
- Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Erika S Helgeson
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Komal Virk
- Division of General Dentistry, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Han Lu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nathaniel S Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Thomas P Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
- Division of Oral Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Brian L Schmidt
- Department of Oral & Maxillofacial Surgery and Bluestone Center for Clinical Research, New York University College of Dentistry, New York, New York, USA
| | - Lauren L Patton
- Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alexander Lin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael T Brennan
- Department of Oral Medicine/Oral & Maxillofacial Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA
- Department of Otolaryngology/Head & Neck Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| |
Collapse
|
3
|
Jost WH, Bäumer T, Bevot A, Birkmann U, Buhmann C, Grosheva M, Guntinas-Lichius O, Laskawi R, Paus S, Pflug C, Schroeder AS, Spittau B, Steffen A, Wilken B, Winterholler M, Berweck S. Botulinum neurotoxin type A in the interdisciplinary treatment of sialorrhea in adults and children-update and practice recommendations. Front Neurol 2023; 14:1275807. [PMID: 38162447 PMCID: PMC10757066 DOI: 10.3389/fneur.2023.1275807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
Sialorrhea is defined as a chronic excessive flow of saliva from the mouth, often with adverse consequences for health and quality of life of patients. In addition to currently used non-drug treatment and systemic drugs, intraglandular Botulinum Neurotoxin A (BoNT/A) injections have been examined in case studies, controlled trials and clinical practice. Two pivotal Phase III trials recently led to market approval in the USA and EU for IncobotulinumtoxinA [Xeomin®, IncoBoNT/A, Clostridium botulinum neurotoxin type A (150 kD), free from complexing proteins, Merz Pharmaceuticals GmbH] for treatment of chronic sialorrhea in adults and pediatric patients. This review provides a multidisciplinary approach to discuss the current state of sialorrhea therapy as well as benefits and current limitations of BoNT/A injections. A consensus regarding treatment recommendations made available to physicians in Germany in 2022 has now been updated here for presentation to an international audience. This review provides a framework including a flow chart for patient selection, recommendations for dosing and the injection process, as well as a discussion of therapeutic goals, long-term benefits and safety aspects. This review is aimed at supporting physicians in developing multidisciplinary and individualized treatment approaches to achieve optimal benefits for patients.
Collapse
Affiliation(s)
| | - Tobias Bäumer
- Institute of Systemic Motor Science, CBBM, University of Lübeck, Lübeck, Germany
| | - Andrea Bevot
- Department of Neuropediatrics and Developmental Medicine, University Children’s Hospital Tübingen, Tübingen, Germany
| | - Ulrich Birkmann
- Department of Neurology, Schluckambulanz, GFO Clinics Troisdorf, Troisdorf, Germany
| | - Carsten Buhmann
- Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | | | - Rainer Laskawi
- Department of Otorhinolaryngology, University Hospital Göttingen, Göttingen, Germany
| | - Sebastian Paus
- Department of Neurology, GFO Clinics Troisdorf, Troisdorf, Germany
| | - Christina Pflug
- Department of Voice, Speech and Hearing Disorders, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - A. Sebastian Schroeder
- Clinic for Child Neurology and Social Pediatrics, Child Center Maulbronn, Maulbronn, Germany
| | - Björn Spittau
- Anatomy and Cell Biology, Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Armin Steffen
- Department for Otorhinolaryngology, University of Lübeck, Lübeck, Germany
| | - Bernd Wilken
- Department of Pediatric Neurology, Klinikum Kassel, Kassel, Germany
| | - Martin Winterholler
- Department of Neurology, Sana Hospital Rummelsberg, Nuremberg/Schwarzenbruck, Germany
| | - Steffen Berweck
- Specialist Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic, Vogtareuth, Germany
| |
Collapse
|
4
|
Population Based Average Parotid Gland Volume and Prevalence of Incidental Tumors in T1-MRI. Healthcare (Basel) 2022; 10:healthcare10112310. [PMID: 36421635 PMCID: PMC9690992 DOI: 10.3390/healthcare10112310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
Representative epidemiologic data on the average volume of the parotid gland in a large population-based MRI survey is non-existent. Within the Study of Health in Pomerania (SHIP), we examined the parotid gland in 1725 non-contrast MRI-scans in T1 weighted sequence of axial layers. Thus, a reliable standard operating procedure (Intraclass Correlation Coefficient > 0.8) could be established. In this study, we found an average, single sided parotid gland volume of 27.82 cm3 (95% confidence interval (CI) 27.15 to 28.50) in male and 21.60 cm3 (95% CI 21.16 to 22.05) in female subjects. We observed positive associations for age, body mass index (BMI), as well as male sex with parotid gland size in a multivariate model. The prevalence of incidental tumors within the parotid gland regardless of dignity was 3.94% in the Northeast German population, slightly higher than assumed. Further epidemiologic investigations regarding primary salivary gland diseases are necessary.
Collapse
|
5
|
Jost WH, Bäumer T, Berweck S, Laskawi R, Spittau B, Steffen A, Winterholler M. [Therapy of Sialorrhea with Botulinum Toxin - An Update]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:222-232. [PMID: 35453157 DOI: 10.1055/a-1802-3867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The most important salivary glands are the paired parotid and submandibular glands. Adults produce 1 to 1.5 liters of saliva which are then regularly swallowed. When the act of swallowing is disturbed, salivation occurs. More rarely, the cause can be found in increased saliva production, for example, when caused through medication. Sialorrhea impairs the quality of life substantially and is frequently often socially stigmatizing. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, as well as, in selected cases, radiation and surgical measures. Over the last 20 years, local injection of botulinum toxin has been successfully applied in the treatment of this condition. With approval of incobotulinumtoxinA toxin for children and adults, this procedure will become the therapy of choice for chronic sialorrhea. The results of the phase III registration trials have demonstrated high efficacy and good safety of the injection treatment in both children and adults.
Collapse
Affiliation(s)
| | - Tobias Bäumer
- Institut für Systemische Motorikforschung, CBBM, Sektion Zentrum für Seltene Erkrankungen, UKSH, Universität zu Lübeck, Lübeck, Germany
| | - Steffen Berweck
- Schön Klinik Vogtareuth, Vogtareuth, Germany.,Dr von Haunersches Kinderspital Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universitat München, München, Germany
| | - Rainer Laskawi
- Georg-August-Universitat Göttingen HNO-Klinik, Göttingen, Germany
| | - Björn Spittau
- Anatomie und Zellbiologie, Medizinische Fakultät OWL, Universität Bielefeld, Bielefeld, Germany
| | - Armin Steffen
- Universitätsklinikum Schleswig-Holstein Campus Lübeck HNO Klinik, Lübeck, Germany
| | | |
Collapse
|
6
|
Wollmer E, Ungell AL, Nicolas JM, Klein S. Review of paediatric gastrointestinal physiology relevant to the absorption of orally administered medicines. Adv Drug Deliv Rev 2022; 181:114084. [PMID: 34929252 DOI: 10.1016/j.addr.2021.114084] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/13/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Abstract
Despite much progress in regulations to improve paediatric drug development, there remains a significant need to develop better medications for children. For the design of oral dosage forms, a detailed understanding of the specific gastrointestinal (GI) conditions in children of different age categories and how they differ from GI conditions in adults is essential. Several review articles have been published addressing the ontogeny of GI characteristics, including luminal conditions in the GI tract of children. However, the data reported in most of these reviews are of limited quality because (1) information was cited from very old publications and sometimes low quality sources, (2) data gaps in the original data were filled with textbook knowledge, (3) data obtained on healthy and sick children were mixed, (4) average data obtained on groups of patients were mixed with data obtained on individual patients, and (5) results obtained using investigative techniques that may have altered the outcome of the respective studies were considered. Consequently, many of these reviews draw conclusions that may be incorrect. The aim of the present review was to provide a comprehensive and updated overview of the available original data on the ontogeny of GI luminal conditions relevant to oral drug absorption in the paediatric population. To this end, the PubMed and Web of Science metadatabases were searched for appropriate studies that examined age-related conditions in the oral cavity, esophagus, stomach, small intestine, and colon. Maturation was observed for several GI parameters, and corresponding data sets were identified for each paediatric age group. However, it also became clear that the ontogeny of several GI traits in the paediatric population is not yet known. The review article provides a robust and valuable data set for the development of paediatric in vitro and in silico biopharmaceutical tools to support the development of age-appropriate dosage forms. In addition, it provides important information on existing data gaps and should provide impetus for further systematic and well-designed in vivo studies on GI physiology in children of specific age groups in order to close existing knowledge gaps and to sustainably improve oral drug therapy in children.
Collapse
|
7
|
Kim EHJ, Wilson A, Motoi L, Mishra SD, Monro JA, Parkar SG, Rosendale D, Stoklosinski H, Jobsis CMH, Wadamori Y, Hedderley D, Morgenstern M. Chewing differences in consumers affect the digestion and colonic fermentation outcomes: In vitro studies. Food Funct 2022; 13:9355-9371. [DOI: 10.1039/d1fo04364a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
It is important to understand variability in consumer chewing behavior for designing food products that deliver desired functionalities for target consumer segments. In this study, we selected 29 participants, representing...
Collapse
|
8
|
Liu H, Qin L, Wu Y, van der Glas HW, Chen J, Wang X. Oral physiological characteristics among Chinese subjects in the eastern region of China. Arch Oral Biol 2019; 108:104539. [DOI: 10.1016/j.archoralbio.2019.104539] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/21/2019] [Accepted: 08/25/2019] [Indexed: 01/06/2023]
|
9
|
Jost WH, Bäumer T, Laskawi R, Slawek J, Spittau B, Steffen A, Winterholler M, Bavikatte G. Therapy of Sialorrhea with Botulinum Neurotoxin. Neurol Ther 2019; 8:273-288. [PMID: 31542879 PMCID: PMC6858891 DOI: 10.1007/s40120-019-00155-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Indexed: 12/11/2022] Open
Abstract
Botulinum neurotoxin (BoNT) is considered the treatment of choice for various symptoms and diseases such as focal dystonia and focal spasticity. The effects of BoNT on the salivary glands have also been known for years, but their use was limited because of a lack of approval studies. Now the indication of sialorrhea is approved in some countries for incobotulinumtoxinA, such as the USA and Europe, and therapy could also become the treatment of choice. According to the pivotal study, a dose of 100 units of incobotulinumtoxinA, which is divided into the parotid and submandibular glands, is recommended. RimabotulinumtoxinB is approved in the USA only. To define the value of this therapy, we must consider anatomy, physiology, and available therapies. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, and, in selected cases, radiotherapy and surgical procedures. A combination of different approaches is optional. On the basis of the evidence and clinical experience, BoNT injections will be the first line of pharmacotherapy for chronic sialorrhea.
Collapse
Affiliation(s)
| | - Tobias Bäumer
- Paediatric and Adult Movement Disorders and Neuropsychiatry, Institut of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Rainer Laskawi
- ENT Department, University Medical Center, Göttingen, Germany
| | - Jaroslaw Slawek
- Neurology Department, Medical University of Gdansk, Gdańsk, Poland
| | - Björn Spittau
- Center for Transdisciplinary Neurosciences Rostock (CTNR), University of Rostock, Rostock, Germany
| | - Armin Steffen
- Department for Otorhinolaryngology, University of Lübeck, UKSH, Lübeck, Germany
| | | | | |
Collapse
|
10
|
Speer I, Preis M, Breitkreutz J. Novel Dissolution Method for Oral Film Preparations with Modified Release Properties. AAPS PharmSciTech 2018; 20:7. [PMID: 30560468 DOI: 10.1208/s12249-018-1255-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/21/2018] [Indexed: 11/30/2022] Open
Abstract
Oromucosal film preparations have gained popularity in pharmaceutical research and development. Therefore, oral films have been integrated into the monograph "oromucosal preparations" of the European Pharmacopeia in 2012. Regulatory authorities explicitly demand dissolution studies for films, but neither refer to suitable methods nor established specifications. Test methods described in the literature are often limited to immediate release formulations or not applicable to investigate the drug release of films with prolonged release profiles considering the different stages of gastrointestinal transit. The aims of this study were to develop a dissolution test method, which is suitable to investigate the drug release of film preparations with immediate as well as modified release profiles and to explore the potential of the test setup considering some physiological characteristics. Therefore, a conventional flow-through cell was equipped with in-house built sample holders. Three-dimensional printing technology was used for prototyping one of the sample holders. Four different types of films were investigated, such as ODFs with immediate (ODFIR) and prolonged release (ODFPR) characteristics as well as a double-layer film (ODFDL), produced with a water-insoluble shielding layer. Anhydrous theophylline was used as a model drug for all film types. Introducing special fixtures for oral films to a conventional flow-through cell enables successful determination of the drug release behavior of oral film preparations with immediate as well as modified release properties. Investigating ODFDL, the application of film sample holders with backing plates such as film sample holder with backing plate (FHB) and 3D printed film sample holder (FH3D) showed prolonged release profiles with 14.6 ± 1.30% theophylline dissolved within 2 h for FHB compared to 92.9 ± 3.33% for the film sample holder without backing plate (FH). This indicates their suitability to examine the integrity of the shielding layer. The application of the backing plate further decreased the drug release of ODFPR < 315 to 61.0 ± 1.69% dissolved theophylline within 2 h using FHB compared to 82.3 ± 0.74% using FH, due to a reduced ODF surface exposed to the dissolution medium. The potential of the dissolution test setup to consider physiological conditions of the human gastrointestinal transit was investigated by applying different flow rates and media compositions to simulate conditions within the oral cavity, stomach, and intestine. For the application of a low flow rate of 1 ml/min, comparable to the salivary flow within the oral cavity, decreased theophylline release was observed, while similar release profiles were obtained for flow rates between 2 and 8 ml/min. Substantial impact on the theophylline release was exerted by varying the composition of the dissolution medium. Since the drug release from ODFPR is controlled by diffusion through a water-insoluble matrix, ion species and concentration strongly affect the release behavior. In the future, IVIVC studies have to be performed to explore, whether obtained data can be used to predict drug release behavior of ODFs during the human gastrointestinal transit.
Collapse
|
11
|
Kojima I, Sakamoto M, Iikubo M, Shimada Y, Nishioka T, Sasano T. Relationship of MR imaging of submandibular glands to hyposalivation in Sjögren's syndrome. Oral Dis 2018; 25:117-125. [PMID: 30007097 DOI: 10.1111/odi.12941] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/24/2018] [Accepted: 07/08/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We analysed the correlation between magnetic resonance images of the parotid and submandibular glands and the salivary flow rate in patients with Sjögren's syndrome. METHODS We retrospectively reviewed magnetic resonance images (heterogeneous signal-intensity distribution and gland volume on T1- and fat-suppressed T2-weighted images, and multiple high-signal-intensity spots on magnetic resonance sialograms in the parotid and submandibular glands) obtained from 66 patients who were diagnosed with Sjögren's syndrome. We evaluated the relationship between these imaging features and their salivary flow rates in stimulated and unstimulated conditions. RESULTS We found that as the disease progressed, both the heterogeneous signal-intensity distribution and the volumes of the parotid and the submandibular glands were significantly related to the stimulated and the unstimulated salivary flow rate. These imaging features were more highly correlated in assessments of the submandibular gland than in those of the parotid gland for both stimulated and unstimulated salivary flow rates. CONCLUSIONS Magnetic resonance image features of heterogeneity and smaller volume in the submandibular gland are reliable for predicting hyposalivation related to the progression of Sjögren's syndrome.
Collapse
Affiliation(s)
- Ikuho Kojima
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Maya Sakamoto
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masahiro Iikubo
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yusuke Shimada
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takashi Nishioka
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takashi Sasano
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
12
|
Fukumoto W, Higaki T, Matsuoka Y, Tatsugami F, Baba Y, Iida M, Awai K. Quantification of the salivary volume flow rate in the parotid duct using the time‐spatial labeling inversion pulse (Time‐SLIP) technique at MRI: A feasibility study. J Magn Reson Imaging 2017; 47:928-935. [DOI: 10.1002/jmri.25846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/14/2017] [Indexed: 01/07/2023] Open
Affiliation(s)
- Wataru Fukumoto
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Toru Higaki
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Yoshiko Matsuoka
- Department of Diagnostic RadiologyHiroshima University HospitalHiroshima Japan
| | - Fuminari Tatsugami
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Yasutaka Baba
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Makoto Iida
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| | - Kazuo Awai
- Department of Diagnostic RadiologyInstitute of Biomedical Health Sciences, Hiroshima UniversityHiroshima Japan
| |
Collapse
|
13
|
Ekström J, Khosravani N, Castagnola M, Messana I. Saliva and the Control of Its Secretion. Dysphagia 2017. [DOI: 10.1007/174_2017_143] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
14
|
Sialosis, Gout Induced or Idiopathic? Case Report. J Oral Maxillofac Surg 2016; 75:343-347. [PMID: 27663535 DOI: 10.1016/j.joms.2016.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/19/2016] [Accepted: 08/20/2016] [Indexed: 12/26/2022]
Abstract
Sialosis is observed in relation to diabetes, alcoholism, and malnutrition. An assumed relation between gout and sialosis is probably based on confusion that originated from the therapeutic use of phenylbutazone for gout and the sialadenitis that the medication caused. This report describes a case of sialosis in a patient with a longstanding history of gout that was idiopathic in origin.
Collapse
|
15
|
Kojima I, Sakamoto M, Iikubo M, Kumamoto H, Muroi A, Sugawara Y, Satoh-Kuriwada S, Sasano T. Diagnostic performance of MR imaging of three major salivary glands for Sjögren's syndrome. Oral Dis 2016; 23:84-90. [PMID: 27580143 DOI: 10.1111/odi.12577] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 08/23/2016] [Accepted: 08/25/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We analyzed the diagnostic performance of the MR imaging findings of the parotid, submandibular, and sublingual glands to discriminate between patients with and without Sjögren's syndrome. METHODS We retrospectively analyzed the correlation between the MR imaging and histopathological findings obtained from 69 patients with clinically suspected Sjögren's syndrome. We evaluated the heterogeneous signal intensity distribution on T1- and T2-weighted images, the multiple high-signal-intensity spots on MR sialograms, and the volume of the parotid, submandibular, and sublingual salivary glands. RESULTS The multiple high-signal-intensity spots in the parotid gland showed the highest sensitivity and diagnostic accuracy (82% and 83%, respectively). In addition, the multiple high-signal-intensity spots and the heterogeneous signal intensity distribution in the submandibular gland showed high specificity (100% and 88%, respectively). The volume of the submandibular gland, but not that of the parotid or sublingual gland, was smaller in patients with Sjögren's syndrome. CONCLUSIONS The presence of multiple high-signal-intensity spots on an MR sialogram in the parotid gland should be considered the best diagnostic indicator for Sjögren's syndrome. The presence of spots, heterogeneity, and the change to smaller volumes in the submandibular gland were also helpful because of their high specificity, particularly in advanced cases.
Collapse
Affiliation(s)
- I Kojima
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - M Sakamoto
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - M Iikubo
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Kumamoto
- Department of Oral Pathology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - A Muroi
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Y Sugawara
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Satoh-Kuriwada
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - T Sasano
- Department of Oral Diagnosis, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
16
|
Prabhu R, Mandel L. Simultaneous Bilateral Hypertrophies of the Parotid Gland and Masseter Muscle: Case Report. J Oral Maxillofac Surg 2016; 75:149-152. [PMID: 27528104 DOI: 10.1016/j.joms.2016.06.193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Abstract
Increased salivary demand can lead to enlarged parotid salivary glands, and increased activity of the masseter muscles can cause masseter hypertrophy. This report describes a most unusual case of simultaneous bilateral hypertrophies of the parotid gland and masseter muscle originating from the very extensive habit of chewing gum. An extensive literature review uncovered many cases of the independent existence of masseteric or parotid hypertrophy, but no example of the simultaneous occurrence of these 2 conditions.
Collapse
Affiliation(s)
- Rohan Prabhu
- Research Assistant, Salivary Gland Center; Fourth-Year Dental Student, Columbia University College of Dental Medicine, New York, NY
| | - Louis Mandel
- Director, Salivary Gland Center; Associate Dean and Clinical Professor, Department of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York, NY.
| |
Collapse
|
17
|
Investigation of salivary function and oral microbiota of radiation caries-free people with nasopharyngeal carcinoma. PLoS One 2015; 10:e0123137. [PMID: 25860481 PMCID: PMC4393271 DOI: 10.1371/journal.pone.0123137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/17/2015] [Indexed: 02/05/2023] Open
Abstract
Radiation caries have been reported to be correlated with radiotherapy-induced destruction of salivary function and changes in oral microbiota. There have been no published reports detailing patients who have remained radiation caries-free following radiotherapy for nasopharyngeal carcinoma. The aim of this study was to investigate the relationship between salivary function, oral microbiota and the absence of radiation caries. Twelve radiation caries-free patients and nine patients exhibiting radiation caries following irradiated nasopharyngeal carcinoma were selected. V40, the dose at which the volume of the contralateral parotid gland receives more than 40 Gy, was recorded. Stimulated saliva flow rate, pH values and buffering capacity were examined to assess salivary function. Stimulated saliva was used for molecular profiling by Denaturing Gradient Gel Electrophoresis. Mutans streptococci and Lactobacilli in saliva were also cultivated. There were no significant differences in V40 between radiation caries-free individuals and those with radiation caries. Compared with normal values, the radiation caries-free group had significantly decreased simulated saliva flow rate, while there were no significant differences in the saliva pH value and buffering capacity. Similar results were observed in the radiation caries group. There was no statistical difference in microbial diversity, composition and log CFU counts in cultivation from the radiation caries-free group and the radiation caries group. Eleven genera were detected in these two groups, among which Streptococcus spp. and Neisseria spp. had the highest distribution. Our results suggest that changes in salivary function and in salivary microbiota do not explain the absence of radiation caries in radiation caries-free individuals.
Collapse
|
18
|
Oral transmucosal drug delivery for pediatric use. Adv Drug Deliv Rev 2014; 73:50-62. [PMID: 23999459 DOI: 10.1016/j.addr.2013.08.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/13/2013] [Accepted: 08/22/2013] [Indexed: 12/25/2022]
Abstract
The formulation of medicines for children remains a challenge. An ideal pediatric formulation must allow accurate dose administration and be in a dosage form that can be handled by the target age group. It is also important to consider the choices and the amount of excipients used in the formulation for this vulnerable age group. Although oral formulations are generally acceptable to most pediatric patients, they are not suitable for drugs with poor oral bioavailability or when a rapid clinical effect is required. In recent years, oral transmucosal delivery has emerged as an attractive route of administration for pediatric patients. With this route of administration, a drug is absorbed through the oral mucosa, therefore bypassing hepatic first pass metabolism and thus avoiding drug degradation or metabolism in the gastrointestinal tract. The high blood flow and relatively high permeability of the oral mucosa allow a quick onset of action to be achieved. It is a simple and non-invasive route of drug administration. However, there are several barriers that need to be overcome in the development of oral transmucosal products. This article aims to provide a comprehensive review of the current development of oral transmucosal delivery specifically for the pediatric population in order to achieve systemic drug delivery. The anatomical and physiological properties of the oral mucosa of infants and young children are carefully examined. The different dosage forms and formulation strategies that are suitable for young patients are discussed.
Collapse
|
19
|
Gao Z, Taniwaki M, Shimada H, Ishihara S, Nakauma M, Funami T, Kohyama K. Ultrasound Analysis of the Effects of Food Bolus Volume on Tongue Movement at the Initiation of Swallowing. J Texture Stud 2013. [DOI: 10.1111/jtxs.12026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Zhihong Gao
- National Food Research Institute; National Agriculture and Food Research Organization; 2-1-12 Kannondai Tsukuba Ibaraki 305-8642 Japan
| | - Mitsuru Taniwaki
- National Food Research Institute; National Agriculture and Food Research Organization; 2-1-12 Kannondai Tsukuba Ibaraki 305-8642 Japan
| | - Hiromi Shimada
- National Food Research Institute; National Agriculture and Food Research Organization; 2-1-12 Kannondai Tsukuba Ibaraki 305-8642 Japan
| | | | | | | | - Kaoru Kohyama
- National Food Research Institute; National Agriculture and Food Research Organization; 2-1-12 Kannondai Tsukuba Ibaraki 305-8642 Japan
| |
Collapse
|
20
|
Age-related relaxo-volumetric quantitative magnetic resonance imaging of the major salivary glands. J Comput Assist Tomogr 2013; 37:272-8. [PMID: 23493218 DOI: 10.1097/rct.0b013e31827b4729] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study age-related characteristics of T1 and T2 relaxation times and volume of the major salivary glands. METHODS Thirty-five subjects (0.5-87 years old) with normal salivary glands were imaged with mixed turbo spin-echo pulse sequences at 1.5-T magnetic resonance units. Bilateral parotid, submandibular, and sublingual glands were segmented manually. Histograms for each salivary gland were generated and modeled with Gaussian functions for every parameter. RESULTS Seventy parotid glands, 52 submandibular glands, and 50 sublingual glands were segmented and the histograms were analyzed. The parotid gland exhibited shorter-peak T1s and longer-peak T2s relative to the submandibular and sublingual glands. The peak T2s for all glands showed a minimum value between 2 and 4 years of age and increased monotonically thereafter. From birth to early adulthood, all glands increased in size logarithmically. CONCLUSION Age-related relaxo-volumetric changes of the major salivary glands show clear T2 and volumetric age-related patterns for all glands.
Collapse
|
21
|
Yamamoto K, Matsusue Y, Komatsu Y, Kurihara M, Nakagawa Y, Kirita T. Association of candy weight loss rate with whole saliva flow rates. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2011; 112:e10-e14. [PMID: 21458319 DOI: 10.1016/j.tripleo.2011.01.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 01/18/2011] [Accepted: 01/22/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The association of candy weight loss rate (CWLR) with whole saliva flow rates (WSFRs) was analyzed. STUDY DESIGN The unstimulated whole saliva flow rate (UWSFR), stimulated whole saliva flow rate by the gum test (SWSFR-GT) and stimulated whole saliva flow rate by the Saxon test (SWSFR-ST) were measured in 300 healthy young adults. CWLR was measured by passively holding sugar candy between the tongue dorsum and hard palate. The degree of discomfort was evaluated by the visual analog scale. RESULTS CWLR was significantly correlated with UWSFR, SWSFR-GT, and SWSFR-ST with Pearson's correlation coefficients of 0.1847 (P = .0013), 0.2097 (P = .0003), and 0.2332 (P < .0001), respectively; however, these were much smaller than those of 0.6858 (P < .0001) between UWSFR and SWSFR-GT, 0.5071 (P < .0001) between UWSFR and SWSFR-ST, and 0.5424 (P < .0001) between SWSFR-GT and SWSFR-ST. The degree of discomfort was significantly lower in the measurement of CWLR than in any WSFRs (P < .0001). CONCLUSIONS CWLR cannot be used as an independent alternative to WSFRs, although it can be measured with less discomfort.
Collapse
Affiliation(s)
- Kazuhiko Yamamoto
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan.
| | | | | | | | | | | |
Collapse
|
22
|
|
23
|
Mozaffari MS, Abdelsayed R, Zakhary I, El-Salanty M, Liu JY, Wimborne H, El-Marakby A. Submandibular gland and caries susceptibility in the obese Zucker rat. J Oral Pathol Med 2010; 40:194-200. [PMID: 20973827 DOI: 10.1111/j.1600-0714.2010.00965.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Obesity is a prevalent disorder characterized as marked insulin resistance and low grade inflammation. We tested the hypothesis that obesity upregulates inflammatory markers in the submandibular gland in association with derangements of its architecture and pre-disposition to caries in obese Zucker rats (OZR). We also examined the potential impact of chromium picolinate (Cr(Pic)3), a nutritional supplement suggested to improve glycemic control, on the aforementioned parameters. DESIGN Male OZR were treated with diets lacking and containing 5 or 10 mg/kg chromium (as Cr(Pic)3) from 6 weeks to about 6 months of age; lean Zucker rats (LZR) served as controls. Thereafter, glycemic status, salivary tissue architecture, and the levels of several inflammatory markers were determined in association with caries susceptibility. RESULTS OZR showed reduced insulin sensitivity, increased ratio of phospho-nuclear factor-kappa B (NF-κB) to total NF-κB, and increased intercellular adhesion molecule-1 level but similar histological features compared to LZR. Importantly, compared to LZR, OZR displayed rampant caries and a tendency for reduced dentin mineral density. Treatment of OZR with Cr(Pic)3 attenuated upregulation of these proinflammatory indicators in association with reduced severity of caries without improving insulin sensitivity. CONCLUSIONS Obesity promotes proinflammatory changes within the submandibular gland, without affecting glandular architecture, in association with rampant caries; Cr(Pic)3 treatment provided some protective effects.
Collapse
Affiliation(s)
- Mahmood S Mozaffari
- Department of Oral Biology, Medical College of Georgia School of Dentistry, Augusta, Georgia 30912-1128, USA.
| | | | | | | | | | | | | |
Collapse
|
24
|
Dinnella C, Recchia A, Vincenzi S, Tuorila H, Monteleone E. Temporary Modification of Salivary Protein Profile and Individual Responses to Repeated Phenolic Astringent Stimuli. Chem Senses 2009; 35:75-85. [DOI: 10.1093/chemse/bjp084] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Leonor SP, Laura SM, Esther IC, Marco ZZ, Enrique AGA, Ignacio MR. Stimulated saliva flow rate patterns in children: A six-year longitudinal study. Arch Oral Biol 2009; 54:970-5. [PMID: 19698936 DOI: 10.1016/j.archoralbio.2009.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 07/23/2009] [Accepted: 07/24/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To find out whether the stimulated saliva flow rate (SSFR) is a variable and unpredictable characteristic as healthy children grow-up. DESIGN Seven-year-old school children (53 boys and 57 girls) were recruited to measure their SSFR in mL/min. Paraffin-stimulated saliva was collected from each child at baseline and once annually, over six years. Forty-four boys and 46 girls remained in the cohort (dropout rate 18%). Cluster analysis was applied to evaluate the natural grouping of individuals according to their SSFR. Partition analysis was applied to calculate the SSFR cut-off value to predict a child's salivation trend. RESULTS Cluster analysis revealed that as they grew-up these children consistently showed one of three different SSFR patterns. The cut-off values to predict a child's salivation trend were 1.76 mL/min for the high SSFR cluster, and 0.5 mL/min for the low SSFR cluster. CONCLUSIONS These findings indicate that a high or low SSFR is a constant individual trait in children.
Collapse
Affiliation(s)
- Sánchez-Pérez Leonor
- Area for Research in Clinical Sciences, Health Attention Department, Metropolitan Autonomous University, Xochimilco Unit, Mexico City, Mexico.
| | | | | | | | | | | |
Collapse
|
26
|
Javed F, Klingspor L, Sundin U, Altamash M, Klinge B, Engström PE. Periodontal conditions, oral Candida albicans and salivary proteins in type 2 diabetic subjects with emphasis on gender. BMC Oral Health 2009; 9:12. [PMID: 19435501 PMCID: PMC2698828 DOI: 10.1186/1472-6831-9-12] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Accepted: 05/12/2009] [Indexed: 11/10/2022] Open
Abstract
Background The association between periodontal conditions, oral yeast colonisation and salivary proteins in subjects with type 2 diabetes (T2D) is not yet documented. The present study aimed to assess the relationship between these variables in type 2 diabetic subjects with reference to gender. Methods Fifty-eight type 2 diabetic subjects (23 males and 35 females) with random blood glucose level ≥ 11.1 mmol/L were investigated. Periodontal conditions (plaque index [PI], bleeding on probing [BOP], probing pocket depth [PD] (4 to 6 mm and ≥ 6 mm), oral yeasts, salivary immunoglobulin (Ig) A, IgG and total protein concentrations, and number of present teeth were determined. Results Periodontal conditions (PI [p < 0.00001], BOP [p < 0.01] and PD of 4 to 6 mm [p < 0.001], salivary IgG (μg)/mg protein (p < 0.001) and salivary total protein concentrations (p < 0.05) were higher in type 2 diabetic females with Candida albicans (C. albicans) colonisation compared to males in the same group. Type 2 diabetic females with C. albicans colonisation had more teeth compared to males in the same group (p < 0.0001). Conclusion Clinical and salivary parameters of periodontal inflammation (BOP and IgG (μg)/mg protein) were higher in type 2 diabetic females with oral C. albicans colonisation compared to males in the same group. Further studies are warranted to evaluate the association of gender with these variables in subjects with T2D.
Collapse
Affiliation(s)
- Fawad Javed
- Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
| | | | | | | | | | | |
Collapse
|
27
|
Whole saliva flow rate and body profile in healthy young adults. Arch Oral Biol 2009; 54:464-9. [DOI: 10.1016/j.archoralbio.2009.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 01/30/2009] [Accepted: 02/11/2009] [Indexed: 11/15/2022]
|
28
|
Ono K, Tanaka T, Inoue H, Ansai T, Sato-Wakasugi N, Muraoka K, Yokota M, Takehara N, Morimoto Y, Inenaga K. Small salivary gland size in patients with xerostomia of unknown etiology. Arch Oral Biol 2009; 54:369-73. [PMID: 19185851 DOI: 10.1016/j.archoralbio.2008.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 12/16/2008] [Accepted: 12/23/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We have recently reported that flow rates of whole saliva in young healthy humans correlate positively with salivary gland sizes. The low rate of salivary secretion in xerostomia patients may be related to the small size of the salivary glands. To investigate this possibility, relationships between salivary secretions and salivary gland sizes were investigated in unknown-etiology xerostomia patients and healthy controls. DESIGN The sizes of the three major salivary glands in seven xerostomia patients and seven age- and gender-matched healthy controls who have no previous disease history and prescription medication related to xerostomia, were measured by use of a magnetic resonance imaging technique. The salivary glands of all subjects failed to show any pathological aspects in magnetic resonance images. The flow rates of unstimulated and chewing-stimulated whole saliva were also measured. RESULTS Flow rates of unstimulated and chewing-stimulated whole saliva and the sizes of the parotid and submandibular glands were significantly lower and smaller in xerostomia patients of unknown etiology when compared with healthy controls. In addition, salivary flow rates per size of the combined three major salivary glands were also significantly lower in the xerostomia patients of unknown etiology. CONCLUSIONS The smaller salivary gland size in xerostomia patients of unknown etiology may be one of the causes of the reduced salivary secretion. The secretion rates as a function of gland sizes were also lower, and so it is likely that functional impairments of the salivary gland are also present in patients with xerostomia of unknown etiology.
Collapse
Affiliation(s)
- K Ono
- Department of Biosciences, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu, Fukuoka 803-8580, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
|
30
|
Bayat-Movahed S, Shayesteh Y, Mehrizi H, Rezayi S, Bamdad K, Golestan B, Mohamadi M. Effects of Qigong exercises on 3 different parameters of human saliva. Chin J Integr Med 2008; 14:262-6. [PMID: 19082797 DOI: 10.1007/s11655-008-0262-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To analyze the effects of a Qigong program on various parameters of unstimulated saliva, including volume, pH and secretory immunoglobulin A (S-IgA) level. METHODS Twice a day from the beginning of Fall 2005, twenty-three healthy volunteers aged 22-24 did special Qigong exercises and massage of acupuncture points which stimulated the energy cycle and increased body water energy. The unstimulated saliva volume and pH were recorded every week in Spring (April, May, June) 2005 before the volunteers started to learn and exercise Qigong, and after Qigong intervention in Spring (April, May, June) 2006. During the period of study, saliva was collected in the same location and on similar dates at the Dental Faculty of Tehran University of Medical Sciences. The S-IgA levels of the last samples of the last week of Spring 2005 and 2006 were measured. RESULTS The unstimulated saliva volume after Qigong exercises (2.94 + or - 0.20 mL/5min) was significantly higher as compared to the pre-Qigong phase (1.65 + or -0.102 mL/5min, P<0.05). The S-IgA level was 105.45 + or - 9.41 mg/mL before doing Qigong exercises, and 156.23 + or - 88.56 mg/mL after doing Qigong exercises, and a statistically significant difference was seen between the two measurements (P=0.005). The change in pH was not statistically significant. CONCLUSIONS The application of Qigong is beneficial for increasing salivary volume and other parameters. Moreover, the results suggest that Qigong may be a useful medication for patients with salivary hyposecretion. Further research is recommended in examining the long-term effects of Qigong on improving salivary volume and other parameters in individuals with salivary hyposecretion.
Collapse
Affiliation(s)
- Saeed Bayat-Movahed
- Sports Medicine Research Center, Medical Sciences/University of Tehran, Tehran, Iran.
| | | | | | | | | | | | | |
Collapse
|
31
|
Inoue H, Ono K, Masuda W, Inagaki T, Yokota M, Inenaga K. Rheological Properties of Human Saliva and Salivary Mucins. J Oral Biosci 2008. [DOI: 10.1016/s1349-0079(08)80027-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
32
|
Abstract
Saliva has many essential functions. As the first digestive fluid in the alimentary canal, saliva is secreted in response to food, assisting intake and initiating the digestion of starch and lipids. During this process, saliva acts as a solvent of taste substances and affects taste sensitivity. Clinically, a more important role is in the maintenance of oral health, including the protection of teeth and mucosa from infections, maintenance of the milieu of taste receptors, and communication ability through speech. Variations in salivary flow can be affected, reversibly or irreversibly, by numerous physiological and pathological factors. Decreased salivary flow results in clinically significant oral discomfort that may manifest as increased caries, susceptibility to oral candidiasis, altered taste sensation or as a host of other problems. Hyposalivation is a condition that is frequently encountered in dental practice. The most common cause is the use of certain systemic medications, which put the elderly at greater risk because they are usually more medicated. Other causes include high doses of radiation and certain diseases such as Sjögren's syndrome. This article reviews the mechanism of salivary secretion, effect of saliva on taste, importance of saliva in oral health, and hyposalivation in relation to ageing, medicine and/or disease and management of hyposalivation.
Collapse
Affiliation(s)
- H Mese
- Department of Oral and Maxillofacial Surgery, and Biopathological Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | |
Collapse
|
33
|
Ono K, Inoue H, Masuda W, Morimoto Y, Tanaka T, Yokota M, Inenaga K. Relationship of chewing-stimulated whole saliva flow rate and salivary gland size. Arch Oral Biol 2007; 52:427-31. [PMID: 17126285 DOI: 10.1016/j.archoralbio.2006.10.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Revised: 10/10/2006] [Accepted: 10/24/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We have recently reported that unstimulated whole saliva flow rates (UWSFR) correlate positively with salivary gland sizes and body profiles of weight and body mass indices. In the present study, the correlations of chewing-stimulated whole saliva flow rates (CWSFR) with salivary gland sizes and the body profiles were investigated, and the results were compared with those of UWSFR. DESIGN Saliva samples were collected from 24 healthy young males and 26 females by the spitting method while chewing paraffin and the CWSFRs were measured. UWSFR and the estimated sizes of the three major salivary glands in our previous study were used. RESULTS The CWSFRs in all subjects and in males correlated positively with UWSFR, but not in females. The CWSFRs in all subjects correlated positively with parotid and/or submandibular gland sizes, weights and body mass indices, just as with UWSFR; however, the correlation coefficients with salivary gland sizes were smaller than those of UWSFR. In contrast to the results of UWSFR, the correlation coefficients of the CWSFRs with parotid gland sizes in all subjects were larger than those with the sizes of the submandibular glands. The CWSFRs in males correlated only with parotid gland sizes, and those in females did not correlate with any of the parameters. CONCLUSIONS The results suggest that the larger the size of the salivary glands, the greater the CWSFR, at least in males.
Collapse
Affiliation(s)
- Kentaro Ono
- Department of Biosciences, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu, Fukuoka 803-8580, Japan
| | | | | | | | | | | | | |
Collapse
|
34
|
Dawes C. Gland size estimation and body mass index improve salivary flow rate assessment. Arch Oral Biol 2007; 52:409-10. [PMID: 17125730 DOI: 10.1016/j.archoralbio.2006.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 10/21/2006] [Indexed: 11/22/2022]
Affiliation(s)
- C Dawes
- Department of Oral Biology, 780 Bannatyne Avenue, Winnipeg, Man. R3E 0W2, Canada.
| |
Collapse
|
35
|
Inoue H, Ono K, Masuda W, Morimoto Y, Tanaka T, Yokota M, Inenaga K. Gender difference in unstimulated whole saliva flow rate and salivary gland sizes. Arch Oral Biol 2006; 51:1055-60. [PMID: 16919593 DOI: 10.1016/j.archoralbio.2006.06.010] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Revised: 06/14/2006] [Accepted: 06/20/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A gender difference in the unstimulated whole saliva flow rate (UWSFR) may be due to a difference in the sizes of the salivary glands. In this study, we investigated the relationships among the UWSFR, gland sizes and body sizes of healthy young adult males and females. DESIGN Unstimulated whole saliva was collected for 5 min by the spitting method in 50 healthy young adults, and the flow rate of the saliva was measured. Heights and weights were measured, and body mass indices (BMI) were calculated. The sizes of the salivary glands were measured by use of a magnetic resonance imaging technique. RESULTS Parotid and submandibular gland sizes and flow rates in females were significantly smaller than those in males, as were also the weights, heights and BMI. In both males and females, there were significant positive correlations between gland sizes and the flow rates, weights and BMI. The variations of the flow rates were reduced by standardizing them with gland sizes, weights and BMI. CONCLUSIONS These results suggest that the lower UWSFR in females as compared with males is due to the smaller gland sizes due to the smaller body sizes.
Collapse
Affiliation(s)
- H Inoue
- Department of Biosciences, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu, Fukuoka 803-8580, Japan
| | | | | | | | | | | | | |
Collapse
|