A case-control study of the association between sialolithiasis and osteoporosis

What is the impact of previous cholelithiasis on sialolithiasis: A systematic review and meta-analysis

Introduction

A sialolith is a salivary stone usually presenting with swelling and pain in the affected salivary gland, most commonly the submandibular gland. There have been speculations about the association between this condition and other systemic diseases, especially those forming stones, such as nephrolithiasis and cholelithiasis. This systematic review and meta-analysis aimed to summarize the studies assessing the relationship between cholelithiasis and sialolithiasis.

Methods

PubMed/MEDLINE, Scopus, Web of Science, and Embase electronic databases were searched according to the keywords related to both disorders without any publication date or language restriction. Case-control and cohort studies evaluating the relationship between salivary and biliary stones were considered eligible. Quality assessment was performed following Newcastle-Ottawa Scale (NOS) for quality assessment of case-control studies. All meta and statistical analyses were performed with Comprehensive Meta-Analysis software.

Results

Two studies fully complied with the defined eligibility criteria and were included, both of which were case-control studies using national-scale databases. In both surveys, the prevalence of previous gallstones in patients with sialolithiasis was compared to that of a control group. Though one of the studies found that there is no relationship between sialolithiasis and cholelithiasis, the meta-analysis revealed that previous cholelithiasis is significantly more prevalent among patients with sialolithiasis (P = 0.000), with an odds ratio of 2.04.

Conclusion

It seems that cholelithiasis is significantly associated with an increase in salivary stone formation. Therefore, a thorough salivary examination in all patients declaring current or past cholelithiasis is recommended. However, more studies, especially prospective cohorts, are needed to make firmer conclusions.

Does low bone mineral density have an association with head and neck soft tissue calcifications?

OBJECTIVES

To evaluate whether low bone mineral density (BMD) has an association with the presence of head and neck soft tissue calcifications (STC), aging, and impaired mandibular canal cortices visibility.

MATERIALS AND METHODS

Panoramic radiographs of 1000 women aged between 50 and 75 years old were evaluated by two examiners to classify BMD using mandibular cortical index (C1- normal, C2-moderately eroded and C3-severely eroded), the presence of STC, and also the mandibular canal cortices visibility at the ramus region. Chi-square test evaluated the association between the variables (α = 5%).

RESULTS

There was no association between bone loss and the presence of head and neck soft tissue calcifications, except for calcified thyroid cartilage, which was less visualized at C3 group than others (p < 0.05). Women aged 61 to 70 years old presented higher bone loss than those between 50 and 60 (p < 0.05). The mandibular canal was more poorly visualized at C3 group than C1 and C2 (p < 0.05).

CONCLUSIONS

In general, no association between BMD and the presence of STC was found. However, greater bone loss had a positive correlation with aging and impaired mandibular canal cortices visibility.

CLINICAL RELEVANCE

No relationship between bone mineral density and the existence of soft tissue calcifications was found. Nevertheless, increased bone loss was positively associated with aging and a reduced mandibular canal cortices visibility. This finding highlights the clinical importance of considering bone density factors when planning treatment strategies for patients with related disorders.

Torus mandibularis and its implication as a risk factor for the formation of sialolithiasis

Sialolithiasis is the formation of a stone within the salivary gland, and approximately 80% of them occur within the submandibular gland. Sialolithiasis can lead to swelling and pain of the gland in the immediate phase and if left untreated, can lead to sialadenitis and even atrophy of the gland. Certain factors have already been established in the formation of sialolithiasis such as dehydration, tobacco smoke, autoimmune disorders and certain medications. One factor we theorise contributes to the formation of sialolithiasis is bony outgrowths on the tongue surface of the jaw, called mandibular tori. These outgrowths can lead to external compression of the submandibular duct, which leads to impeded salivary flow and the potential for sialolith formation. We present two cases in which individuals had submandibular sialolithiasis in the setting of extensive mandibular tori.