Asymptomatic bilateral facial swelling

Evaluation of submandibular and parotid salivary glands by ultrasonography in patients with diabetes

BACKGROUND

Microvascular complications of diabetes mellitus (DM) include oral manifestations and complications, including xerostomia, reduced salivary flow, susceptibility to infection, periodontal disease and salivary gland enlargement.

OBJECTIVE

The present study aims to evaluate B-mode ultrasonography (USG) parameters such as size, volume and echogenicity of the submandibular and parotid salivary glands on both sides, shear-wave elastography (SWE) value and colour Doppler properties in patients with DM and healthy control groups.

METHODS

In total, 160 right and left submandibular glands and 160 right and left parotid glands of 80 patients, 40 patients (20 type 1 DM, 20 type 2 DM) and 40 healthy control group, between the ages of 18-70 were examined by USG. Echogenicity, parenchyma internal structure, margin and dimensional measurements (antero-posterior length, supero-inferior length, medio-lateral length and volume) and colour Doppler with 'ML 6-15-D Matrix Array (4-15 MHz)' probe, shear-wave elastography '9L-D (2-8 MHz)' probe was investigated.

RESULT

Statistically significant difference was observed in echogenicity in the right submandibular gland, echogenicity in the right parotid gland, margin characteristics, parenchymal homogeneity and colour Doppler characteristics between the type 1 DM, type 2 DM and control groups (p < .05). It was observed that the size, volume and SWE values of both submandibular and parotid glands were higher in the DM patient group than in the control group. Higher values were observed in type 2 DM compared to type 1 DM in the patient group.

CONCLUSION

USG is an effective imaging technique in investigating the effects of diabetes on the submandibular and parotid salivary glands.

Diabetes Mellitus and Its Influence on Oral Health: Review

Diabetes mellitus (DM) is one of the most common diseases all over the world. The effect of this endocrine disease on body systems cannot be ignored, where its oral side effects are well distinguished. As this disease incident is increasing dramatically, it is essential for the health care providers to be fully aware of the disease diagnosis, management and to deal with it in a full confident. This review discusses the disease itself, its complications, methods of diagnosis as well as its management. Furthermore, oral manifestations and dental considerations that should be followed when treating patients with diabetes mellitus have been discussed in this review.

Xerostomia in patients with diabetes mellitus (pilot study)

Relevance. Saliva performs some essential functions indispensable for oral health. Patients with diabetes mellitus (DM) often complain of xerostomia. Long-term dry oral mucosa in diabetic patients adversely affects the quality of life and causes speech. chewing. swallowing. and taste problems; it leads to multiple caries and inflammatory periodontal diseases.Aim. To evaluate the detection rate and determine the x erostomia nature in patients with DM.Materials and methods. The interview and survey included 251 patients aged 18-82 y.o. with Type 1 DM. latent auto-immune diabetes in adults and Type 2 DM. The patients informed the study of DM duration. current therapy duration. xerostomia presence and nature. The patients’ records provided information about the established diagnosis. age. glycohemoglobin (HbA1c). body mass index (BMI). and prescribed DM therapeutic regimen. The data were statistically analysed using the StatTech v. 2.4.8 software. Results. 134 (53.4%) patients complained of a transient dry mouth associated with blood sugar levels increase; 6 (2.4%) patients noted dry mouth if blood sugar levels decreased; 30 subjects (12.0 %) and 10 subjects (4.0 %) reported constant and stress-associated dry mouth. respectively (р > 0.05). Patients over 80 declared dry mouth associated with blood sugar decrease more often than patients aged 45-64 and 65-80 y.o. (р = 0.002*; р45-64 – over 80 = 0.012; рover 65 – over 80 < 0.001); 21.1% of patients aged 65-80 noted permanently dry mouth (р = 0.028). Patients with persisting xerostomia (permanent dry mouth and stress-associated dry mouth) had statistically significant. higher BMI of 33 (31-37) kg/m2 (р = 0.019) and 36 (34-41) kg/m2 (р = 0.002). respectively. The higher glycohemoglobin level increase was more statistically significant in patients with DM. who reported dry mouth associated with glucose increase. The evaluation of xerostomia nature vs to diagnosis. sex. DM duration. drug therapy scheme. and smoking did not reveal any statistically significant differences.Conclusion. Xerostomia presents an additional problem for patients with DM. Patient education and the selection of individual products for oral care by dentists may improve oral health parameters in the long run.

Oral manifestations of systemic disease

While the majority of disorders of the mouth are centred upon the direct action of plaque, the oral tissues can be subject to change or damage as a consequence of disease that predominantly affects other body systems. Such oral manifestations of systemic disease can be highly variable in both frequency and presentation. As lifespan increases and medical care becomes ever more complex and effective it is likely that the numbers of individuals with oral manifestations of systemic disease will continue to rise. The present article provides a succinct review of oral manifestations of systemic disease. In view of this article being part of a wider BDJ themed issue on the subject of oral medicine, this review focuses upon oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease.

Bilateral Parotid Swelling in Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is recognized by the presence of polycystic ovaries, irregular menstruation, and increased androgen levels. Many patients have insulin resistance or impaired glucose tolerance and an associated development of type 2 diabetes mellitus. A patient with PCOS is presented whose cosmetic concerns centered on the prolonged existence of substantial bilateral parotid swelling. The pathophysiology, diagnosis, and therapy of sialosis are discussed.