Increased calcium and decreased magnesium and citrate concentrations of submandibular/sublingual saliva in sialolithiasis.

OBJECTIVE: The purpose of the present study was to investigate the electrolyte alterations of submandibular/sublingual saliva in submandibular sialolithiasis patients compared with saliva from healthy controls. DESIGN: Submandibular/sublingual saliva was collected from 10 submandibular sialolithiasis patients and from 10 sex- and age-matched healthy controls. Ion chromatography was performed to determine the concentrations of inorganic cations (potassium, calcium, magnesium, and sodium), inorganic anions (chloride, phosphate, nitrate, and sulphate) and organic anions (thiocyanate, lactate, acetate, and citrate). RESULTS: The calcium concentration was significantly higher in sialolithiasis patients than in controls (P<0.05). In contrast, the levels of magnesium and citrate in the saliva of sialolithiasis patients were significantly reduced compared to the values obtained in controls (P<0.05). No significant differences were detected among other ions. CONCLUSIONS: Our findings indicate that saliva electrolyte composition of sialolithiasis patients is substantially altered with respect to crystallisation mechanisms. Increased calcium ion as a crystallisation substance and decreased magnesium and citrate ions as crystallisation inhibitors may be involved in the etiopathology of calculi formation.

Non-neoplastic salivary gland diseases.

A wide range of non neoplastic disorders can affect the salivary glands, although the more common are: mumps, acute suppurative sialadenitis, Sjögren's syndrome and drug-induced xerostomia. Salivary dysfunction is not a normal consequence of old age, and can be due to systemic diseases, medications or head and neck radiotherapy. Diagnosis of salivary disorders begins with a careful medical history, followed by a cautious examination. While complaints of xerostomia may be indicative of a salivary gland disorder, salivary diseases can present without symptoms. Therefore, routine examination of salivary function must be part of any head, neck, and oral examination. Health-care professionals can play a vital role in identifying patients at risk for developing salivary dysfunction, and should provide appropriate preventive and interventive techniques that will help to preserving a person's health, function, and quality of life. The present work provides an overview of most of the non neoplastic disorders of the salivary glands, in which the general presentation, pathology, and treatments are discussed.

Statherin levels in saliva of patients with precancerous and cancerous lesions of the oral cavity: a preliminary report.

OBJECTIVE: The aim of this study was to measure concentration of human salivary statherin in patients with oral cavity pathologies and salivary gland diseases. SUBJECTS AND METHODS: Levels of statherin were analysed with High Performance Liquid Chromatography (HPLC) in following groups of subjects: group A: 24 patients with neoplastic diseases of salivary glands, group B: 13 patients with inflammatory lesions of salivary glands, group C: 13 patients with precancerous and cancerous lesions of the oral cavity excluding salivary gland tumors, group D: 20 healthy volunteers (control group). RESULTS: Our preliminary data indicated a sensible reduction of the statherin level in the saliva of patients with precancerous and cancerous lesions of the oral cavity (group C) compared with the healthy subjects (group D). The statherin levels are not significantly reduced either in the inflammatory (group B) or in the salivary glands tumours (group A), compared with the healthy subjects (group D). CONCLUSION: Statherin could play a protective effect in oral cavity in association with its other functions.

Sialolithiasis: mechanism of calculi formation and etiologic factors.

BACKGROUND: Sialolithiasis is a common disease of salivary glands. The etiology of these calculi is little known and their exact mechanism of formation is unknown. METHODS: The composition and structure of 21 sialoliths were studied and the composition of the saliva of each corresponding patient was determined (pH, calcium, magnesium, phosphorus, citrate and phytate). RESULTS: Eighteen sialoliths exhibited similar macro and microstructure, being constituted by hydroxyapatite (HAP) and organic matter, normally arranged in a multilayer structure. The three remaining sialoliths were exclusively constituted by organic matter. The salivary Ca of patients with HAP calculi was significantly higher than that found in the saliva of the healthy group. The salivary phytate concentration of patients with HAP calculi was significantly inferior to that found in patients with calculi exclusively formed by organic matter, as well as to that found in saliva of healthy group. Significant differences between the salivary magnesium concentrations of patients with HAP calculi and the control group were also observed. No significant differences between pH and citrate concentrations of the three groups were found. CONCLUSIONS: It was concluded that the deficit of crystallization inhibitors such as myo-inositol hexaphosphate (phytate) was also an important etiologic factor implied in the sialolith development.

Amylase crystalloids in salivary gland lesions: report of a case with a review of the literature.

Several types of crystalloids may be found in fine-needle aspiration cytology of salivary gland lesions. Amylase crystalloids (sometimes referred to as nontyrosine crystalloids) are tabular structures with frequent pointed ends that have received little attention until recent years. We report on a parotid cyst containing the latter type of crystalloids in a 51-yr-old white woman. The cytologic and radiologic findings were diagnostic of sialolithiasis. To the best of our knowledge, amylase crystalloids have been observed only in benign salivary gland lesions. Although this statement may be helpful in the diagnostic workup of patients presenting with parotid lumps, we do not recommend rendering a specific diagnosis based on the presence of such crystalloids. Good clinical and radiological correlation, as well as close follow-up, is mandatory in this setting.

[Reproducibility of the qualitative interpretation of dynamic salivary radionuclide scans with excretory stimulation]. / Reproducibilidad de la interpretación cualitativa de la gammagrafía salival dinámica con estímulo excretor.

OBJECTIVE: To evaluate intraobserver and interobserver agreement in the qualitative interpretation of dynamic salivary radionuclide scans to detect salivary disease, and the agreement between interpretation of dynamic and static image compositions. MATERIAL AND METHODS: Two observers (A, B) interpreted 110 dynamic salivary radionuclide scans with excretory stimulation based on dynamic image composition. Both again interpreted every studies: A based on dynamic image composition and B on static image composition. Kappa statistics were used to determine the degree of intraobserver and interobserver agreement. RESULTS: Considering all the studies, the dynamic composition showed an intraobserver agreement of 0.76 and interobserver agreements of 0.58 and 0.61. In patients with clinical sicca syndrome, agreements were 0.60, 0.52 and 0.62, respectively. For all the cases, the agreements between dynamic and static composition was 0.62 (intraobserver), and 0.42 and 0.43 (interobserver). For patients with clinical sicca syndrome these agreements were 0.63 (intraobserver), and 0.36 and 0.51 (interobserver). CONCLUSION: Intraobserver and interobserver agreement in the qualitative interpretation of dynamic salivary radionuclide scan with excretory stimulation are moderate and notable-moderate overall and in patients with clinical sicca syndrome. These agreements are greater than between dynamic and static image composition.

[The diagnosis of sialolithiasis taking into account the stage of the pathological process]. / Diagnostika sliunnokamennoi bolezni s uchetom stadii patologicheskogo protsessa.

A total of 142 patients with sialolithiasis were examined, treated, and followed up. Analysis of clinical manifestations and morphologic changes has revealed a staged pattern of this condition, depending on the sialolith localization, disease standing, and incidence of inflammation exacerbations. The authors consider that a profound study of clinical symptoms with the use of mathematical statistics methods permits a sufficiently accurate identification of the histologic stage of the process and helps define the scope of surgical intervention.