Clinical investigation of the major and minor salivary glands in patients with autoimmune diseases (Sjogren's syndrome and idiopathic inflammatory myopathies) and in patients wearing complete dentures (Hungarian text)

Objective of this study was to describe the oral properties of Sjogren's syndrome (SS) and idiopathic inflammatory myopathies (IIM) compared to healthy controls. Particular attention was given to the determination of palatal salivary flow rate and the subjective problems associated with denture wearing in SS patients. A further aim was to compare the unstimulated whole (UWS) and palatal (PS) saliva flow rates of patients wearing complete dentures and patients with SS and to test whether xerostomia or hyposalivation has a negative influence on maxillary complete denture stability. A third aim was to determine the influence of new complete dentures on UWS and PS flow rates in healthy individuals. Subjects And Methods: In the SS and the IIM groups after the determination of their general health state a questionnaire was employed to obtain and record the subject's symptoms. Clinical assessments were made of their oral mucosal, dental and periodontal and denture status. Sialometric tests were performed to determine the flow rates of unstimulated whole (WS) and in the SS-group: palatal saliva (PS). In the IIM-group: light- and electron microscopic analysis of the symptoms of capillary abnormalities or signs of focal infiltration in labial biopsy specimens were carried out; for comparison with healthy controls. The masticatory force (MF) and the handgripping force was measured with a specially developed device. All participants in the third study were questioned about possible subjective oral complaints (xerostomia or instability of the dentures), through use of a standardized questionnaire. UWS and PS flow rates of the healthy subjects (controls) and of the SS-patients were measured. In the fourth part of the study, new complete dentures were fabricated for healthy patients. Flow rates of UWS and PS were measured before ans seven days after the insertion in order to compare data with their pre-fabrication values. According to the results, that dental and periodontal status correlate with the possible autoantibody positivity, authors can state that the oral health status of patients both with SS and IIM might be considerably related to the general autoimmune process, and no more than partly to the hyposalivation. SS patients' chief complaint is glossodynia, their most frequent mucosal alteration is the erythema of the hard palate. As it is indicated by the results of this study, IIM patients have significant gingival oedema, and telangiectasia. Dysphagia either because of xerostomia or macroglossia, or secondary to the oesophageal dysmotility, weakness of the masticatory muscles makes eating difficult in IIM. Obtained data strongly suggest that the reduction in the thickness of the palatal film in SS patients is due to a decrease in the volume of the mixed, whole saliva, not to the viscous palatal saliva. Remaining palatal mucous saliva flow can help to stabilize the maxillary complete denture in patients with hyposalivation. Neither unstimulated whole nor palatal saliva flow rate are influenced by the placement of new dentures in healthy complete denture wearers.