D. Gutman

Clinical Science Whole-saliva Secretion Rates in Old and Young Healthy Subjects

Resting and stimulated whole-saliva secretion rates were compared in old and young healthy volunteers. The stimulated secretion rate was similar in both age groups, while the resting flow rate was significantly lower in the old females and males as compared with rates in the young.

The salivary flow rate and composition of whole and parotid resting and stimulated saliva in young and old healthy subjects

Resting and stimulated whole and parotid salivary composition and flow rate were examined in 63 healthy volunteers. No significant differences were found between the young and old in secretion rates and salivary concentrations of sodium, potassium, calcium, magnesium, and total protein. The activity of amylase in the resting and stimulated parotid saliva was significantly lower in the old.

Patient motivation and response to surgical correction of prognathism.

Twenty-five patients operated upon between 1969 and 1973 for correction of mandibular prognathism were recalled in 1975 and asked to evaluate their attitudes toward the procedure and the postoperative results. All but one were satisfied with the results. Postoperative numbness of the lip and chin lasting more than 6 months was commonly noted following the intraoral sagittal split method. This did not influence the patients satisfaction with the operation. The minimal postoperative scar following the extraoral oblique osteotomy was not a negative factor. Most patients underwent the surgical procedure for esthetic reasons. A large number (68 per cent) noted a change in personality postoperatively. A rationale for selective preoperative psychologic counseling is suggested.

Xerostomia--diagnosis and treatment

Seventy-one patients complaining of mouth dryness were examined. Decreased salivary rate of flow was found in fifty-six. Twenty-two patients did not respond to stimulation and were treated with artificial saliva. The thirty-four responding patients were treated with a mouthwash containing citric acid (Saliram). Of the patients using Saliram, 91 percent were satisfied with the results, and in 16 percent of these an increase in salivation was observed and persisted after treatment was discontinued.

Oral side effects of head and neck irradiation: Correlation between clinical manifestations and laboratory data

Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena.

Effects of irradiation on saliva in cancer patients

Whole unstimulated saliva was analyzed in 15 healthy individuals and 15 patients with malignant tumors in the head and neck region before and during irradiation therapy. Flow rate, pH, electrolytes (Na, K, Ca, Mg), protein and phosphate were measured. There was a decrease in rate of flow, and pH changed towards acidity. The most significant finding was the increased sodium content. We believe that irradiation reduces the reabsorption ability of the tubuli, causing the sodium content of the saliva to increase.

Relation between idiopathic glossodynia and salivary flow rate and content

From a series of 50 patients complaining of sore tongue, 13 were found to be suffering from idiopathic glossodynia. All were women in the postmenopausal stage. The salivary flow rate, protein, phosphate, and electrolyte content (Na, K, Ca, Mg) were measured in unstimulated saliva of these patients. Protein, potassium and phosphate concentrations were significantly higher than in the control group. The results indicate that hormonal disbalance might be a factor in the etiology of this type of sore tongue.

Sialochemistry for diagnosis of Sjogren's syndrome in xerostomic patients

The flow rate and composition of whole unstimulated saliva were measured in fifteen healthy controls and in forty-eight xerostomic patients, fourteen suffering from xerostomia per se, twenty-two from xerostomia with keratoconjunctivitis sicca (KCS), and twelve from xerostomia, KCS, and rheumatoid arthritis. A significant lower salivary flow rate was found in all the xerostomic patients. Sodium, potassium, and IgA concentrations were significantly elevated in the KCS and in the RA + KCS group in comparison with the patients who had xerostomia per se and with the healthy controls. Sialochemistry is thus recommended for the diagnosis of Sjögrens syndrome in xerostomic patients.

Treatment of Mandibular Fractures by Means of Compression Osteosynthesis

This report is a retrospective study of 76 patients with mandibular fractures treated by compression osteosynthesis. Good results were achieved in 83% of the cases. The complications encountered were either soft tissue infections or minor malocclusions. It was concluded that the relatively low rate of complications can be further reduced by careful selection of patients and meticulous performance of the technique.

Eminectomy as surgical treatment for chronic mandibular dislocations

Conservative and surgical methods are used to treat chronic dislocations of the temporomandibular joint. Different techniques described in the literature are discussed. 8 cases treated by eminectomy are presented and the results are evaluated.