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Sjögren's syndrome, or SS, is a multisystem inflammatory disorder of the exocrine glands with a wide range of extraglandular involvement. Symptoms of dry eyes and xerostomia, although not invariably present, are characteristic features of SS. An increased risk of oral and dental diseases is a prominent consequence of SS.
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... such cases, the salivary glands may become tender to palpation. Although SS affects all of the salivary glands, it is not uncommon for recurrent sialadenitis to be limited to one or two salivary glands (Figure 1). Therefore, in cases of recurrent sialadenitis, it may be advisable to investigate for possible SS before considering surgical intervention. ...
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Sjögren's syndrome (SS) is a complex rheumatoid disease that mainly affects exocrine glands, resulting in xerostomia (dry mouth) and xerophthalmia (dry eye). SS is characterized by autoantibodies, infiltration into exocrine glands, and ectopic expression of MHC II molecules on glandular epithelial cells. In contrast to the well-characterized clinic...
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Rationale:
Sjogren's syndrome(SS) is a chronic autoimmune disease, which damages exocrine glands especially salivary and lacrimal glands, with xerostomia and xerophthalmia as common symptoms.
Patient concerns:
We report a case of a 49-year-old woman presented with pancytopenia. Her laboratory examinations lead us diagnose her as Sjogren's syndro...
Citations
... Greek [4], d. California's -Californian-Fox CF [5], and e. revised version of the European criteria proposed by the American-European Consensus Group [6][7][8]. A well-rounded treatment strategy should directly tackle the systemic symptoms, carefully adjusting the dosage of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, immunoregulators, immunodepressors, etc, based on individual needs (symptoms presentation and severity). ...
... The patient received oral hygiene instructions tailored to manage xerostomia. These included using a gentle toothpaste and a sugarless chewing gum [8] to stimulate saliva production. She was advised to avoid salty, spicy foods and substances that exacerbate xerostomia, such as caffeine [6], and to increase her fluid intake, particularly water [12]. ...
... The aforementioned challenges were addressed carefully through local vasoconstriction, a meticulous focus on achieving maximum marginal accuracy within the boundaries of the provisional and final restorations, and the creation of smooth, even surfaces on both the margins and external surfaces of the restorations. Saliva substitute was not provided to the patient due to its high cost [6], and citrus candies were also withheld due to their potential demineralization effect [8]. ...
Sjögren's syndrome is a chronic, inflammatory autoimmune disorder characterized by lymphocyte infiltration of the exocrine glands. Notably, the rehabilitation of partially edentulous patients with Sjögren's syndrome is limited by the scarce availability of studies that could inform therapeutic modalities and potential challenges during clinical procedures. This case report aimed to present the oral rehabilitation of a patient with Sjögren's syndrome who received fixed partial dentures (FPDs). A 28-year-old female patient sought treatment to restore her missing teeth. She was diagnosed with Sjögren's syndrome by a rheumatologist adhering to the revised version of the European criteria proposed by the American-European Consensus Group and was on a medication regimen including prednisolone, hydroxychloroquine, pantoprazole, pilocarpine, and tear substitutes to manage her condition. The final treatment plan consisted of extractions, management of gingivitis, post-and-core restorations, and a 2 mm vertical dimension increase with the placement of 15 porcelain-fused-to-metal (PFM) crowns and 4 short-span bridges. The patient underwent regular clinical and radiographic evaluations every 3 months since June 2020. Throughout this period, the fixed prostheses, teeth, and periodontal tissues demonstrated remarkable stability and exhibited no complications. This three-year case study provides evidence that meticulous planning and clinical execution can facilitate successful oral rehabilitation in young edentulous patients with Sjögren's syndrome. Tooth-supported fixed prostheses can effectively restore oral function and aesthetic appeal in these individuals, provided they undergo more frequent dental examinations than the general population and maintain a cooperative attitude throughout the treatment process.
... Segundo o Consenso Europeu-Americano (2002) os critérios de classificação incluem sinais e sintomas clínicos, testes objetivos relacionados xeroftalmia e xerostomia, anormalidades sorológicas características (presença de Anti-Ro / SSA e /ou Anti-La / SSB) e análise histopatológica compatível das glândulas salivares menores (Sankar et al., 2014). Em decorrência da etiologia subjacente da síndrome não ser adequadamente compreendida e o amplo espectro de apresentações clínicas existentes, o processo diagnóstico pode apresentar limitações (Al-Hashimi, 2001). Com isso, ressalta-se a importância do manejo interdisciplinar entre o reumatologista, cirurgião-dentista e oftalmologista para a promoção de um correto diagnóstico e controle do paciente com SS (Pintor et al., 2015). ...
A Síndrome de Sjögren é uma alteração de origem autoimune, de caráter crônico que afeta principalmente o epitélio das glândulas lacrimais e salivares. As principais características clínicas são a secura ocular (xeroftalmia), sensação de boca seca (xerostomia) e redução do fluxo salivar. Este estudo teve por objetivo, por meio de uma revisão sistemática de literatura, caracterizar a Síndrome de Sjögren, incluindo alterações secundárias de doenças concomitantes que impactam na qualidade de vida do paciente, avaliar de forma interdisciplinar as manifestações sicca (xeroftalmia e xerostomia), relatar a inter-relação da microbiota oral e a patogênese da síndrome, além de descrever as manifestações intraorais, oftalmológicas e sistêmicas. Para obter os dados necessários realizou-se uma pesquisa bibliográfica nas bases de dados PUBMED com os seguintes descritores MeSH: “Sjögren's Syndrome” and "dentistry", "Ophthalmology" estes foram combinados através do operador booleano "AND" e SCIELO com a palavra-chave “Sjögren's Syndrome”. Foram incluídos apenas artigos originais, nos idiomas português, inglês e espanhol, considerando o período de 2016 a 2022. No total, 655 estudos foram encontrados, sendo que destes, apenas 13 foram selecionados por estarem de acordo com os critérios de inclusão. Os estudos analizados demonstraram que a Síndrome de Sjögren demanda um manejo multidisciplinar, no qual é de extrema importância a interação entre Reumatologista, Odontólogo e oftalmologista, contribuindo para o diagnóstico precoce, o controle dos sinais e sintomas e para promover o tratamento individualizado, proporcionando qualidade de vida a esses pacientes.
... Oral dryness in a majority of the individuals (tens of millions) is due to the adverse effects of medications (1)(2)(3)(4)(5)(6)(7)(8). Chronic disease and medical treatments, such as chemotherapy and radiotherapy, to the head and neck region are also commonly associated with dry mouth (1)(2)(3)(4)(5)(6)(7)(8)(11)(12)(13)(14). Other etiological factors include dehydration, mouth breathing, caffeine intake, and tobacco use; however, these factors do not necessarily reflect the permanent loss of salivary gland function (15)(16)(17). ...
Background:
Dry mouth, also commonly known as "xerostomia", is a prominent symptom that is often overlooked by dental practitioners and patients. The purpose of this study was to pilot the development of a mobile application for assessing dry mouth symptoms. The application will allow patients to self-assess and enhance knowledge, awareness and communication with dental practitioners in their management of dry mouth.
Method:
The first phase of the study was to draw on common knowledge and awareness by conducting two focus groups of dental professionals and community members on content, practicality, functionality, design, and effectiveness. The second phase of the study was the development of the dry mouth mobile application followed by the third phase of the study that consisted of face-validity interviews to obtain feedback on the application.
Results:
Fifty two percent (n=15) of the dental professionals estimated being aware of the prevalence of dry mouth in 40% or more of their patients. Thirty Nine percent of (n=9) community estimated being aware of the prevalence of dry mouth in 40% or more of the community. When asked about their awareness of the etiologies of dry mouth, 100% (n=29) of dental professionals reported that multiple medications and smoking were primary factors whereas the community members indicated that illness and dehydration (87%, n=20) were primary factors in dry mouth. Dental professional's (25% n=7) were very confident in recognizing symptoms and 28% (n=8) were very confident they knew how to manage dry mouth symptoms. Furthermore, 22% (n=5) of the community members were also very confident about recognizing dry mouth symptoms and 13% (n=3) were very confident knowing how managing it. The ToP report generated from the discussions identified "themes" that were utilized in the development of the mobile application. Most individuals who participated in the validity interviews agreed that the dry mouth mobile application was useful, appealing, easy to use and the self-assessment test gave clear and concise information. The application was made available to download from the iTunes Appstore (2019-2020).
Conclusion:
The dry mouth pilot study indicated that the mobile application was beneficial for self-assessment and easy to use. Development of advanced technology tools such as the dry mouth application can promote communication between patients and their dental practitioners to discuss management options for dry mouth.
... The parasympathomimetic medication (cevimeline and pilocarpine) may also be indicated, but we have to inform the patient that he may have side effects like headaches, sweating vasodilatation and urinary frequency. [17] Sjögren's syndrome is a widely underdiagnosed disease. When stratifying evaluating patients based on primary or secondary Sjögren's syndrome, researchers found that those with primary disease -when the condition happens on its own -had a lower failure rate of implants (2.5%) compared to patients with secondary Sjögren's syndrome -when the disease is caused by pre-existing conditions. ...
Introduction: Oral rehabilitation is based on establishing a correct diagnosis and designing a plan to give appropriate treatment to each clinical case. Patients’ aesthetic requirements show an increasing trend in current practice. Sjögren’s syndrome and obesity can have a negative impact on a person’s quality of life, and it is therefore imperative to identify and reduce these significant barriers to paving the way for better oral health and the overall well-being of the individual. Hypertension NYHA II type patients may present oral manifestations like ageusia, burning sensation, xerostomia, lichenoid reactions or gingival hyperplasia. Case presentation: This time, at our clinic, a 71-year-old man requested a complex oral rehabilitation. He presented partial edentulism at both arches. We are talking about a non-smoking patient, with chronical medication treatment for the mentioned pathology. Conclusions: A well-controlled hypertensive patient is not a risk in clinical practice. When choosing an implant based therapy, the old age of the patient can be considered a negative factor for successful results, but it is not a strict contraindication. This case report shows the most suitable treatment solution, regarding all the advantages and disadvantages of other treatment options, represented by implant supported fixed prosthetic restaurations.
... Sjögren syndrome is treatable. Early diagnosis and consequently proper treatment may prevent serious complications and greatly improve the quality of life for these patients [5]. However, patients with Sjögren syndrome are generally picked up at a late stage in their disease, after the salivary and lacrimal glands are already destroyed, because they are asymptomatic until that time. ...
Purpose. The goal of this paper is to find out the correlation, and evaluate the accuracy of labial minor salivary gland biopsy as a diagnostic tool in the multidisciplinary management of patients with Sjögren’s syndrome. Patients and Methods. Thirty seven patients referred to our outpatient office between January 2016 and December 2017 from a rheumatologist for biopsy examination, as part of the complex diagnostic plan for suspected Sjögren syndrome were included in the current study. Each specimen was examined histomorphometrically by the pathologist to calculate the focus score describing the degree of salivary gland inflammatory infiltration. Results. From the total number of patients, 25 presented with an established Sjögren syndrome diagnosis by fulfilling the revised American-European criteria. From those 15 had a positive lip biopsy. The rest 10 patients from the total group who were diagnosed with Sjögren syndrome based on the same criteria had a negative lip biopsy. Conclusion. The labial minor salivary gland biopsy is a valuable diagnostic tool to establish the diagnosis of Sjögren syndrome. However, a positive biopsy result must always be correlated with all the other diagnostic criteria to prove the exact diagnosis.
... [2][3] It is the most common autoimmune disease next to Rheumatoid arthritis primarily affecting perimenopausal and post-menopausal females with a female: males ratio of 9:1. [3][4][5] Sjogren's syndrome may be classified into primary and secondary types. Patients with primary SS have keratoconjuctivitis sicca (KCS) and xerostomia, whereas those with secondary SS have KCS, xerostomia and other underlying autoimmune diseases such as rheumatoid arthritis, systemic lupus erythromatosus (SLE) and systemic sclerosis, as well as other connective tissue disorders. ...
BACKGROUND: Sjögren’s syndrome is a slowly progressive
inflammatory disorder that involves the exocrine glands (lacrimal
glands and salivary glands) leading to the dryness of the eyes and
mouth. It is a rare condition that is seen commonly in females of the
middle age.
OBJECTIVE: To present challenges encountered during the
management of oral symptoms in a patient with Sjögren’s syndrome.
CASE REPORT: A 46-year-old female Nigerian Patient who
presented with bilateral facial swelling with complaint of dry eyes,
dry mouth, and knee joint pain. Investigations done using
sialography with contrast medium of the left parotid and Schirmer’s
test of both eyes were diagnostic of Sjögren’s syndrome. Proper
treatment could not be instituted until about one year after the
patient’s initial presentation due to the non-availability of the
required medications in the country.
CONCLUSION: Poor access to the recommended medications for
the treatment of patients with Sjogren’s syndrome poses a challenge
to the clinician, rendering such patients helpless and unsatisfied.
... Sjögren's syndrome is frequently identified by the dentist on the basis signs and symptoms of xerostomia [33]. Ago, GW182, and Rck/p54 are proteins that aid in the functioning of miRNAs and are localised in the cytoplasm as GW bodies (GWB). ...
Immune-mediated oral disorders are characterised by their chronicity, and some are refractory
to treatment. Interference RNA (iRNA) has been implicated in the underlying mechanism of such
immune-mediate oral and refractory inflammatory oral diseases. iRNA-based understanding of the
mechanism in these diseases may help to produce non-invasive diagnostic methodologies and treatment
modalities of such drug non-responsive diseases. Oral lesions in these immune-mediated diseases can
precede the occurrence of lesions in other regions of the body. The early diagnosis and treatment of
these drug non-responsive diseases might benefit the patient by reducing chronicity and probably even
resolving the disease. This aim of the present minireview is to give an overview of the possible implications
of iRNA on the pathogenesis, diagnosis, and treatments of immune-mediated and inflammatory
oral diseases. The manuscript can form the framework for research on iRNA in these immune-mediated
oral disorders.
... This commonly results in the development of xeroph- thalmia (dry eyes) and xerostomia. [1][2][3] It can occur as a primary entity (primary SS) defined as the sicca syndrome ac- companied by salivary swelling or in association with several other autoimmune diseases (secondary SS). 1,4 Clinical features can involve the skin, eyes, oral cavity, salivary glands, and systems, including musculoskeletal, pulmonary, gas- trointestinal, renal, neurologic, and hematologic. ...
Sjögren’s syndrome (SS) is a rare condition characterized by structural damage and secretory dysfunction of the lacrimal and salivary glands that leads to dryness, particularly xerophthalmia (eyes) and xerostomia (mouth). No cure is known; however, the effects of the disease are manageable and symptoms may be reduced. Although the salivary damage is irreversible, the dental decay and oral infections may be prevented, which highlights the importance that the dentist plays in the diagnosis and management of SS. The cardinal features of this disease are summarized through the case report of a primary SS in a 23-year-old woman who received an early diagnosis based on clinical features, laboratory investigations, lower lip biopsy, and imaging findings.
... A Síndrome de Sjögren (SS) é uma doença inflamatória crónica caracterizada por infiltração linfocitária das glândulas exócrinas. [1][2][3] Os sintomas mais comuns são a disfunção das glândulas salivares e lacrimais, originando eventuais situações de xerostomia/hipossialia e queratoconjuntivite seca. 1-3 Dependendo dos critérios de classificação apresenta uma prevalência na população adulta entre 0,5 a 3%, considerando-se como uma das patologias auto-imunes mais comuns. ...
... [5][6][7][8] Por conseguinte, a saúde oral pode revelar-se como um fator influenciador da qualidade de vida destes doentes. [1][2][3] Ao longo dos últimos anos, alguns estudos têm sido realizados de modo a aferir o impacto que a SS possui na qualidade de vida sistémica (QVS) e oral (QVO). 9-11 A avaliação da qualidade de vida consiste na utilização de instrumentos construídos de forma a avaliar a perspetiva do doente, os quais são traduzidos, validados e testados psicometricamente para uma cultura social específica. ...
... Este resultado poderá estar associado ao FSEM diminuído, o qual é uma condição habitual em indivíduos com SS que, associado às suas respetivas consequências, pode tornar difícil e desconfortável a utilização de prótese removível. 1,29 Adicionalmente, num estudo recente é sugerido que a utilização de prótese removível, por si, está relacionada com uma pior QVO. 30 Hipoteticamente, um estadio mais avançado do SSP pode estar relacionado com um agravamento da sintomatologia, bem como com um maior nível de necessidade de tratamento dentário e consequente utilização de prótese removível. Com base nestas considerações, como constatado na literatura, 29 a reabilitação fixa com implantes pode beneficiar, especialmente, indivíduos com SSP, eliminando os fatores negativos associados à prótese removível, aumentando o seu conforto físico e, por conseguinte, a sua qualidade de vida geral. ...
Objective: To evaluate the oral and systemic quality of life, as well the use of removable prosthesis in a sample of a Portuguese population with Primary Sjögren's Syndrome (PSS). Methods: A sample of 50 patients with PSS was selected according to predefined inclusion criteria. All patients salivary flow rates and DMF index were obtain previously. The oral and systemic quality of life questionnaires (OHIP-14 and SF-12, respectively) were administered twice. Properties were examined including test-retest reliability using intra-class correlation coefficient (ICC), internal consistency using Cronbach's alpha and the possible correlations between the study variables with Pearson's correlation. The relation between the use of removable prosthesis and the other variables was analyzed with Student's independent t test. Results were presented as mean and 95% confidence interval with a=0.05 Results: Good results were obtained for internal consistency and test-retest reliability (Cronbach's alpha OHIP-14 = 0.91; SF-12 = 0.90; ICC OHIP-14 = [0.57:0.88]; SF-12 = [0.49:0.96]. Pearson's correlation suggests the presence of a negative correlation between the OHIP-14's total score with the SF-12's scores and the rest salivary flow. The use of removable prosthesis is associated with a lower physical SF-12's score Conclusion: A correlation between oral and systemic quality of life is suggested in patients with PSS. The use of removable prosthesis might be associated with a lower physical condition, although further studies are needed. © 2017 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
... The Syndrome of Sjögren (SSj) is a chronic systemic illness of autoimmune etiology that acomete mainly the exocrine glands, especially salivares and lacrimais [1,2]. Dry mouth/ hyposalivation and xerophthalmia are explained by tissue inflammation that generates replacement of the acini and ducts of the salivary and ocular glands by fibrous tissue [3,4]. ...
