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牙科临床中干燥综合征的管理

The management of Sjögren's syndrome in dental practice.

作者信息

al-Hashimi I

机构信息

Salivary Dysfunction Clinic, Baylor College of Dentistry, Department of Periodontology, 3302 Gastom Ave., Dallas, Texas 75246, USA.

出版信息

J Am Dent Assoc. 2001 Oct;132(10):1409-17; quiz 1460-1. doi: 10.14219/jada.archive.2001.0056.

Abstract

BACKGROUND

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.

TYPES OF STUDIES REVIEWED

The author reviewed recent medical and dental studies that have advanced our understanding of the causes and treatment of SS. She particularly focused on studies addressing the diagnosis and treatment of the oral component of the disease.

RESULTS

Sjögren's syndrome is a widely underdiagnosed disease. A delay in the diagnosis of SS may have a significant physical, psychological and economic impact on the affected person. The pathogenesis of SS appears to involve a number of factors: immunological, genetic, hormonal and possibly infectious. Successful management of SS requires a multidisciplinary approach, and the dentist plays an essential role in the diagnosis and treatment of the disease. ORAL IMPLICATIONS: Impairment of salivary function in SS increases the risk of developing oral diseases. Effective management of oral health comprises enhancement of salivary output (cholinergic agonist drugs such as pilocarpine or cevimeline) and prevention and treatment of dental caries, oral candidiasis and allergic mucositis. Finally, periodic evaluation of various clinical and laboratory parameters is needed to monitor disease status.

摘要

背景

干燥综合征(SS)是一种累及外分泌腺的多系统炎症性疾病,常伴有多种腺体外表现。干眼和口干症状虽并非SS所特有,但为其典型特征。SS的一个突出后果是口腔和牙齿疾病风险增加。

综述的研究类型

作者回顾了近期推进我们对SS病因及治疗理解的医学和牙科研究。她尤其关注针对该疾病口腔部分诊断和治疗的研究。

结果

干燥综合征是一种普遍诊断不足的疾病。SS诊断延迟可能对患者产生重大的身体、心理和经济影响。SS的发病机制似乎涉及多种因素:免疫、遗传、激素以及可能的感染因素。成功管理SS需要多学科方法,牙医在该疾病的诊断和治疗中起着至关重要的作用。

口腔影响

SS患者唾液功能受损会增加患口腔疾病的风险。有效的口腔健康管理包括增加唾液分泌(使用毛果芸香碱或西维美林等胆碱能激动剂药物)以及预防和治疗龋齿、口腔念珠菌病和过敏性口腔炎。最后,需要定期评估各种临床和实验室参数以监测疾病状态。

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