Papadopoulou Erofili, Piperi Evangelia, Georgaki Maria, Vardas Emmanouil, Nikitakis Nikolaos G
Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, AthensGreece.
J Oral Maxillofac Res. 2022 Dec 31;13(4):e5. doi: 10.5037/jomr.2022.13405. eCollection 2022 Oct-Dec.
Aplasia of the salivary glands, either partial or involving all the major and possibly the minor salivary glands, is a very rare cause of hyposalivation. The aim of this case report is to present a case of aplasia of the major and minor salivary glands and discuss the relevant literature.
A 23-year-old woman, with a non-contributory medical and family history was referred due to rampant caries, that could not be attributed to any obvious aetiology. No sicca symptoms, previous parotid gland swelling or general symptoms were reported. Clinically, oral mucosa dryness and extended dental erosions and caries were observed, while the orifices of the excretory ducts of the parotid and submandibular salivary glands were not evident. Unstimulated and stimulated saliva flow rates were severely diminished, while a diagnostic biopsy of the lower lip revealed absence of minor salivary glands. Detailed hematologic and immunological investigations to exclude systemic disorders were also within normal limits. Ultrasound and magnetic resonance imaging revealed the absence of all major salivary glands, confirming the clinical diagnosis of congenital aplasia of the salivary glands.
Oral hygiene instructions and dietary advice were given while dental products with fluoride and saliva substitutes were administered and appropriate dental treatment was implemented. Regular dental follow-up was also advised.
Timely diagnosis of aplasia of the salivary glands is important, considering the detrimental effects of the absence of saliva on oral health. Management consists of the use of saliva substitutes, nutritional adaptation, maintenance of oral health and regular dental follow-ups.
涎腺发育不全，无论是部分还是累及所有主要及可能的小涎腺，都是导致唾液分泌减少的非常罕见的原因。本病例报告的目的是呈现一例大小涎腺发育不全的病例并讨论相关文献。
一名23岁女性，既往病史及家族史均无特殊，因猖獗龋前来就诊，病因不明。未报告有干燥症状、既往腮腺肿胀或全身症状。临床检查发现口腔黏膜干燥、广泛的牙体侵蚀和龋齿，而腮腺和下颌下腺排泄管开口不明显。非刺激性和刺激性唾液流速均严重降低，下唇诊断性活检显示无小涎腺。排除全身性疾病的详细血液学和免疫学检查结果也均在正常范围内。超声和磁共振成像显示所有主要涎腺均缺失，证实了涎腺先天性发育不全的临床诊断。
给予口腔卫生指导和饮食建议，同时使用含氟牙科产品和唾液替代品，并实施了适当的牙科治疗。还建议定期进行牙科随访。
考虑到唾液缺乏对口腔健康的有害影响，涎腺发育不全的及时诊断很重要。治疗包括使用唾液替代品、营养调整、保持口腔健康和定期牙科随访。
