Khoury Zaid H, Sultan Ahmed S
Department of Oral Diagnostic Sciences and Research, Meharry Medical College, School of Dentistry, Nashville, Tennessee, USA.
Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA.
J Prosthodont. 2023 Dec;32(9):766-775. doi: 10.1111/jopr.13725. Epub 2023 Jul 6.
To provide a detailed overview of the fundamentals of saliva constituents and production. The review outlines the clinical manifestations as a consequence of salivary gland dysfunction and management strategies for patients with salivary gland dysfunction. Prosthodontic implications of saliva and salivary gland dysfunction are presented.
English-language literature relating to saliva constituents, physiologic saliva production, clinical manifestations secondary to salivary gland dysfunction, salivary biomarkers, and management strategies were retrieved via electronic search. Relevant articles were summarized for this manuscript with a view toward providing pragmatic information.
Saliva is produced by three pairs of major and minor salivary glands. The major salivary glands, namely, the parotid, submandibular, and sublingual glands, contribute approximately 90% of saliva production. Saliva contains serous and mucinous secretions produced by different types of cells within salivary glands. Parasympathetic and sympathetic fibers innervate the major salivary glands, and upon stimulation, the parasympathetic innervation increases serous secretions, while the sympathetic innervation increases protein secretion. Stimulated saliva is mainly derived from the parotid glands which are composed of serous acini, while unstimulated saliva is mainly derived from the submandibular glands which are composed of mixed seromucous acini. As major salivary glands contribute the most to salivary flow, local or systemic factors influencing those glands can disrupt saliva production resulting in clinically significant oral manifestations.
This review provides a fundamental overview of saliva production. In addition, the review highlights the various clinical manifestations secondary to salivary gland dysfunction, explores salivary biomarkers for screening of systemic diseases, discusses management strategies for patients with salivary gland dysfunction, and outlines the prosthodontic implications of saliva and salivary gland dysfunction.
详细概述唾液成分及分泌的基本原理。本综述概述了唾液腺功能障碍的临床表现以及唾液腺功能障碍患者的管理策略。还介绍了唾液及唾液腺功能障碍对口腔修复学的影响。
通过电子检索获取与唾液成分、生理性唾液分泌、唾液腺功能障碍继发的临床表现、唾液生物标志物及管理策略相关的英文文献。对相关文章进行总结以撰写本手稿，旨在提供实用信息。
唾液由三对大唾液腺和小唾液腺分泌。大唾液腺，即腮腺、下颌下腺和舌下腺，分泌的唾液约占总量的90%。唾液包含唾液腺内不同类型细胞产生的浆液性和黏液性分泌物。副交感神经和交感神经纤维支配大唾液腺，受到刺激时，副交感神经支配增加浆液性分泌，而交感神经支配增加蛋白质分泌。刺激后的唾液主要来自由浆液性腺泡组成的腮腺，而未刺激时的唾液主要来自由混合浆液黏液性腺泡组成的下颌下腺。由于大唾液腺对唾液流量的贡献最大，影响这些腺体的局部或全身因素会扰乱唾液分泌，导致具有临床意义的口腔表现。
本综述提供了唾液分泌的基本概述。此外，该综述强调了唾液腺功能障碍继发的各种临床表现，探讨了用于筛查全身性疾病的唾液生物标志物，讨论了唾液腺功能障碍患者的管理策略，并概述了唾液及唾液腺功能障碍对口腔修复学的影响。
