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Biomedical subjects

I al-Hashimi

Publications and source records attributed to I al-Hashimi.

11 recordsLinked to original sources
PubMed2001

The management of Sjögren's syndrome in dental practice.

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.

Candidiasis↗
PubMed2001

A new medication for treatment of dry mouth in Sjögren's syndrome.

Traditionally, treatment of dry mouth in SS is focused on palliative measures (using salivary substitutes). However, due to the dynamic nature of the oral cavity, the salivary substitute is removed from the mouth during swallowing. Therefore, the duration of effect of salivary substitutes is short. Another drawback is that salivary substitutes do not provide the protective roles of saliva. Effective treatment of dry mouth requires increasing salivary output. Gustatory stimulation of the salivary glands with sugar free gum and sugar free candies may be effective in inducing salivary output, however, they impose significant inconvenience on the patient which can compromise compliance. Pharmacological stimulants provide an alternative effective measure and improve compliance. Both Salagen and Evoxac are FDA approved salivary stimulants. They are effective, and safe given awareness of their indications, contraindications, potential adverse effects, and patient's tolerance.

Contraindications↗
PubMed2001

Oral and periodontal status in Sjögren's syndrome.

Sjögren's syndrome is a multi-system chronic inflammatory disease of the exocrine glands. Inflammation of the salivary glands leads to reduction in salivary output, which imposes a significant impact on oral health. Dentists and dental hygienists are the primary healthcare providers to identify early signs and symptoms of Sjögren's syndrome. Early diagnosis of Sjögren's syndrome is fundamental for effective management of the disease.

Dental Plaque↗
PubMed1999

The effect of parotid salivary flow rate on the levels of salivary antimicrobial proteins in patients with Sjögren's syndrome.

OBJECTIVE: The purpose of this study was to examine the effect of salivary flow rate on the levels of antimicrobial salivary proteins in 24 patients with Sjögren's syndrome and 22 age- and race-matched healthy control subjects. METHOD AND MATERIALS: Parameters examined included stimulated salivary flow rate, total salivary protein, lactoferrin, lysozyme, amylase, and secretory immunoglobulin A. RESULTS: The mean total salivary protein and the mean salivary amylase were significantly greater in patients than in controls. However, no significant difference was observed in the mean stimulated salivary flow rates or the levels of lactoferrin, lysozyme, or secretory immunoglobulin A of patients and controls. To examine the effect of salivary flow rate on the levels of salivary antimicrobial protein, the levels of these proteins in patients with salivary flow rate of < or = 0.3 mL/min per gland were compared to those in healthy controls with salivary flow rate > or = 0.4 mL/min per gland. Analyses showed the levels of lactoferrin to be significantly higher among patients than among controls. CONCLUSION: The levels of salivary amylase and lactoferrin may be influenced by the levels of salivary output in patients with Sjögren's syndrome. The relationship between salivary flow rate and the levels of amylase and lactoferrin is not clear at the present time.

Adult↗
PubMed1998

Evaluation of the levels of oral Candida in patients with Sjögren's syndrome.

OBJECTIVE: The purpose of this study was to investigate the levels of oral Candida in patients with Sjögren's syndrome METHODS: The Candida count and salivary flow rate of patients with Sjögren's syndrome were compared with those of healthy control subjects. Candida cultures were obtained from oral rinses. The numbers of colony-forming units were determined through use of the Spiral System. RESULTS: The mean Candida count of patients with Sjögren's syndrome was 1672 +/- 1455 colony-forming units per mL; the count of healthy control subjects was 0.00 colony-forming units per mL. The mean salivary flow rate of patients with Sjögren's syndrome was significantly lower than that of healthy control subjects (0.16 +/- 0.13 mL/min/gland vs 0.55 +/- 0.24 mL/min/gland, respectively; p = 0.0001). However, Spearman rank correlation analyses did not reveal a significant correlation between salivary flow rate and Candida count (in colony-forming units per mL) among patients with Sjögren's syndrome. CONCLUSIONS: Alteration in the oral microbial flora in patients with Sjögren's syndrome may be enhanced by the reduction in salivary output.

Candida↗
PubMed1997

Prevalence of periodontal disease in patients with Sjögren's syndrome.

The periodontal status of 25 patients with Sjögren's syndrome was compared with that of an age-, sex-, and race-matched healthy controls. Clinical evaluation included determination of number of teeth, decayed/missing/filled surfaces, probing pocket depth, clinical attachment level, plaque index, gingival index, bleeding on probing, and measurement of alveolar bone level (examined with radiography). Results of the study suggest that patients with Sjögren's syndrome have a significantly higher plaque index score (p < 0.005), higher decayed/missing/filled surfaces scores (p < 0.05), increased alveolar bone loss (p < 0.05), deeper clinical attachment level (p < 0.05), and increased cementoenamel junction-alveolar bone crest distance (p < 0.005). Although no significant difference was found in the number of cases of "established periodontitis" between the Sjögren's syndrome and controls, odds ratio analysis suggests that patients with Sjögren's syndrome are at 2.2 times higher risk of having adult periodontitis than healthy controls.

Adult↗
PubMed1996

Masticatory function in patients with xerostomia.

The effects of reduced salivary output in patients suffering from xerostomia on masticatory function has not been previously studied. This study compares masticatory performance and kinematic activity of patients suffering from xerostomia with age-, sex-, and number of occluding pairs-matched healthy controls. Masticatory function was evaluated by assessment of chewing motion and muscle activity during chewing an artificial food (CutterSil), chewing gum and swallowing a bolus of almond. Chewing motion was recorded with the Optotrak computer system. Bilateral muscle activity of both masseter and anterior temporalis was recorded using surface electrodes. Results of this study revealed significant differences between patients and controls in their ability to process food and masticatory muscle activity. The majority of patients could not break down the artificial food, others had a larger median particle size than the controls. A significant difference was also observed in the number of chewing cycles required to swallow almonds, the patients required more than twice as many chews as the controls, P < 0.001. The right masseter muscle displayed significantly less activity for the patient than the controls. These findings suggest that patients with xerostomia exhibit reduced ability to process food. The observed decline in masticatory performance is probably due to reduced activity of the muscles of mastication.

Aged↗
PubMed1996

Pilocarpine, an old drug; a new formulation.

This article is intended to familiarize dental practitioners with a new drug preparation, Salagen, which is specifically indicated for treatment of dry mouth. Salagen, an oral form of the drug pilocarpine, is a parasympathetic agonist which causes widespread effects on many vital tissues and organs, including the heart, blood vessels, smooth muscle, and exocrine glands. The safety and efficacy of pilocarpine relies greatly on the accurate diagnosis of the underlying cause of dry mouth and an understanding of its mechanism of action. The purpose of this article is to provide dental practitioners with a brief review of the physiology of salivary secretion and the pharmacology of pilocarpine, including its mechanism of action. It is hoped that this information will provide a better understanding of the appropriate use of this medication.

Administration, Oral↗
PubMedDate not supplied

The level of cariogenic micro-organisms in patients with Sjögren's syndrome.

Sixteen patients with caries-inactive sjögren's syndrome with low parotid salivary flow rates (< 0.25 mL/min) and 18 caries-inactive control subjects with higher salivary flow rates were compared. Mutans streptococci (MS) and lactobacilli (LB) counts were measured by means of Dentocult SM strip mutans and LB assays. The group with Sjögren's syndrome displayed higher counts of MS (P = 0.014) and LB (p = 0.003) when compared with controls. The results of this study indicate that patients with caries-inactive Sjögren's syndrome and low salivary flow may have higher colonization of cariogenic micro-organisms than healthy individuals.

Aged↗
PubMedDate not supplied

The status of lactoferrin and total iron binding capacity of human parotid saliva in Sjögren's syndrome.

UNLABELLED: Sjögren's syndrome (SS) is chronic salivary gland disorder characterized by a reduction in salivary and lacrimal secretion. Elevation in salivary lactoferrin has been reported in SS patients. Fluctuation in the iron binding capacity of lactoferrin has been associated with cellular damage. OBJECTIVE: The purpose of this study was to compare the levels of salivary lactoferrin, total iron, and iron binding capacity in Sjögren's syndrome (SS) patients and healthy controls. METHODS: SDS-PAGE was used to examine the presence of lactoferrin in 102 patients and 20 healthy controls. A colorimetric assay was used to examine the level of total salivary iron and iron binding capacity in patients and controls. RESULTS: A higher number of SS patients exhibited elevated levels of lactoferrin as compared to controls (86% vs. 20%, respectively). No significant difference was observed in the mean level of total iron in the saliva between patients and controls (12.6 micrograms/100 ml vs. 11.1 micrograms/100 ml, respectively). However, the total iron binding capacity of lactoferrin was significantly lower among SS patients than healthy controls (38.2 micrograms/100 ml vs. 61.8 micrograms/100 ml, respectively), p = 0.019. CONCLUSION: The overall results of this study suggest a possible impairment of the iron binding capacity of saliva in SS patients. Such impairment may contribute to the cellular damage of the salivary glands observed in SS patients.

Aged↗