Juan Aitken-Saavedra

By Alejandro Escobar and Juan P. Aitken-Saavedra

Xerostomia or dry mouth sensation is considered a complex condition that affects several stomatological functions that drives to the detriment of the quality of life of individuals who suffer from it. Often, xerostomia is accompanied by a decrease in salivary flow or hyposalivation, and this condition leads to oral health problems such as dental caries, candidiasis, and mucosal complications. Currently, the diagnosis and therapeutic methods for this condition are varied and it is difficult to achieve favorable results in all cases, since the etiology seems to be multifactorial where both local factors and systemic conditions would participate. This chapter presents, in a concise shape, the relevant data about etiology of xerostomia, such as age, autoimmune diseases, systemic diseases, infectious diseases, neuropathic complications, psychogenic factors and therapeutically consumption of drugs among others, and the current available treatments.

Part of the book: Salivary Glands

By Maite Cuturrufo-Inostroza, Constanza Morales, Laura Chaparro and Juan Aitken-Saavedra

Sjögren’s syndrome (SS) is a systemic autoimmune disease that remains difficult to diagnose and can be classified as primary (pSS) or secondary, depending on its association with other autoimmune conditions. This study aimed to evaluate the accuracy of salivary biomarkers (SBs) in the diagnosis and progression of pSS. A systematic review was conducted between March and August 2023 following PRISMA guidelines. Literature searches were performed in PubMed, Web of Science, and SciELO using the terms “Sjögren’s Syndrome” AND “saliva.” Studies published in the last 10 years, involving humans and written in Spanish, English, or Portuguese, were included if they assessed the diagnostic or prognostic accuracy of SBs. The risk of bias was evaluated using the ROBINS-E tool. Thirty-five case-control and cohort studies were included; 25 evaluated the diagnostic use of SBs, highlighting markers such as neutrophil gelatinase-associated lipocalin, interleukin-6, and beta-2 microglobulin, all significantly elevated in pSS patients (p < 0.05). Eleven studies assessed disease progression, showing associations between higher SB concentrations and longer disease duration, higher focus score (FoSc), and hyposalivation. Epidermal growth factor (EGF) was the most frequently cited biomarker, decreased in advanced disease and related to epithelial integrity, while the S100A8/A9 protein complex was elevated in pSS patients with lymphoma or high FoSc (p < 0.05). These findings suggest that SBs associated with inflammation have potential as the complementary diagnostic tools for pSS, though further validation and standardized methodologies are required to confirm their clinical utility and improve patient outcomes.

Part of the book: Salivary Analysis