A randomized controlled trial to verify the irrigation of salivary glands in relieving xerostomia in patients with Sjögren's syndrome

Hongming Du; Zhen Fu; Yi Zhong; Yi Yuan; Jing Zhao; Xu Ding; Sheng Li; Shiyu Gao; Yuchi Zhu; Haiyang Song; Heming Wu

doi:10.3389/fimmu.2022.1039599

A randomized controlled trial to verify the irrigation of salivary glands in relieving xerostomia in patients with Sjögren's syndrome

Front Immunol. 2022 Nov 10:13:1039599. doi: 10.3389/fimmu.2022.1039599. eCollection 2022.

Authors

Hongming Du^{1

2

3}, Zhen Fu⁴, Yi Zhong^{2

3

5}, Yi Yuan^{1

2

3}, Jing Zhao¹, Xu Ding^{1

2

3}, Sheng Li^{1

2

3}, Shiyu Gao^{1

2

3}, Yuchi Zhu^{1

2

3}, Haiyang Song^{2

3

5}, Heming Wu^{1

2

3}

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
² Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China.
³ Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, Jiangsu, China.
⁴ Department of Stomatology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
⁵ Department of General Dentistry, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Abstract

Objective: To verify the effect of triamcinolone acetonide (TA) and major salivary glands saline irrigation on relieving xerostomia in Sjögren's syndrome (SS) patients.

Methods: The enrolled 49 SS patients were randomly assigned to the control group (no irrigation, n=16), saline group (irrigation with saline, n=17) and TA group (irrigation with TA, n=16). Fourteen cases of each group were treated differently but received the same examinations. The examinations include unstimulated whole saliva flow (UWS), chewing-stimulated whole saliva flow (SWS), citric acid-stimulated parotid flow (SPF), Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI) and EULAR SS Patient Reported Index (ESSPRI) of 1 week before irrigation (T0) and 1 week(T1), 8 weeks (T8), 16 weeks (T16) and 24 weeks (T24) after major salivary irrigation.

Results: Each group had 14 cases with completed follow-ups. Both TA and saline irrigation of major salivary glands resulted in higher SWS and SPF of T8, T16 and than those at T0. ESSPRI (oral dryness domain) of T8, T16 and T24 were significantly lower than that at T0, respectively (P < 0.05). SWS and SPF of T8, T16 and T24 in the saline group were significantly higher than in the control group (P< 0.05). XI and ESSPRI (oral dress domain) of T8, T16 and T24 in the saline group were significantly lower than those in the control group, respectively (P< 0.05). SWS and SPF of T16 and T24 in the TA group were significantly higher than in the control group (P< 0.05). All cases with completed follow-up in TA and saline groups were divided into responders and non-responders. Compared with responders, the UWS, SWS, SPF and CODS of T0 in non-responders were significantly increased (P<0.05). Compared with responders, the XI and ESSPRI of T0 in non-responders were significantly decreased (P<0.05).

Conclusion: The irrigation of major salivary glands by TA and saline relieve xerostomia in SS patients. Patients with non-severe xerostomia (responders) have better relief after irrigation than patients with severe xerostomia (non-responders).

Clinical trial registration: www.chictr.org.cn, identifier (ChiCTR210052314).

Keywords: Sjögren’s syndrome; irrigation; saliva; salivary glands; xerostomia.

Publication types

Randomized Controlled Trial

MeSH terms

Humans
Parotid Gland
Saliva
Salivary Glands
Sjogren's Syndrome* / complications
Sjogren's Syndrome* / therapy
Xerostomia* / etiology
Xerostomia* / therapy