Salivary Gland Dysfunction
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Salivary Gland Dysfunction
Salivary gland diseases (SGDs) are multiple and varied in cause. There are three paired major salivary glands in humans – the parotid glands, the submandibular glands, and the sublingual glands. In addition there are about 800-1000 minor salivary glands in the mucosa of the mouth. The parotid gland is located in front of each ear, and secretes mostly serous saliva via the parotid duct (Stenson duct) into the mouth, usually opening roughly opposite the maxillary second molar. The submandibular gland is located medial to the angle of the mandible, and it drains its mixture of serous and mucous saliva via the submandibular duct (Wharton duct) into the mouth, usually opening in a punctum located in the floor of mouth. The sublingual gland is located below the tongue, on the floor of the mouth. It drains its mostly mucous saliva into the mouth via about 8-20 ducts which open along the plica sublingualis (a fold of tissue under the tongue). The function of the salivary glands is to se ...
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Submandibular Gland
The paired submandibular glands (historically known as submaxillary glands) are major salivary glands located beneath the floor of the mouth. They each weigh about 15 grams and contribute some 60–67% of unstimulated saliva secretion; on stimulation their contribution decreases in proportion as the parotid secretion rises to 50%. The average length of the normal human submandibular salivary gland is approximately 27mm, while the average width is approximately 14.3mm. Structure Lying superior to the digastric muscles, each submandibular gland is divided into superficial and deep lobes, which are separated by the mylohyoid muscle: * The superficial lobe comprises most of the gland, with the mylohyoid muscle runs under it * The deep lobe is the smaller part Secretions are delivered into the submandibular duct on the deep portion after which they hook around the posterior edge of the mylohyoid muscle and proceed on the superior surface laterally. The excretory ducts are then cross ...
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Antimicrobial
An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals are used against fungi. They can also be classified according to their function. Agents that kill microbes are microbicides, while those that merely inhibit their growth are called bacteriostatic agents. The use of antimicrobial medicines to treat infection is known as antimicrobial chemotherapy, while the use of antimicrobial medicines to prevent infection is known as antimicrobial prophylaxis. The main classes of antimicrobial agents are disinfectants (non-selective agents, such as bleach), which kill a wide range of microbes on non-living surfaces to prevent the spread of illness, antiseptics (which are applied to living tissue and help reduce infection during surgery), and antibiotics (which destroy microorganisms within the body). The ...
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Hyposalivation
Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause. This symptom is very common and is often seen as a side effect of many types of medication. It is more common in older people (mostly because this group tend to take several medications) and in persons who breathe through their mouths. Dehydration, radiotherapy involving the salivary glands, chemotherapy and several diseases can cause reduced salivation (hyposalivation), or a change in saliva consistency and hence a complaint of xerostomia. Sometimes there is no identifiable cause, and there may sometimes be a psychogenic reason for the complaint. Definition Xerostomia is the subjective sensation of dry mouth, which is often (but not always) associated with hypofunction of the salivary glands. The term is derived from the Greek words ξηρός (''xeros'') meaning "dry" and στόμα (''stoma ...
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Inferior Alveolar Nerve
The inferior alveolar nerve (IAN) (also the inferior dental nerve) is a branch of the mandibular nerve, which is itself the third branch of the trigeminal nerve. The inferior alveolar nerves supply sensation to the lower teeth. Structure The inferior alveolar nerve is a branch of the mandibular nerve. After branching from the mandibular nerve, the inferior alveolar nerve travels behind the lateral pterygoid muscle. It gives off a branch, the mylohyoid nerve, and then enters the mandibular foramen. While in the mandibular canal within the mandible, it supplies the lower teeth (molars and second premolar) with sensory branches that form into the inferior dental plexus and give off small gingival and dental nerves to the teeth. Anteriorly, the nerve gives off the mental nerve at about the level of the mandibular 2nd premolars, which exits the mandible via the mental foramen and supplies sensory branches to the chin and lower lip. The inferior alveolar nerve continues anteriorl ...
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Cyst
A cyst is a closed sac, having a distinct envelope and cell division, division compared with the nearby Biological tissue, tissue. Hence, it is a cluster of Cell (biology), cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubble); however, the distinguishing aspect of a cyst is that the cells forming the "shell" of such a sac are distinctly abnormal (in both appearance and behaviour) when compared with all surrounding cells for that given location. A cyst may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst may resolve on its own. When a cyst fails to resolve, it may need to be removed surgically, but that would depend upon its type and location. Cancer-related cysts are formed as a defense mechanism for the body following the development of mutations that lead to an uncontrolled cellular division. Once that mutation has occurred, the affected cell ...
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Stafne Defect
The Stafne defect (also termed Stafne's idiopathic bone cavity, Stafne bone cavity, Stafne bone cyst (misnomer), lingual mandibular salivary gland depression, lingual mandibular cortical defect, latent bone cyst, or static bone cyst) is a depression of the mandible, most commonly located on the lingual surface (the side nearest the tongue). The Stafne defect is thought to be a normal anatomical variant, as the depression is created by ectopic salivary gland tissue associated with the submandibular gland and does not represent a pathologic lesion as such. Classification It is a classed as a pseudocyst, since there is no epithelial lining or fluid content. This defect is usually considered with other cysts of the jaws, since it can be mistaken for such on a radiograph. Signs and symptoms There are no symptoms, and no signs can be elicited on examination. Medical imaging such as traditional radiography or computed tomography is required to demonstrate the defect. Usually the de ...
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Ectopic Salivary Gland Tissue
Ectopic salivary gland tissue which is located in sites other than the normal location is variously described as aberrant, accessory, ectopic, heterotopic or salivary gland choristoma. Accessory salivary glands An ''accessory salivary gland'' is ectopic salivary gland tissue with a salivary gland duct system. The most common location of accessory salivary gland tissue is an extra major salivary gland in front of the parotid gland. It is typically about 3 cm or less in size, and drains into the parotid duct via a single tributary. Accessory parotid tissue is found in 21-56% of adults. Any disease process which affects the salivary glands, including cancer, may also occur within an accessory salivary gland tissue. Heterotopic salivary gland tissue ''Salivary gland heterotopia'' is where salivary gland acini cells are present in an abnormal location without any duct system. The most common location is the cervical lymph nodes. Other reported sites of heterotopic salivary gland ...
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Salivary Gland Atresia
Salivary gland atresia is congenital blockage or absence of the orifice of a major salivary gland duct or part of the duct itself. It is a very rare condition. The submandibular salivary gland duct is usually involved, having failed to cannulate during embryological development. The condition first becomes apparent in the first few days after birth where a submandibular swelling caused by a retention cyst is noticed. References Salivary gland pathology {{congenital-malformation-stub ...
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Salivary Gland Aplasia
Salivary gland aplasia (also termed salivary gland agenesis) is the congenital absence of salivary glands. Usually the term relates to the absence of some or all of the major salivary glands. It is a rare condition, and most known cases have been in association with syndromes of the ectodermal tissues, particularly the lacrimal apparatus. Example syndromes which have been reported with salivary gland aplasia include hereditary ectodermal dysplasia, mandibulofacial dysostosis and hemifacial microsomia. The main significance of the condition is a lack of saliva, causing xerostomia (dry mouth), with accompanying susceptibility to dental caries (tooth decay), infections of the mouth, and upper respiratory tract infections (e.g., candidiasis, ascending sialadenitis, laryngitis and pharyngitis Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a Rhinorrhea, runny nose, cough, headac ...
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Congenital Disorder
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth defects are divided into two main types: structural disorders in which problems are seen with the shape of a body part and functional disorders in which problems exist with how a body part works. Functional disorders include metabolic and degenerative disorders. Some birth defects include both structural and functional disorders. Birth defects may result from genetic or chromosomal disorders, exposure to certain medications or chemicals, or certain infections during pregnancy. Risk factors include folate deficiency, drinking alcohol or smoking during pregnancy, poorly controlled diabetes, and a mother over the age of 35 years old. Many are believed to involve multiple factors. Birth defects may be vi ...
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Sialadenitis
Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands. Sialadenitis can be further classed as acute or chronic. Acute sialadenitis is an acute inflammation of a salivary gland which may present itself as a red, painful swelling that is tender to touch. Chronic sialadenitis is typically less painful but presents as recurrent swellings, usually after meals, without redness. Causes of sialadenitis are varied, including bacterial (most commonly ''Staphylococcus aureus''), viral and autoimmune conditions. Types Acute ;Predisposing factors * sialolithiasis * decreased flow (dehydration, post-operative, drugs) * poor oral hygiene * exacerbation of low grade chronic sialoadenitis ;Clinical features * painful swelling * reddened skin * edema ...
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