Objective was to evaluate characteristic oral parameters in patients with Sjögren's syndrome(SS).

1. patients (49) controls(43) Oral mucosal changes Clinical and laboratory data of patiens with SS SS (49) 3.WS ≤ 0.1ml/min 2.Subjective xerostomia 1.Oral symptoms Controls (43) Associated diseases in patients with SS 3765 K. MÁRTON1, I. BOROS1, M. ZEHER2, T. ZELLES1, P. FEJERDY1, and G. NAGY1: Oral Symptoms,Palatal Salivary Gland Function And Denture Wearing In Sjögren's Syndrome 1: Department of Prosthodontics Semmelweis University, Hungary, 2: Medical and Healthcare Center University of Debrecen, Hungary atrophy of the oral mucosa 5 1 + - Intact mucosa + Denturestomatitis - Glosso-dynia SSn=49 controlsn=43 Whole resting saliva flow rate (ml/min) 0.12 ± 0.13a, 0.38 ± 0.24a Rheumatoid arthritis 7 angular cheilitis 1 2 palatal saliva (µl/ min/cm2) 1.70±1.14 1.38±0.83 palatal saliva (µl/ min/cm2) 1.54±1.01 1.75±0.98 palatal saliva(µl/ min/cm2) 1.78±1.50 1.45±0.95 1.32±0.57 Smokers (No) 3 - Male /Female ratio 3:46 Polyarthritis 4 oral candidiasis 4 - DMF-T-score ±SDa 27.18±6.17 23.06±6.99 Palatal saliva flowrate(µl/cm2/min) 1.57 ± 1.02 1.35 ± 2.5 10(out of 18 denture wearers) Keratoconjunctivitis sicca 43 Arthralgia 12 2 (out of 13 denture wearers) denture stomatitis a D±SD 1.73 ±2.64 2.25 ±2.83 Subjective xerostomia 45 Spondylarthrosis 8 desquamative gingivitis 1 - M±SDb 20.32±9.44 15.67±10.32 Whole resting saliva flow rate <=0.1ml/min 33 Chronic hepatitis or biliary cirrhosis 4 aphta 1 - F±SD 4.87±5.04 5.12±4.73 Sialoadenitis 26 Pulmonary symptoms 1 teleangiectasia 1 1 Completely edentulous (No) 11 9 cheilitis 1 - Positive focus score 36 SLE 1 Edentulous on one jaw 7 3 lichen oris (reticular form) - 1 Autoantibodies to Ro(SS-A) 13 Pseudolymphoma 1 RPD-wearer 8 1 14 5 sum Autoantibodies to Ro(SS-B) 9 Myositis 1 Fixed restoration wearer 17 11 Lingual mucosal changes ANA positivity 1 Gastrointestinal symptoms 6 PPD (mm±SD) c 2.28±1.09 1.82±0.73 fissuration of the tongueb mucosal atrophy slight reddeningc 20 2 ROSE(RF) positivity 6 Colitis 5 PPD >/=5mm (No of patients) 14 14 17 4 ANCA positivity 1 Thyreoid symptoms 4 PPD >/= 5mm (average No of sites/person±SD) 1.6±3(0-12) 1.31±1.99(0-7) ANF positivity 2 Neuropathia 1 black hairy tongue (lingua pilosa nigra) 8 (1 smoker) 2 Gingival Bleeding Index (Ainamo-Bay) (%±SD) d 20.09±23.56 10.54±11.57 ENA positivity 1 Hypertonia 9 median rhomboid glossitis 3 5 AMA(antimitochondrial antibody) positivity 2 Cardial symptoms 4 geographical tongue 1 2 sum 50 15 Vasculitis 4 Objective was to evaluate characteristic oral parameters in patients with Sjögren's syndrome(SS). Patients This study included 49 patients (46 women and 3 men) between the age of 32 and 76 years(Aver:55± 11) who were referred to the outpatient clinic at the 3-rd Department of Internal Medicine of University Medical School, in Debrecen, Hungary. All the patients fulfilled the diagnostic criteria for Sjögren’s syndrome proposed by the European Community Study Group. The clinical and laboratory data and the associated diseases of patients were evaluated to a standard protocol (Table 1.). The orofacial condition of 43 randomly selected healthy controls (29 woman and 14 men) between 15 and 82years of age (average: 47 ± 9 ) were also examined. Results Salivary gland function in patients with SS and in controls 2% a: p<10-6, by the paired Student’s t-test Clinical profile of 49 patients with Sjögren’s syndrome The frequency of the daily routine care of patients and controls Palatal saliva flow rate in relation to different symptoms (1, 2, 3) in patients with SS Oral clinical findings in patients with SS and controls Average:1.6 Average:1.35 Oral soft tissue alterations Methods After detailed history taking the patients were asked about their oral hygienic habits, their complains,and biopsy of their lower labial salivary glands were performed.The resting whole (WS)- and palatal saliva(PS) flow rate,the state of the oral soft tissues were assessed,the involvement of the TMJ and the worn dental appliances were examined.Measurement of interincisal distance(IID) at maximal opening of the mouth was carried out,the number of decayed, missing and filled teeth(DMF-T number),the periodontal probing depth (PPD),the oral hygiene index (OHI-Greene Vermillion)and gingival bleeding index(Ainamo-Bay) were also registered. For statistical analyis the SPSS 8.5-software program was used. a: p<0.05, b:p<0.03, c: p<0.05, d: p<10-5 by the paired Student’s t-test The WS was decreased,the DMF-T score was increased and that showed positive correlation with anti-SSA and/or anti-SSBantibody(AB) and focusscore(No of foci>/=1)(FS) positivity in SS.The PPD and the gingival bleeding index were also elevated in SS, and demonstrated positive correlation with AB-positivity. PS, OHI and IID did not differ from those of the controls. Conclusions:Attention should be payed to the fact that inspite of the WS depletion PS was not fallen,and SS-patients did not complain about denture instabitlity. The results suggest the evidence of early toothloss,higher caries incidency,increased PPD and a higher frequency of gingival involvement, raised number of soft tissue alterations and TMJ symptoms in SS. a,: p<0.05 by the χ-square test;b: p<0.01 by the χ-square test; c: p<0.01 by the χ-square test

2. Clinical and laboratory data of patiens with SS Associated diseases in patients with SS Rheumatoid arthritis 7 Male /Female ratio 3:46 Polyarthritis 4 Keratoconjunctivitis sicca 43 Arthralgia 12 Subjective xerostomia 45 Spondylarthrosis 8 Whole resting saliva flow rate <=0.1ml/min 33 Chronic hepatitis or biliary cirrhosis 4 Sialoadenitis 26 Pulmonary symptoms 1 Positive focus score 36 SLE 1 Autoantibodies to Ro(SS-A) 13 Pseudolymphoma 1 Autoantibodies to Ro(SS-B) 9 Myositis 1 ANA positivity 1 Gastrointestinal symptoms 6 ROSE(RF) positivity 6 Colitis 5 ANCA positivity 1 Thyreoid symptoms 4 ANF positivity 2 Neuropathia 1 ENA positivity 1 Hypertonia 9 AMA(antimitochondrial antibody) positivity 2 Cardial symptoms 4 Vasculitis 4 Clinical profile of 49 patients with Sjögren’s syndrome

3. patients (49) controls(43) Oral mucosal changes Oral soft tissue alterations atrophy of the oral mucosa 5 1 angular cheilitis 1 2 oral candidiasis 4 - 10(out of 18 denture wearers) 2 (out of 13 denture wearers) denture stomatitis a desquamative gingivitis 1 - aphta 1 - teleangiectasia 1 1 cheilitis 1 - lichen oris (reticular form) - 1 14 5 sum Lingual mucosal changes fissuration of the tongueb mucosal atrophy slight reddeningc 20 2 17 4 black hairy tongue (lingua pilosa nigra) 8 (1 smoker) 2 median rhomboid glossitis 3 5 geographical tongue 1 2 sum 50 15 a,: p<0.05 by the χ-square test; b: p<0.01 by the χ-square test; c: p<0.01 by the χ-square test

4. SSn=49 controlsn=43 Smokers (No) 3 - DMF-T-score ±SDa 27.18±6.17 23.06±6.99 D±SD 1.73 ±2.64 2.25 ±2.83 M±SDb 20.32±9.44 15.67±10.32 F±SD 4.87±5.04 5.12±4.73 Completely edentulous (No) 11 9 Edentulous on one jaw 7 3 RPD-wearer 8 1 Fixed restoration wearer 17 11 PPD (mm±SD) c 2.28±1.09 1.82±0.73 PPD >/=5mm (No of patients) 14 14 PPD >/= 5mm (average No of sites/person±SD) 1.6±3(0-12) 1.31±1.99(0-7) Gingival Bleeding Index (Ainamo-Bay) (%±SD) d 20.09±23.56 10.54±11.57 Oral clinical findings in patients with SS and controls a: p<0.05, b:p<0.03, c: p<0.05, d: p<10-5 by the paired Student’s t-test

5. SS (49) 3.WS ≤ 0.1ml/min 2.Subjective xerostomia 1.Oral symptoms Controls (43) Palatal saliva flow rate in relation to different symptoms (1, 2, 3) in patients with SS + - Intact mucosa + Denturestomatitis - Glosso-dynia Whole resting saliva flow rate (ml/min) 0.12 ± 0.13a, 0.38 ± 0.24a palatal saliva (µl/ min/cm2) 1.70±1.14 1.38±0.83 palatal saliva (µl/ min/cm2) 1.54±1.01 1.75±0.98 palatal saliva(µl/ min/cm2) 1.78±1.50 1.45±0.95 1.32±0.57 Palatal saliva flowrate(µl/cm2/min) 1.57 ± 1.02 1.35 ± 2.5 Salivary gland function in patients with SS and in controls a: p<10-6, by the paired Student’s t-test