Abstract

STURLA ROJAS, G.; ROMO ORMAZABAL, F.  and  TORRES-QUINTANA, M.A.. Integral dental clinical management of patients with Sjögren's syndrome: a proposal. Av Odontoestomatol [online]. 2014, vol.30, n.4, pp.205-217. ISSN 2340-3152.

Sjögren´s syndrome (SS) is an autoimmune, chronic and inflammatory disease characterized by infiltration of plasma cells and lymphocytes in the exocrine glands. The pathogenesis of SS is related to immune, neurological, genetic, viral and hormonal factors. Complications are related to glandular destruction and mucosal dryness. The poor quality and quantity of saliva brings devastating consequences to dental and oral health. Alterations in the enamel structure, constant presence of caries in tooth surfaces exposed, mainly cervical, failures in the adhesion of filling materials, keratoses on the mucous membranes, burning mouth syndrome and discomfort in the use of dentures, despite the exhaustive management of the oral environment, are described. A late diagnosis of SS leads to serious physical, psychological and economic consequences in these patients. Its diagnosis and treatment are of great interest to the dentist. Clinical experience indicates that those teeth restored with fixed prostheses have an improved survival and rehabilitation with implant-supported prostheses would provide greater comfort for patients. The dental clinic must have a comprehensive approach to injury and the form of treatment should be considered as patients at high risk of caries based on CAMBRA (Caries management by risk assesement). Effective management of oral health in these patients includes improving the production of saliva, oral mucosal preservation and regular assessment of oral status. A comprehensive dental care protocol consisting of three phases, is proposed: 1) Initial, palliative and preventive phase, 2) Restorative and rehabilitation phase, and 3) Maintenance phase.

Keywords : Sjögren's syndrome; Sicca syndrome; xerostomia; dental restoration failure.

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