# Evaluation of ultrasonographic features of major salivary glands and oral manifestations in patients with Sjögren's Syndrome

## TL;DR

This study explores how ultrasound imaging of salivary glands and oral symptoms can help diagnose Sjögren's Syndrome, an autoimmune disease affecting saliva production.

## Contribution

The study identifies correlations between salivary gland ultrasound scores, salivary flow rate, and oral symptoms in Sjögren's Syndrome patients.

## Key findings

- Ultrasonography scores were higher in Sjögren's Syndrome patients compared to healthy controls.
- Lower salivary flow rates correlated with higher ultrasound scores and more oral symptoms in patients.
- Submandibular glands showed more ultrasound changes than parotid glands in early Sjögren's Syndrome.

## Abstract

Sjögren's Syndrome (SS) is an autoimmune disease characterized by the involvement of exocrine glands and leading to various oral manifestations. The present study aimed to investigate the relationships between the salivary glands' ultrasonographic findings, the frequency of oral manifestations, the DMFT index and the unstimulated salivary flow rate in patients diagnosed with SS and to compare these parameters with healthy controls.

The ultrasonographic findings of the parotid and submandibular glands in 43 patients with SS were evaluated according to the Hocevar and Milic scoring system. The frequency of oral manifestations, the unstimulated salivary flow rate, and the DMFT index were calculated and the relationships between these parameters were examined. The ultrasonography findings and the DMFT index ​​of SS patients were compared with the 43 healthy control group.

The total Hocevar and Milic scores were higher in the patients than in the controls (p<0.05). The submandibular gland Hocevar score, the DMFT index, the frequency of burning mouth, and stomatitis were higher in patients with salivary flow rate ≤0.1 ml/min (p<0.05). Hocevar and Milic total scores were lower in patients with a salivary flow rate>0.1 ml/min. A positive correlation was observed between ultrasonography scores and DMFT in the patients (p<0.05). The mean total Hocevar score was found to be higher in submandibular gland than in the parotid gland (p=0.042).

The increase in salivary gland ultrasonography scores in SS correlated with a decrease in unstimulated salivary flow rate, an increase in the DMFT index and some oral manifestations. Ultrasonography scores showed that, in the early stages of SS, the submandibular gland parenchyma was more affected than the parotid gland. The diagnosis of SS is difficult, and dentists can play an important role in the early diagnosis of the disease by evaluating the oral manifestations and ultrasonography findings.

Key words:Sjögren syndrome, salivary gland ultrasonography, oral manifestations, dmft index, salivary flow rate.