Therapy-induced dysfunction of salivary glands: implications for oral health.
Therapy-induced dysfunction of salivary glands: implications for oral health.
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DOI：
10.1111/j.1754-4505.1985.tb00593.x
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发表时间：
1985-11-01
期刊：
影响因子：
--
通讯作者：
Wright, W E
中科院分区：
文献类型：
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作者：
Baum, B J;Bodner, L;Wright, W E
在过去的10年里，很明显，唾液对口腔中所有组织的维持和功能至关重要。口的两个主要生理作用是开始营养和产生语音。专门的咀嚼（牙齿和牙周组织）和感觉（味觉，触觉，疼痛和热感受器）结构已经进化来完成这些任务。然而，口腔的功能需要口腔组织暴露于外部环境。唾液保护这些组织免受环境的侵害，并保持功能的完整性。唾液中含有润滑糖蛋白和抗菌蛋白，润滑糖蛋白能使粘膜组织保持水合、柔韧和绝缘，抗菌蛋白能调节口腔微生物定植的程度和性质。几种钙结合磷蛋白促进暴露的牙齿结构的持续矿化，各种有机和无机缓冲剂中和口腔细菌产生的潜在有害酸。唾液还提供了将促味剂递送至味觉感受器的介质。因此，任何干扰唾液产生的情况都可能在口腔中产生广泛的负面后遗症，并导致额外的全身并发症。许多治疗可能会影响唾液腺功能;大约250种药物，包括大多数抗高血压药，抗抑郁药，镇静剂，抗组胺药和利尿剂化合物，对唾液产生有不良影响。然而，我们将主要关注其他治疗方案，放疗和联合化疗。这些疗法通常用于肿瘤性疾病的非手术治疗或作为肿瘤手术的辅助治疗。接受头颈部照射或化疗或两者的患者通常会出现严重的口腔并发症，极端情况下可能会影响预期的治疗过程或通过改变正常的口腔功能降低患者的生活质量。
N THE PAST 10 years, it has become apparent that saliva is critical to the maintenance and function of all tissues in the I mouth.’The two major physiologic roles of the mouth are the initiation of alimentation and the production of speech. Specialized masticatory (teeth and periodontium) and sensory (taste, tactile, pain, and thermal receptors) structures have evolved to accomplish these tasks. However, the functions of the mouth require exposure of the oral tissues to the external environment. Saliva protects these tissues from environmental insults, and maintains functional integrity. Saliva contains lubricatory glycoproteins that keep mucosal tissues hydrated, pliable, and insulated, and antibacterial proteins that regulate the extent and nature of oral microbial colonization. Several calcium-binding phosphoproteins promote continuous remineralizations of exposed tooth structure, and various organic and inorganic buffering agents neutralize potentially harmful acid produced by oral bacteria. Saliva also provides a medium for delivery of tastants to gustatory receptors. Therefore, any situation that disturbs saliva production will probably have broad negative sequelae in the mouth and cause additional systemic complications. Many therapies may affect salivary gland function; approximately 250 drugs, including most antihypertensives, antidepressants, tranquilizers, antihistamines, and diuretic compounds, have adverse effects on saliva production.’However, we will primarily focus on other treatment regimens, radiation, and combined chemotherapy. These therapies are typically used in nonsurgical management of neoplastic disease or as adjuncts to oncologic surgery. Patients receiving irradiation to the head and neck or chemotherapy, or both, generally have major oral complications, extreme cases of which can compromise the desired course of treatment or diminish the patient’s quality of life through altered normal oral function.