Rheumatoid Arthritis: Wolff A

Fedele S, Wolff A, Strietzel F, López RM, Porter SR, Konttinen YT. · UCL Eastman Dental Institute, London, United Kingdom. · J Rheumatol. · Pubmed #18671323 No free full text.

This publication has no abstract.

Mignogna MD, Fedele S, Lo Russo L, Lo Muzio L, Wolff A. · Department of Odontostomatological and Maxillofacial Sciences, Section of Oral Medicine, University of Naples Federico II, Naples, Italy. · J Oral Pathol Med. · Pubmed #15610399 No free full text.

Abstract: Sjögren's syndrome (SS) is a systemic autoimmune exocrinopathy that affects mainly the salivary and lacrimal glands, leading to progressive reduction in saliva and tear flow. Although the underlying immuno-mediated glandular destruction is thought to develop slowly over several years, a long delay from the start of the symptoms to final diagnosis has been frequently reported. A limited knowledge concerning SS natural history is among the major causes of the actual diagnostic delay. Although very few studies have been focused on the analysis of SS early clinical onset, a series of oral features preceding xerostomia/hyposalivation development in patients eventually diagnosed as having SS have been reported. Sialochemistry alterations, salivary gland swelling, early dental loss and sialorrhea have been observed before the onset of typical signs and symptoms (namely xerostomia and/or hyposalivation), which usually lead to SS clinical presentation and diagnosis. Here we suggest, after evaluating available data, that the traditional 'untouchable' association between SS and xerostomia/hyposalivation might probably be reconsidered, and that astute clinicians should not underestimate the possible presence or development of SS in patients without xerostomia/hyposalivation and presenting these atypical early oral features.

Kaplan I, Zuk-Paz L, Wolff A. · Institute of Pathology, Rabin Medical Center, Petah-Tiqva, Tel-Aviv, Israel. · Oral Surg Oral Med Oral Pathol Oral Radiol Endod. · Pubmed #18417382 No free full text.

Abstract: OBJECTIVE: To investigate the association of salivary flow rates with oral symptoms and oral mucosal status. STUDY DESIGN: The study population included 462 Israeli subjects attending a xerostomia clinic. After patient history and oral mucosal examination, major gland sialometry, and complementary tests, patients were divided into 6 groups: drug-induced salivary gland hypofunction (SGH), Sjögren syndrome (SS), radiation-induced SGH, idiopathic SGH, xerostomia without SGH, and control. RESULTS: Oral mucosal alterations were more prevalent in all SGH groups than in the control group. Oral symptoms (except speech impairment) were more frequent in all SGH groups. The postradiation group showed the highest frequency of oral mucosal alterations and of swallowing and mastication complaints. Individuals complaining of xerostomia (compared with those who did not) displayed lower major salivary gland flow rates and a higher frequency of oral mucosal alterations CONCLUSIONS: Presence of oral mucosal alterations may help but are not enough to identify patients for further evaluation of SGH. Difficulties in mastication and swallowing are most specifically related to advanced SGH.