sialolithiasis maddy malabar dental college.pptx

sialolithiasis maddy malabar dental college

1. SialolIthiasis Submitted by Adithya madhav s Final year part 1

2. Contents Introduction Definition Etiopathogenesis Clinical features Investigation Management Summary

3. Introduction Also known as ‘Salivary gland stone’ or ‘salivary gland calculus’ Most common calcifications found in soft tissues of oro-orbital region Seen in both major and minor salivary glands.

4. Definition It is defined as the formation of calcific concentrations within the parenchyma or ductal system of the major or minor salivary glands.

5. Composition Calculus : Organic material covered with concentric shells of calcific material. Crystalline structure : Hydroxyapatite and octacalcium phosphate. Chemical composition : Calcium phosphate with carbon and traces of Mg, K, Cl, NH³⁺

6. Etiopathogenesis Metabolic Mechanism Salivary Stagnation Coexisting Inflammation Precipitation of Salivary salt in matrix Neurohumoral Condition Nidus and matrix Formation

7. Factors Anatomic Length and tortous course of the disease Located in dependent position Greater size and position of the orifices Orifice smaller than lumen Physiologic High mucin content Greater alkalinity and organic matter Greater concentration of Ca++ and PO² salts Low concentration of CO² content.

8. GANDULAR DUCTAL Types

9. CLINICAL FEATURES Age- middle age Sex- male predilection Symptoms:More severe symptoms in extraglandular and intraductal cases Pain: Swelling: Intermittent, transient swelling During meals Resolves after meals: demand subsides • Systemic symptoms: Fever Malaise Maybe due to acute suppurative process Duct obstruction accumulation Pain under pressure
13. Signs • Pus : Exudate from duct orifice • Surrounding tissue : severe inflammaatory reaction, redness, tenderness • On Palpation : Firmer and larger than usual • Size : few mms to several cms

10. SWAB TEST If stone is present in one duct only saliva secretion will occur from only one duct. Swab on the orifice of both ducts The swab near affected duct will remain dry. MINOR SALIVARY DUCT Rare occurance Buccal mucosa most common Near commissure or near the mandibular muco buccal fold Age 39yrs

11. INVESTIGATION Radiographic features Metallic duct probe Palpation

12. Radiographic features

13. Radiographic features Occlusal view

14. Sialography Sialography Radiolucent sialoliths Ductal dilatation caused by associated sialoliths

15. Ct scan Dense radiopaque area

16. Management

17. Manual manipulation Manual manupulation In case of small stone Gentle massage of the gland Moves stone towards the duct orifice Other modalities- Sialagogues' Moist heat Inc fluid intake

18. Stone in submandibular salivary gland

19. Stone in submandibular gland Excision of the gland is recommended Antibiotics In case of acute infections Salivary gland endoscopy Newer method Removal of sialolithiasis Lithotripsy Fragmentation of stone in gland

20. Summary It is the formation of calcific concentrations within the parenchyma or ductal system of the major or minor salivary glands. Submandibular gland is most commonly affected

21. Reference Textbook of Oral Medicine: Burket ; 9 th Ed White and Pharoah : Oral Radiology 6 th Ed

22. Thank you