Treatment specifics for sialadenosis of the parotid glands in patients undergoing eradication therapy

Relevance. Treating patients with comorbid pathologies of the parotid salivary glands (PSGs) and the gastrointestinal tract presents a significant clinical challenge. Sialadenosis commonly develops in acid-dependent diseases associated with H. pylori (HP) infection, often manifesting as complaints of dry mouth. This condition leads to a reduction in local immunological defense due to decreased levels of sIgA, which is predominantly sourced from parotid secretion. Gastroenterologists typically prescribe eradication therapy that includes a proton pump inhibitor (PPI), which, according to its pharmacodynamic properties, can cause drug-induced xerostomia.

Material and methods. A total of 115 individuals with sialadenosis of the PSGs and HP infection, confirmed by a positive urease rapid test in parotid secretion, aged 46.42 ± 6.21 years, were examined. The participants were randomly assigned into groups based on the prescription of absorbable gingival collagen membranes and the dose of a complex immunoglobulin preparation (CIP). The groups were as follows: Group I – 35 individuals without local therapy; Group II – 40 patients receiving 30 mg CIP; Group III – 40 patients receiving 60 mg CIP. Additionally, a control group consisting of 20 healthy individuals aged 44.46 ± 4.12 years was included. Gastroenterologists prescribed a standard triple eradication regimen, which included a proton pump inhibitor (PPI) at double dosage, 1000 mg amoxicillin, and 500 mg clarithromycin, taken twice daily for 14 days. All participants underwent comprehensive dental examinations at various stages: diagnosis, day 14 of eradication, and days 21 and 28 of observation.

Results. A significant increase in PSG sialometry and sIgA levels in parotid secretion was observed in patients using absorbable gingival collagen membranes and CIP in addition to standard treatment. At a CIP dose of 60 mg, a negative urease rapid test was determined in parotid secretion by day 14, while at 30 mg, this occurred by day 21, confirming the effectiveness of the therapy.

Conclusion. Treating patients with PSG sialadenosis undergoing eradication therapy requires a comprehensive interdisciplinary approach. It is necessary to include absorbable gingival collagen membranes and CIP at a dose of 60 mg twice daily for 21 days.  

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