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Post on 20-Jul-2015
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Xerostomia is a common problem among adults, its incidence ranging from 10-29% of general
population and treating them has always been a clinical challenge for a Prosthodontist.
Salivary gland secretion is regulated by autonomic
nervous system and is regulated by three component
reflex archAfferent receptors and nerves carry impulses induced from sialogogicgustation and mastication
Central connection and processing nucleus ( Salivary nucleus in medulla oblongata)
Efferent reflex arm containing parasympathetic and sympathetic nerve bundles
Neuro-electrical stimulator are miniature intra oral device, they increase the salivation by means of stimulating the salivary reflex arch
Generations of salivary
pacemakersHow it works??
First Generation: Salitron
Manufactured by Biosonic USA
• Consists of mouth piece(MP) and
external module both connected
by cord.
• MP was held between the dorsal
side of tongue and palate
• Signals generated by this
stimulated the nerve and
resulted in increased salivary
secretion
• But was cumbersome in size and
high cost decreased its
popularity
Self- contained electronic splint:
Saliwell GenNarino
• The miniature electrode, battery
and the circuit is embedded with
a thermoplastic splint.
• Electrode is located close to the
third molar area to enable
stimulation of lingual nerve.
• Splint can be customized for
each patient and the electrode
can be controlled via remote
control
• This device is similar to a night
guard splint.
• It is small and easy to handle,
but needs to be replaced when
its battery runs out.
Miniature electrode supported by
a dental implant:Saliwell Crown• It is fixed avoids the
disadvantages of removable
type.
• Dimension of the electrode is
similar to a molar tooth and can
be adapted to a commercially
available dental implant.
• In addition to electrical stimulus
it also contains wetness detector
which detects the oral moisture
and regulates its electrical
impulse automatically.
• Implant is placed in lower third
molar region to assure close
proximity to lingual nerve and to
avoid interference with normal
oral functions.
Future trends: Currently research is going on in field of genetics and tissue
engineering to create more secreting cells in the gland. However, studies have
so far been conducted with rodents, human investigation is yet to be explored
Conclusion: Xerostomia has multiple causes but all of them, regardless of their etiology affect
the normal quality of living. Neuro electrical stimulation offers a new non pharmacological method of
treatment which overtakes the relevant role in therapeutic stimulation salivation for the patients
requiring long term therapy.
References:
Gloria Lafaurie 1, Stefano Fedele 2, Rafael Martín-Granizo López 3, Andy Wolff 4, Frank Strietzel 5, Stephen R. Porter 6, Yrjö T. Konttinen Med Oral Patol Oral Cir Bucal. 2009 Feb 1;14 (2):E76-80.
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