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Microsc Microanal. 2017 Feb;23(1):88-96. doi: 10.1017/S1431927617000022. Epub 2017 Feb 6.

Identification of Objective Morphometric Markers of Xerostomia in the Oral Mucosa Epithelium with In Vivo Confocal Microscopy.

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1Department of Oral Biology, Faculty of Dentistry,University of Oslo,Sognsvannsveien 10,PO Box 1052,0316 Oslo,Norway.
2The Norwegian Dry Eye Clinic,Lille Grensen 7,0159 Oslo,Norway.
4Department of Clinical and Experimental Medicine,Linköping University,SE-581 83 Linköping,Sweden.
5Schepens Eye Research Institute/Massachusetts Eye and Ear,Harvard Medical School,20 Staniford Street,Boston,MA 02114,USA.


The purpose of this work was to determine whether the morphology of the oral mucosa epithelium (OME) of patients with xerostomia differ from patients without xerostomia. In total, 34 patients with dry eye disease (DED) with or without xerostomia were examined at The Norwegian Dry Eye Disease Clinic with in vivo confocal microscopy of the lower lip. In addition, age- and gender-matched healthy controls (HC) were included. DED patients with xerostomia had a higher superficial to deep backscatter ratio compared with DED patients without xerostomia (p=0.002) and HC (p=0.001). Regression analysis demonstrated that this ratio was related to xerostomia independently of gender and age (p<0.001). Sensitivity and specificity of detecting xerostomia were 0.78 and 0.85, respectively, when using a superficial to deep backscatter ratio cut-off value of 0.995 (p=0.004). The mean nucleus to cytosol backscatter ratio in the superficial OME was lower in patients with xerostomia than in those without xerostomia (p=0.034). In vivo confocal microscopy is a potential tool for evaluating the oral cavity and to assess changes in the OME associated with xerostomia, objectively and quantitatively. The cause of the increased backscatter in the superficial OME in xerostomia, however, remains to be elucidated.


in vivo confocal microscopy; dry mouth; oral mucosa epithelium; xerostomia

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