Zainab Assy

218 SUMMARY In this thesis, I performed research to improve the the current, available diagnostic tools for dry mouth by developing a new method for measuring the perceived dryness at specific various intra-oral locations. More specifically, we focussed on the role of specific intra-oral surface areas, and the salivary distribution over these areas. Furthermore, to understand which factors affect the use of dry-mouth interventions, the use of these interventions by various dry-mouth patients was investigated. Chapter 2 described the Regional Oral Dryness Inventory (RODI), a newly developed questionnaire which quantifies the severity of dryness at various locations in the mouth. It was found that there is a significant difference in dry-mouth feeling between different intra-oral locations. The most severe oral dryness was perceived at the posterior palate and the least dry location was experienced at the floor of the mouth. We envisaged that the RODI might help to discriminate among different causes of oral dryness in patients, which is explored in Chapter 3. It was concluded that the RODI questionnaire was indeed able to identify differences in perceived intra-oral dryness of different patient groups. For example, both healthy volunteers as well as Sjögren’s syndrome (SS) patients experienced the posterior palate as most dry. In turn, patients suffering from dry mouth due to medication experienced the anterior tongue as most dry. Besides, it was found that SS patients, including those using ≥4 medications had the highest RODI scores for all intra-oral regions, in contrast to healthy controls and dry-mouth patients using up to 4 medications. These findings suggest that the RODI questionnaire might be a useful diagnostic tool for dry-mouth diagnostics, because it can help distinguish between possible causes of oral dryness in patients. It was postulated that the dimensions of the intra-oral surface area, especially the palatal surface area, affect the distribution of saliva over various mucosal surfaces and thereby could influence the dry mouth feeling at various intraoral regions. This topic was explored in Chapter 4 where the intra-oral surface areas were quantified using cone-beam computed tomography (CBCT) in combination with digital analysis. Additionally, the potential correlations between intra-oral surface areas and facial anthropomorphic measurements were investigated. At one hand, this study presented a reproducible technique for the determination of intra-oral surface areas in human cadavers. On the other hand, this study found a moderate, but statistically significant,

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