[An artificial salivary gland. Indications. Technical note concerning installation]

Idiopathic or iatrogenic aptyalism is responsible for disabling odontostomatological symptoms and constitutes a predisposing factor for bucco-dental complications. Drug treatment designed to stimulate the salivary parenchyma is doomed to failure in cases of severe, irreversible alteration of the glandular acini. The only available treatment is palliative consisting of buccal artificial salivation. Two modalities of endobuccal administration of artificial saliva have been developed: prosthesis-reservoir and "artificial salivary gland". The "artificial salivary gland" consists of a system connecting an external reservoir to the buccal cavity via a catheter implanted over part of its path. The artificial saliva stored in the reservoir is advanced mechanically as far as the mouth where it is released according to an adjustable flow rate. The insertion of a medical silicone catheter is an outpatient procedure with a simple postoperative course. Under normal conditions, one millilitre of saliva solution per hour is sufficient to ensure satisfactory humidification of the buccal mucosa. Dysfunction of the system is generally due to a mechanical problem and any consequent alterations are treated as required. The indications for "artificial salivary gland" must be reserved to semi-urgent cases with severe aptyalism and as a therapeutic relay in the context of global management of the aptyalic patient. This new modality of administration could be extended to other diseases requiring endobuccal drip treatment.