Classification of submandibular salivary stones based on ultrastructural studies

Area of Science:

• Oral Medicine
• Biomaterials Science
• Pathology

Background:

• Sialolithiasis is a common clinical issue with unknown causes and limited treatment options.
• Current understanding of salivary stone formation is incomplete.
• Surgical intervention is the primary treatment for sialolithiasis.

Purpose of the Study:

• To investigate the ultrastructure of submandibular sialoliths.
• To propose a new classification system for salivary stones based on their composition and structure.
• To understand the path of origin and development of different sialolith types.

Main Methods:

• Ultrastructure examination of submandibular sialoliths.
• Utilized scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS).
• Analyzed core, intermediate, and superficial layers of sialoliths.

Main Results:

• Sialoliths were classified into three types: calcified (CAL), lipid/organic (LIP), and mixed (MIX).
• CAL and MIX share similar core structures, while LIP cores are predominantly organic.
• Intermediate layers show increasing organic content in LIP and MIX types; superficial layers are similar across all types.

Conclusions:

• A novel classification for submandibular salivary gland stones (sialoliths) was introduced.
• CAL and LIP types appear to have distinct origins, with MIX stones evolving from CAL to LIP characteristics.
• High organic content in all sialolith layers significantly impedes dissolution within salivary ducts.