Table 4

Data of index test methods and reference methods in the studies included in the review
First author, year of publication Test method Reference method Authors’ conclusion
Al-Hashimi 1998 [31] 3 different gel electrophoresis systems European Community criteria for the diagnosis of Sjögren’s syndrome [42] Salivary electrophoresis is a potentially useful test for the diagnosing of Sjögren’s syndrome
▪immobilized pH gradient (IPG)
Almståhl 2003 [32] Sialochemistry The Copenhagen criteria for Sjögren’s syndrome [47] The concentrations of electrolytes in stimulated whole saliva, in individuals with hyposalivation, seem to be more related to the reason for the hyposalivation than to the salivary secretion rate.
El-Miedany 1999 [33] Salivary smears Criteria of Fox et al. for Sjögren’s syndrome [48] The saliva ferning test is a useful diagnostic aid in autoimmune xerostomia, approx equivalent to Shrimer’s test in xeropthalmia
Håkansson 1994 [34] 99mTc-scintigraphy ▪Copenhagen criteria for pSS [47] Salivary gland scintigraphy is a sensitive and valid method to measure salivary gland function and abnormalities
▪Shrimer-1 test
▪van Bijsterveld score
▪Tear-film break-up time
Hay 1998 [35] Questionnaire ▪Sialometry [42-44] Only weak associations were found between self-reported symptoms of dry eyes and dry mouth and objective measures said to define Sjögren’s syndrome in the general population
▪Shrimer-1 test
▪Measurement of antibodies (ELISA, indirect immunofluorescence, Latex test)
Kalk 2001 [36] ▪Sialometry Revised European classification criteria for SS [43-45] Glandular sialometry and sialochemistry are not useful tools for differentiating SS from other salivary gland disease.
▪Sialochemistry Parotid sialography was used to fulfill the criteria on the oral component.
Kalk 2002 [37] ▪Sialometry Revised European classification criteria for SS [43-45] Gland-specific sialometry and sialochemistry may eventually replace other, more invasive, diagnostic techniques for diagnosing SS.
▪Sialochemistry Parotid sialography was used to fulfill the criteria on the oral component.
Kanehira 2009 [38] Filter paper comprising 3 spots containing 30 μg starch and 49.6 μg potassium iodide per spot. Sialometry (unstimulated whole saliva < 0.1 ml/min)a This screening technique might be effective for estimation of salivary flow.
Kohn 1992 [39] 99mTc-scintigraphy Sialometry (Unstimulated parotid and SM/SL < 0.1 ml/min Stimulated parotid and SM/SL < 0.6 ml/min)* Salivary gland scintigraphy is a useful method in assessing salivary gland flow rates
Lee 2002 [40] ▪Oral mucosal wetness Sialometry (unstimulated whole saliva <0.15 ml/min) a Measurements of oral mucosal wetness could be thought of as one of the diagnostic methods for assessing dry mouth.
(SialopaperTM Periotron 8000®)
López-Jornet 2006 [41] Oral Schirmer’s test Revised European classification criteria for SS [46] Oral Shrimer’s test can be used as a simple, objective test to diagnose salivary gland hypofunction.
Navazesh 1992 [42] ▪Lip dryness Sialometry (unstimulated whole saliva ≤0.20 ml/min) a Four clinical measures that together predict the presence of or absence of salivary gland hypofunction were identified: dryness of lips, dryness of buccal mucosa, absence of saliva produced by gland palpation, and total DMFT.
▪Buccal mucosal dryness
▪Salivary pool
▪Major salivary gland palpation
▪Tongue mucosa
▪Total DMFT
Pedersen 1999 [43] ▪Sialometry European classification for pSS [42] Rating of oral dryness by visual analogue scales or categorised questionnaires are valuable for the evaluation of oral involvement in pSS.
▪Labial salivary gland biopsy
▪Serological examination
▪Categorised questionnaire
Pennec 1993 [44] ▪Sialometry European classification for pSS [42] The most efficient combination of tests for the oral component of SS appears to be salivary gland scintigraphy plus saliva flow rate or salivary lactoferrin.
▪Salivary lysozyme
▪Salivary lactofferin
▪Parotic sialography
▪Salivary gland scintigraphy (99mTc)
▪Labial salivary gland biopsy
Sánchez-Guerrero 2002 [45] Wafer test For the oral component parotid secretion rate according to Fox et al. [48] The wafer test is valid and reliable for identifying subjects with xerostomia
▪European questionnaire for sicca syndrome
▪Schirmer-1 test
Sreebny 1988 [4] Questionnaire Sialometry (unstimulated whole saliva ≤ 0.1 ml/min) a Dry mouth and several other symptoms are common in an outpatient population and they are a valid indicator of salivary gland hypofunction
Wolff 1998 [46] Oral mucosal wetness(SialopaperTM Periotron 6000®) Sialometry (unstimulated whole saliva ≤ 0.1 ml/min) a Salivary pH Measurement of palatal mucosal wetness might be useful in assessing medication compliance and may serve as a guide to medication administration.
Wolff 2002 [47] 3-g-all-sucrose candy Sialometry (unstimulated SM/SL < 0.1 ml/min + either stimulated parotid <0.25 ml/min or stimulated SM/SL < 0.15 ml/min) a The candy weight-loss test is a measure of salivary hypofunction, which correlates with saliva output and reports of subjective dry mouth

a Cut-off value defining salivary gland hypofunction

Löfgren et al.

Löfgren et al. BMC Oral Health 2012 12:29   doi:10.1186/1472-6831-12-29

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