{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:18:11Z","timestamp":1788391091283,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T00:00:00Z","timestamp":1577318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the impact of gustatory stimulants of salivary secretion (GSSS) on Sj\u00f6gren's syndrome patients\u2019 self\u2010perception of xerostomia, oral health\u2010related quality of life (OHRQoL) and salivary secretion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 110 Sj\u00f6gren's syndrome patients were randomly allocated to be treated with either a malic acid lozenge or a citric acid mouthwash and then crossed over. Before and after the interventions, the Xerostomia Inventory 5 (SXI\u20105\u2010PL) and the Oral Health Impact Profile (OHIP\u201014\u2010PT) questionnaires (both in the Portuguese language) were administered to patients. Unstimulated, mechanical and gustatory\u2010stimulated salivary flows were determined. Repeated measures and between\u2010subject analyses were performed. Statistical significance was set at 5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the intervention and within each group, both GSSS elicited a reduction in the SXI\u20105\u2010PL and OHIP\u201014\u2010PT scores and an increase in salivary output, significant in the malic acid lozenge group. The malic acid treatment resulted in a greater effect size and percentage improvement than citric acid mouthwash. The malic acid lozenge also produced a significant greater salivary output than the citric acid rising solution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Sj\u00f6gren's syndrome patients, lozenges containing malic acid increased saliva production and xerostomia relief, resulting in improved quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/odi.13251","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T08:26:28Z","timestamp":1575879988000},"page":"313-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Patient\u2010related outcomes in Sj\u00f6gren syndrome treated with stimulants of salivary secretion: Randomized clinical trial"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-2681","authenticated-orcid":false,"given":"Ant\u00f3nio Duarte Sola Pereira","family":"da Mata","sequence":"first","affiliation":[{"name":"Oral Biology &amp; Biochemistry Research Group LIBPhys\u2010FCT UID\/FIS\/04559\/2013 Faculdade de Medicina Dent\u00e1ria Universidade de Lisboa Lisboa Portugal"},{"name":"New York University New York NY USA"},{"name":"Clinic Hugo Madeira\u2010Advanced Aesthetics &amp; Implantology Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-4413","authenticated-orcid":false,"given":"Jo\u00e3o Pedro de Almeida Rato","family":"Amaral","sequence":"additional","affiliation":[{"name":"Oral Biology &amp; Biochemistry Research Group LIBPhys\u2010FCT UID\/FIS\/04559\/2013 Faculdade de Medicina Dent\u00e1ria Universidade de Lisboa Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0588-6843","authenticated-orcid":false,"given":"William Murray","family":"Thomson","sequence":"additional","affiliation":[{"name":"Sir John Walsh Research Institute School of Dentistry The University of Otago Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3764-0808","authenticated-orcid":false,"given":"Filipe","family":"Barcelos","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Reumatologia Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Vaz Patto","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Reumatologia Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5596-8479","authenticated-orcid":false,"given":"Ruben Miguel Nunes","family":"Pereira","sequence":"additional","affiliation":[{"name":"Oral Biology &amp; Biochemistry Research Group LIBPhys\u2010FCT UID\/FIS\/04559\/2013 Faculdade de Medicina Dent\u00e1ria Universidade de Lisboa Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-8281","authenticated-orcid":false,"given":"Duarte Nuno da Silva","family":"Marques","sequence":"additional","affiliation":[{"name":"Oral Biology &amp; Biochemistry Research Group LIBPhys\u2010FCT UID\/FIS\/04559\/2013 Faculdade de Medicina Dent\u00e1ria Universidade de Lisboa Lisboa Portugal"},{"name":"Implantology Institute Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2001.0056"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/17455057.3.1.107"},{"issue":"2","key":"e_1_2_8_4_1","first-page":"137","article-title":"Validation of oral health impact profile\u201014 and its association with Hypossialia in a Sj\u00f6gren syndrome Portuguese population","volume":"43","author":"Amaral J.","year":"2018","journal-title":"Acta Reumatologica Portuguesa"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-014-0201-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206418"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2005.00259.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22974"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2011.01879.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2009.01513.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2011.01038.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12313"},{"key":"e_1_2_8_13_1","first-page":"444","volume-title":"Statistical significance versus effect size. 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