{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:40:19Z","timestamp":1762947619224,"version":"3.45.0"},"reference-count":79,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background\/Objectives: Salivary stones, also known as sialoliths, are calcified structures that develop within the salivary glands and\/or their ducts. They occur in approximately 1 per 10,000 to 30,000 individuals per year, primarily affecting adults between 30 and 50 years of age. Although several hypotheses have been proposed, the exact mechanisms of formation and their predisposing factors are yet to be confirmed. The submandibular gland is the most commonly affected site, accounting for nearly 80% of cases, while giant and asymptomatic sialoliths are rare clinical findings in dental practice. This study is divided into two components: first, a case report of a giant, asymptomatic sialolith located in Wharton\u2019s duct; second, a systematic review of the literature to explore the clinical procedures, diagnoses, outcomes, and other relevant aspects of this pathology. Methods: The case involved a 42-year-old woman who sought dental care due to the presence of a painless sublingual swelling. Intraoral examination and imaging revealed a calcified mass consistent with sialolithiasis in Wharton\u2019s duct. The stone was successfully removed via sialolithotomy. For the systematic review, an extensive search was conducted in PubMed, Embase, and Cochrane Library up to June 2025, using specific keywords. Initially, 262 studies were identified. After applying inclusion and exclusion criteria, six case reports were included in the final analysis. Results: All selected studies described giant salivary stones located in Wharton\u2019s duct and\/or the parenchyma of the submandibular gland, notably without associated pain. Computed tomography and ultrasonography were the most commonly used imaging modalities for diagnosis. In all cases, the primary treatment was sialolithotomy. Conclusions: This study explored a rare case report of an asymptomatic giant sialolith in Wharton\u2019s duct, and it includes a systematic review focused exclusively on asymptomatic giant sialoliths. It specifically addresses key characteristics, preferred imaging modalities, treatment strategies, and clinical considerations for managing this uncommon condition. Registration number: Prospero registration n\u00ba CRD420251076737.<\/jats:p>","DOI":"10.3390\/clinpract15110205","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T10:35:31Z","timestamp":1762770931000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Giant Asymptomatic Submandibular Sialolith: A Case Report Accompanied by Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Renato Gomes","family":"Azevedo","sequence":"first","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luan Felipe","family":"Toro","sequence":"additional","affiliation":[{"name":"Department of Basic Subjects, Marilia Medical School (FAMEMA), Mar\u00edlia 17519-030, S\u00e3o Paulo, Brazil"},{"name":"Department of Basic Sciences, School of Dentistry, Sao Paulo State University (UNESP), Ara\u00e7atuba 16015-050, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vin\u00edcius Franz\u00e3o","family":"Ganzaroli","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences, School of Dentistry, Sao Paulo State University (UNESP), Ara\u00e7atuba 16015-050, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vin\u00edcius Jos\u00e9","family":"Ifanger","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan Ayres","family":"de Faria","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo Ubiali","family":"de Rezende","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"da Concei\u00e7\u00e3o Francisquini","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gestter Willian Lattari","family":"Tessarin","sequence":"additional","affiliation":[{"name":"School of Dentistry, University Center in the North of S\u00e3o Paulo (UNORTE), S\u00e3o Jos\u00e9 Do Rio Preto 15020-040, S\u00e3o Paulo, Brazil"},{"name":"Department of Basic Sciences, School of Dentistry, Sao Paulo State University (UNESP), Ara\u00e7atuba 16015-050, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/ger.12544","article-title":"Concurrent giant sialoliths within the submandibular gland parenchyma and distal segment of Wharton\u2019s duct: Novel case report","volume":"38","author":"Brooks","year":"2021","journal-title":"Gerodontology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12014-023-09402-3","article-title":"Proteomic analysis of sialoliths from calcified, lipid and mixed groups as a source of potential biomarkers of deposit formation in the salivary glands","volume":"20","author":"Musial","year":"2023","journal-title":"Clin. 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