Increased calcium and decreased magnesium and citrate concentrations of submandibular/sublingual saliva in sialolithiasis Yu-xiong Su a,b,1 , Kai Zhang b,1 , Zun-fu Ke c,1 , Guang-sen Zheng a,b , Mei Chu a,b , Gui-qing Liao a,b, * a Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China b Institute of Stomatological Research, Guanghua School of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China c Department of Pathology, Medical School of Sun Yat-sen University, 74 The Second Zhongshan Road, Guangzhou 510080, China 1. Introduction Obstructive salivary gland disease is one of the most common problems that afflict salivary glands and is a major cause of salivary gland dysfunction and sialoadenectomy. 1 Sialoliths located in Wharton’s duct or in Stensen’s duct are the most frequent cause of obstruction and consequent acute or chronic infection. The incidence of salivary calculi is 60 cases/million/ year. 2 However, the exact cause of sialolithiasis per se remains elusive. archives of oral biology 55 (2010) 15–20 article info Article history: Accepted 11 November 2009 Keywords: Submandibular gland Salivary calculi Saliva Electrolyte abstract Objective: The purpose of the present study was to investigate the electrolyte alterations of submandibular/sublingual saliva in submandibular sialolithiasis patients compared with saliva from healthy controls. Design: Submandibular/sublingual saliva was collected from 10 submandibular sialolithia- sis patients and from 10 sex- and age-matched healthy controls. Ion chromatography was performed to determine the concentrations of inorganic cations (potassium, calcium, magnesium, and sodium), inorganic anions (chloride, phosphate, nitrate, and sulphate) and organic anions (thiocyanate, lactate, acetate, and citrate). Results: The calcium concentration was significantly higher in sialolithiasis patients than in controls (P < 0.05). In contrast, the levels of magnesium and citrate in the saliva of sialo- lithiasis patients were significantly reduced compared to the values obtained in controls (P < 0.05). No significant differences were detected among other ions. Conclusions: Our findings indicate that saliva electrolyte composition of sialolithiasis patients is substantially altered with respect to crystallisation mechanisms. Increased calcium ion as a crystallisation substance and decreased magnesium and citrate ions as crystallisation inhibitors may be involved in the etiopathology of calculi formation. # 2009 Elsevier Ltd. All rights reserved. * Corresponding author at: Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China. Tel.: +86 20 83862531; fax: +86 20 83822807. E-mail address: drliaoguiqing@hotmail.com (G.-q. Liao). 1 The contribution of these authors for the current article was equal. available at www.sciencedirect.com journal homepage: http://www.elsevier.com/locate/aob 0003–9969/$ – see front matter # 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.archoralbio.2009.11.006