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Quintessence International (Berlin,... 2018Advances in transplant medicine and availability of effective immunosuppressive regimens have dramatically improved survival for patients afflicted with end-stage organ... (Review)
Review
Advances in transplant medicine and availability of effective immunosuppressive regimens have dramatically improved survival for patients afflicted with end-stage organ failure. However, chronic immunosuppression predisposes transplant patients to infection caused by a wide spectrum of endogenous or exogenous pathogens as well as necrotizing periodontal conditions. This article reviews clinical features, diagnosis, and management of necrotizing stomatitis in the context of therapeutic immunosuppression and discusses the integral function of dentists in eliminating oral foci of infection in preparation for transplantation as well as life-long maintenance of oral health post-transplant. We also present a renal transplant patient who developed massive soft and hard tissue necrosis in the anterior mandible. Disproportionate periodontal destruction in relation to local factors raised suspicion of iatrogenic overimmunosuppression, and he was hospitalized for management of profound neutropenia.
Topics: Dental Care for Chronically Ill; Dentists; Humans; Immunocompromised Host; Necrosis; Professional Role; Stomatitis
PubMed: 29629439
DOI: 10.3290/j.qi.a40126 -
Supportive Care in Cancer : Official... Aug 2023To assess the effect of a mucoadhesive herbal medicine containing curcuminoids and a glycerinated extract of Bidens pilosa L. (FITOPROT) in association with... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of a mucoadhesive phytomedicine (Curcuma longa L. and Bidens pilosa L.) on radiotherapy-induced oral mucositis and quality of life of patients undergoing head and neck cancer treatment: randomized clinical trial.
PURPOSE
To assess the effect of a mucoadhesive herbal medicine containing curcuminoids and a glycerinated extract of Bidens pilosa L. (FITOPROT) in association with photobiomodulation (PBM) therapy and a Preventive Oral Care Program (POCP) compared to PBM and POCP in the treatment of radiotherapy (RT)-induced oral mucositis (ROM) and in the quality of life of these patients.
METHODS
A double-blind clinical trial was performed with head and neck cancer patients undergoing RT or chemoradiotherapy. Participants were randomized into two groups: Group 1 (n=27): PBM and POCP; and Group 2 (n=25): PBM, POCP and FITOPROT. The PBM protocol was daily irradiation, 660 nm, 25mW, 0.25 J/point from the first until the last day of RT. The FITOPROT was used as mouthwash twice a day. ROM was evaluated based on the scales of the World Health Organization and National Cancer Institute. The quality of life was evaluated using the University of Washington Questionnaire, OHIP-14 and Patient-Reported Oral Mucositis Symptom Scale. The MMAS-8 questionnaire was used to evaluated the adherence to POCP and FITOPROT. Data were collected at baseline, 7, 14, 21, and 30 RT sessions.
RESULTS
No statistical differences were found between the groups for the ROM evaluation. Both groups experienced worsening of the quality of life during the RT. No statistically significant differences between groups were observed for any of the instruments evaluated.
CONCLUSION
The results suggest that PBM associated with FITOPROT and POCP control the severity of ROM and stabilize the QoL of patients with head and neck cancer.
TRIAL REGISTRATION
Brazilian Registry of Clinical Trials (ReBEC-RBR-9vddmr; UTN code: U1111-1193-2066), registered in August 8th, 2017.
Topics: Humans; Bidens; Quality of Life; Curcuma; Stomatitis; Head and Neck Neoplasms; Plant Extracts; Low-Level Light Therapy
PubMed: 37566179
DOI: 10.1007/s00520-023-07971-5 -
Primary Dental Journal Jun 2022The effectiveness of denture stomatitis (DS) treatment should be evaluated by associating clinical and mycological parameters. Although widely used in clinical studies,...
The effectiveness of denture stomatitis (DS) treatment should be evaluated by associating clinical and mycological parameters. Although widely used in clinical studies, the Newton classification does not accurately represent the degree of severity of palatal inflammation in terms of extent of the lesions and intensity of the erythema. Therefore, a modified Newton classification has been proposed considering the coverage area of palatal inflammation and the erythema level. This consistent and direct ranking will help standardise randomised clinical trials, as well as the statistical comparison among blind evaluations of the obtained scores within and between studies.
Topics: Erythema; Humans; Inflammation; Stomatitis; Stomatitis, Denture
PubMed: 35658661
DOI: 10.1177/20501684221101095 -
International Journal of Environmental... Feb 2023One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an... (Review)
Review
One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.
Topics: Female; Humans; Aged; Stomatitis, Denture; Dentures; Antifungal Agents; Dentists; Professional Role; Candidiasis, Oral; Stomatitis; Candida albicans
PubMed: 36833718
DOI: 10.3390/ijerph20043029 -
Current Pharmaceutical Biotechnology 2023Mucositis is a debilitating and severe side effect of chemotherapy and radiotherapy. It is responsible for reducing the patient's quality of life and represents a... (Review)
Review
Mucositis is a debilitating and severe side effect of chemotherapy and radiotherapy. It is responsible for reducing the patient's quality of life and represents a significant economic burden in oncology. Currently, there is no definitive and definite treatment for this disease. Intracellular signalling pathways have provided excellent drug development resources, particularly cancer therapeutic development. In recent decades, active research has been conducted to describe the pathogenesis of mucositis and the role of nuclear factor-kappa B (NF-κB) signalling pathways in mucositis development. Insights into the mechanisms of mucositis are creating new approaches for effective targeted treatment and their success in clinical use. Several studies have concentrated on elucidating the functional significance of NF-kB activation and its signalling mechanisms in mucositis in recent decades. Also, evidence indicates that NF-κB is the primary node for the development and progression of mucositis. Its altered expression is associated with increased mucosal injury in mucositis. Hence, regulating the activation of NF-κB could be a powerful strategy for the clinical management of mucositis. Thus, this review examines the role of NF-κB as a potential therapeutic target for chemotherapy and radiation-induced mucositis therapy.
Topics: Humans; Mucositis; NF-kappa B; Quality of Life; Stomatitis; Neoplasms
PubMed: 36999705
DOI: 10.2174/1389201024666230331121328 -
Current Pharmaceutical Biotechnology 2023Preclinical and clinical evidence implies that destructive therapies in local and malignant tissue are frequently used on patients with head and neck cancer.... (Review)
Review
BACKGROUND
Preclinical and clinical evidence implies that destructive therapies in local and malignant tissue are frequently used on patients with head and neck cancer. Consequently, the microbiome of the treated and adjacent regions is affected. Disruption of the normal microbiome plays an important role not only in the disease progression but also in its emergence, therefore new therapies involving probiotics, prebiotics, and synbiotics have been developed to control or regulate this microbial disruption.
OBJECTIVE
This review aims to describe the current and potential uses of probiotics at different stages of development of head and neck squamous cell carcinoma, as an adjuvant therapy to prevent common complications such as radiation-induced oral mucositis (RIOM) and its role in other areas.
METHODS
Currently, there is no widely effective strategy to treat or prevent this kind of cancer. Surgery, radiation therapy, and chemotherapy are the three main treatments for head and neck cancer. Some therapies can also cause long-term health problems, or complications which might change the way you eat, talk, hear and breathe.
RESULTS
The main uses for which probiotics have been studied are: Prevention and reduction of severity of RIOM, change in dental plaque to reduce dysbiosis, and reduction of complications in post-operated patients. Potential uses of probiotics include the reduction of disease initiation and progression by reducing local inflammation caused by bacteria and other organisms.
CONCLUSION
The incidence and severity of RIOM may be lessened by probiotics. To establish its uses in additional clinical settings, though, more studies are necessary.
Topics: Humans; Probiotics; Head and Neck Neoplasms; Prebiotics; Synbiotics; Stomatitis
PubMed: 36788699
DOI: 10.2174/1389201024666230213094953 -
Lancet (London, England) Apr 2017
Topics: Adult; Colitis, Ulcerative; Diagnosis, Differential; Foot Ulcer; Humans; Male; Paronychia; Pyoderma; Stomatitis; Toes; Wound Healing
PubMed: 28017401
DOI: 10.1016/S0140-6736(16)32400-X -
Supportive Care in Cancer : Official... Nov 2022To evaluate the effectiveness of antioxidants in the prevention and management of oral mucositis in adults undergoing radiotherapy and/or chemotherapy with diagnosed... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate the effectiveness of antioxidants in the prevention and management of oral mucositis in adults undergoing radiotherapy and/or chemotherapy with diagnosed head and neck cancer (HNC) compared to placebo intervention.
METHODS
Cochrane, EMBASE, PubMed, and Web of Science databases were used to search for randomized controlled trials (RCTs) comparing oral or topical antioxidants with placebo in clinically diagnosed HNC adult patients receiving radiotherapy with/without chemotherapy. The primary outcome was to assess the efficacy of the antioxidant to prevent and decrease the incidence/prevalence and severity of oral/oropharyngeal mucositis. The risk of bias was assessed following Cochrane's guidelines.
RESULTS
The database search resulted in 203 records up to February 19, 2021. Thirteen RCTs were included with 650 HNC-diagnosed patients. Included studies showed a statistically significant improvement in mucositis severity score for all antioxidants except melatonin. However, further studies are needed as only one study reported outcomes for zinc, propolis, curcumin, and silymarin. Patients receiving vitamin E were 60% less likely to develop severe mucositis grade 2 or higher than those receiving placebo in one study (P = 0.040). Patients receiving zinc were 95% less likely to develop severe mucositis (grades 3-4) in one study compared to placebo (P = 0.031). One meta-analysis showed no statistical difference in the risk of having severe mucositis (grades 3-4) with 199 patients compared to placebo for honey (n = 2 studies, P = 0.403). Meta-analyses could not be conducted for zinc, propolis, curcumin, melatonin, silymarin, and selenium due to the lack of studies reporting similar outcomes for the same intervention.
CONCLUSION
Though oral and topical antioxidants significantly improved mucositis severity scores in HNC patients receiving radiotherapy with/without chemotherapy in individual studies, the quality of the evidence was low due to the small number of studies and unclear/high-risk bias. Additionally, large RCTs are needed to confirm these results.
Topics: Adult; Humans; Antioxidants; Mucositis; Curcumin; Propolis; Melatonin; Stomatitis; Head and Neck Neoplasms; Silymarin; Zinc
PubMed: 35680672
DOI: 10.1007/s00520-022-07190-4 -
The Journal of Dermatology Jun 2022Toothpastes are one of the most common personal care products among people of all ages. The various toothpaste types and their complex ingredients could cause irritation...
Toothpastes are one of the most common personal care products among people of all ages. The various toothpaste types and their complex ingredients could cause irritation or allergic reactions. Allergic contact stomatitis has been often seen in clinical practice; however, desensitizing toothpastes as a trigger are often unrecognized. Here, we report three cases of allergic contact stomatitis due to stannous chloride-containing desensitizing toothpastes. General dentists and other professionals should pay more attention to the safety and adverse effects of toothpastes.
Topics: Humans; Hypersensitivity; Inflammation; Stomatitis; Toothpastes
PubMed: 35261076
DOI: 10.1111/1346-8138.16338 -
Military Medicine Mar 2017We report a case of a type IV hypersensitivity reaction causing oral stomatitis, presumed to be the result of common dental adhesives. The case was diagnosed using patch...
We report a case of a type IV hypersensitivity reaction causing oral stomatitis, presumed to be the result of common dental adhesives. The case was diagnosed using patch testing to the dental adhesives that were used in the patient. Both of the adhesives tested contained a form of acrylate that is being seen more frequently in the literature as a cause of type IV hypersensitivity reactions. Metals can cause allergic reactions; however, other contact items need to be considered as a cause of oral allergic reactions. Cases of allergic stomatitis are rising and there is question if all-in-one adhesives may be contributing to this rise.
Topics: Dental Cements; Humans; Hypersensitivity; Male; Oral Ulcer; Patch Tests; Stomatitis; Young Adult
PubMed: 28290980
DOI: 10.7205/MILMED-D-16-00232