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Brazilian Journal of Otorhinolaryngology 2007Increasing the intensity of radiation therapy and chemotherapy in the management of cancer has increased the incidence of adverse effects, especially oral mucositis. (Review)
Review
UNLABELLED
Increasing the intensity of radiation therapy and chemotherapy in the management of cancer has increased the incidence of adverse effects, especially oral mucositis.
AIM AND METHODS
a bibliographical review was conducted on the definition of oral mucositis, its clinical findings, the incidence, its etiology, the pathophysiology, associated morbidity, prevention and treatment.
RESULTS
current studies define oral mucositis as a very frequent and painful inflammation with ulcers on the oral mucosa that are covered by a pseudo membrane. The incidence and severity of lesions are influenced by patient and treatment variables. Oral mucositis is a result of two major mechanisms: direct toxicity on the mucosa and myelosuppression due to the treatment. Its pathophysiology is composed of four interdependent phases: an initial inflammatory/vascular phase; an epithelial phase; an ulcerative/bacteriological phase; and a healing phase. It is considered a potential source of life-threatening infection and often is a dose-limiting factor in anticancer therapy. Some interventions have been shown to be potentially effective to prevent and treat oral mucositis. Further intensive research through well-structured clinical trials to obtain the best scientific evidence over the standard therapy of oral mucositis is necessary to attain ideal parameters for radiotherapy and chemotherapy.
Topics: Antineoplastic Agents; Humans; Mouth Mucosa; Neoplasms; Radiotherapy; Stomatitis
PubMed: 17923929
DOI: 10.1016/s1808-8694(15)30110-5 -
BMC Cancer Mar 2018The aim of the present study was to evaluate the physical properties of "admixture paste", which is a commercially available gel containing hinokitiol for use against...
BACKGROUND
The aim of the present study was to evaluate the physical properties of "admixture paste", which is a commercially available gel containing hinokitiol for use against severe stomatitis, and its characteristics as a moisturizing gel and denture adhesive.
METHODS
The admixture paste, which contained dexamethasone (Dexaltin®), gel for oral care (Refrecare H®) and petrolatum, and its 3 components, either alone or in different combinations, were subjected to viscosity, adhesiveness and elution testing to compare their physical properties. Viscosity was measured with a stress-controlled rheometer. Adhesive force was measured by tension test. Elution under a simulated oral environment was evaluated by monitoring with a fixed-point camera and absorbance. Both adhesiveness and elution were evaluated every hour for 6 h. A linear mixed-effects model was used to assess differences in the time course of elution between samples. In 3 og-rank test was used to compare time to elution into saliva among samples.
RESULTS
The results of viscosity testing demonstrated that the admixture paste had similar viscosity to cream-type denture adhesives and this was temperature independent. In the adhesiveness tests, the admixture paste showed stronger adhesiveness than that of cream-type denture adhesives. In the elution test, the admixture paste demonstrated gradual dissolution and apparent temporal changes for 6 h in a simulated oral environment.
CONCLUSIONS
The results of the present study demonstrated that the admixture paste has adhesive force similar to those of denture adhesives and good local retention in saliva, and that it might be suitable for therapeutic use in patients with severe stomatitis derived from radiotherapy and/or chemotherapy for cancer.
Topics: Adhesives; Administration, Oral; Chemoradiotherapy; Dexamethasone; Drug Liberation; Follow-Up Studies; Head and Neck Neoplasms; Humans; Prognosis; Stomatitis; Viscosity
PubMed: 29499657
DOI: 10.1186/s12885-018-4017-2 -
Supportive Care in Cancer : Official... Oct 2021To discuss the role of benzydamine in the prevention and treatment of radiation-induced oral mucositis (OM) in head and neck (H&N) cancer patients. This document...
PURPOSE
To discuss the role of benzydamine in the prevention and treatment of radiation-induced oral mucositis (OM) in head and neck (H&N) cancer patients. This document represents an expert opinion paper on indications and key-role aspects in OM pathogenesis, prevention and treatment.
ORAL MUCOSITIS
OM represents a common side effect of chemotherapy (CHT) and radiotherapy (RT). It consists in a painful erythema involving the oral cavity mucosa, which may progress to ulceration. Five biologically dynamic phases are considered crucial in mucositis: "initiation, signalling, amplification, ulceration and healing". Oral environment and microbiota are fundamental in mucositis development being involved in susceptibility to infections and in ulceration consequences. Different agents against mucositis have been studied and the use of benzydamine is strongly supported in literature. The Multinational Association of Supportive Care in Cancer and International Society for Oral Oncology (MASCC/ISOO) guidelines recommend its use for the prevention of OM in H&N patients undergoing RT and RT/CHT.
BENZYDAMINE
Benzydamine is a local anti-inflammatory drug with analgesic properties. It can decrease TNF-α, IL-1β and prostaglandin synthesis, also inhibiting leukocyte-endothelial interactions, neutrophil degranulation, vasodilation and vascular permeability. Literature agrees on the beneficial effects of benzydamine in preventing and reducing oral mucositis severity in H&N cancer patients undergoing RT/CHT.
CONCLUSIONS
Mucositis represents a major concern in H&N cancer patients and a clinical and economical issue. A multimodal and multidisciplinary approach is needed for its management. International guidelines recommend benzydamine for OM prevention and treatment in H&N cancer patients, but further "real world" trials should be designed.
Topics: Benzydamine; Chemoradiotherapy; Head and Neck Neoplasms; Humans; Mucositis; Stomatitis
PubMed: 33649918
DOI: 10.1007/s00520-021-06048-5 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2009Pyostomatitis vegetans (PV) is a rare condition characterized by pustules that affect the oral mucosa. It is a highly specific marker for inflammatory bowel disease and... (Review)
Review
Pyostomatitis vegetans (PV) is a rare condition characterized by pustules that affect the oral mucosa. It is a highly specific marker for inflammatory bowel disease and its correct recognition may lead to the diagnosis of ulcerative colitis or Crohn's disease. Thus, a presumptive diagnosis of PV should suggest a complete gastrointestinal investigation. PV pathogenesis is as yet unknown, although immunological and microbial factors have been suggested as possible aetiological factors. Pyostomatitis vegetans is characterized by erythematous, thickened oral mucosa with multiple pustules and superficial erosions. A peripheral eosinophilia has been observed in most cases reported. Histology shows epithelial acanthosis and superficial ulceration with intraepithelial and / or subepithelial abscesses containing large numbers of eosinophils. The underlying connective tissue exhibits neutrophil and eosinophil infiltration, with miliary abscesses in some cases. Treatment of PV focuses on control of the underlying disease.
Topics: Humans; Stomatitis; Suppuration
PubMed: 19242389
DOI: No ID Found -
Alimentary Pharmacology & Therapeutics Nov 2003Chemotherapy and radiotherapy, whilst highly effective in the treatment of neoplasia, can also cause damage to healthy tissue. In particular, the alimentary tract may be... (Review)
Review
Chemotherapy and radiotherapy, whilst highly effective in the treatment of neoplasia, can also cause damage to healthy tissue. In particular, the alimentary tract may be badly affected. Severe inflammation, lesioning and ulceration can occur. Patients may experience intense pain, nausea and gastro-enteritis. They are also highly susceptible to infection. The disorder (mucositis) is a dose-limiting toxicity of therapy and affects around 500 000 patients world-wide annually. Oral and intestinal mucositis is multi-factorial in nature. The disruption or loss of rapidly dividing epithelial progenitor cells is a trigger for the onset of the disorder. However, the actual dysfunction that manifests and its severity and duration are greatly influenced by changes in other cell populations, immune responses and the effects of oral/gut flora. This complexity has hampered the development of effective palliative or preventative measures. Recent studies have concentrated on the use of bioactive/growth factors, hormones or interleukins to modify epithelial metabolism and reduce the susceptibility of the tract to mucositis. Some of these treatments appear to have considerable potential and are at present under clinical evaluation. This overview deals with the cellular changes and host responses that may lead to the development of mucositis of the oral cavity and gastrointestinal tract, and the potential of existing and novel palliative measures to limit or prevent the disorder. Presently available treatments do not prevent mucositis, but can limit its severity if used in combination. Poor oral health and existing epithelial damage predispose patients to mucositis. The elimination of dental problems or the minimization of existing damage to the alimentary tract, prior to the commencement of therapy, lowers their susceptibility. Measures that reduce the flora of the tract, before therapy, can also be helpful. Increased production of free radicals and the induction of inflammation are early events in the onset of mucositis. Prophylactic administration of scavengers or anti-inflammatories can partially counteract or limit some of these therapy-mediated effects, as can the use of cryotherapy. The regular use of mouthwashes, mouth coatings, antibiotics and analgesics is essential, prior to and during loss and ablation of the epithelial layer. Granulocyte-macrophage colony-stimulating factor/granulocyte colony-stimulating factor or the use of laser light therapy may aid restitution and repair. Glutamine supplements may be beneficial in the repair/recovery phase.
Topics: Age Factors; Cytokines; Gastroenteritis; Gastrointestinal Agents; Humans; Intestinal Mucosa; Intestine, Large; Intestine, Small; Mouth Mucosa; Risk Factors; Sex Factors; Stomatitis
PubMed: 14616150
DOI: 10.1046/j.1365-2036.2003.01784.x -
BMC Oral Health Oct 2021Nattokinase (NK) is a promising alternative in the prevention and treatment of cardiovascular diseases due to its potent fibrinolytic activity. In this study, we...
BACKGROUND
Nattokinase (NK) is a promising alternative in the prevention and treatment of cardiovascular diseases due to its potent fibrinolytic activity. In this study, we investigated the effect of crude nattokinase extract on the healing of acetic acid-induced oral mucositis in mice.
METHODS
Bacillus subtilis culture media (BSCM) was isolated into the supernatant, named nattokinase crude extract (NCE), and the pellet was named Bacillus subtilis mass (BSM). An oral mucositis model was established in mice by applying 50% glacial acetic acid to the buccal mucosa. According to the treatment conditions, the mice were divided into BSCM, NCE, BSM and phosphate buffered saline (PBS) groups. The weight of the mice, oral mucositis healing score and histopathological examination were used to evaluate the treatment.
RESULTS
Fibrinolytic activities of BSCM, NCE and BSM were approximately 8069, 10,800 and 80 U/ml, respectively. The weight gain of mice in the NCE group was significantly different from the PBS group after three days' treatment (p < 0.05). The oral mucositis score of NCE group was significantly higher than other groups (p < 0.05). The differences in histopathology scores between the NCE and other groups were statistically significant (p < 0.01).
CONCLUSIONS
NCE could possess remarkable potential to reduce pain and promote oral mucositis healing with minimal safety concerns. In this study, we first report that NCE from the supernatant of Bacillus subtilis can promote the healing of oral mucositis, which extends the application scope of NK.
Topics: Animals; Complex Mixtures; Fermentation; Mice; Stomatitis; Subtilisins
PubMed: 34717590
DOI: 10.1186/s12903-021-01914-4 -
Medicina (Kaunas, Lithuania) Aug 2023Oral mucositis is a common and debilitating side effect induced by stem cell transplantation that is experienced by cancer patients undergoing chemotherapy or radiation... (Meta-Analysis)
Meta-Analysis Review
Oral mucositis is a common and debilitating side effect induced by stem cell transplantation that is experienced by cancer patients undergoing chemotherapy or radiation therapy. This condition involves inflammation and ulceration of the oral mucosa, leading to pain, difficulty with eating and speaking, and an increased risk of infections. Mucositis not only compromises the quality of life for cancer patients, but also affects treatment outcomes and may necessitate dose reductions or treatment delays. This scientific article provides a comprehensive overview of mucositis. The purpose of this literature review with a meta-analysis is to evaluate the efficacy of laser therapy in treating post-transplant mucositis. : A search of the literature from 3 May 2023 was carried out on three online databases, PubMed, Scopus, and Web of Science. Only studies that treated patients with laser therapy were considered; only studies with the placebo-treated control group were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the std. mean difference between the two groups (laser and placebo). : There were 230 papers included in this review. Two hundred twenty-seven were excluded. Furthermore, a manual search was performed. After the search phase, three articles were considered in the study. The overall effect showed differences in the degree of mucositis in the laser-treated patients compared with the placebo group. The meta-analysis shows a reduction in the degree of mucositis in the patients treated with laser therapy (std. mean difference -1.34 [-1.98; -0.98]; C.I. 95%). : The application of laser therapy results in decreased severity of oral mucositis from radiation and chemotherapy. Our study shows that the application of low-level laser therapy in the treatment of transplant mucositis has excellent efficacy in relieving the symptoms and severity of mucositis.
Topics: Humans; Hematopoietic Stem Cell Transplantation; Low-Level Light Therapy; Quality of Life; Stomatitis
PubMed: 37629703
DOI: 10.3390/medicina59081413 -
BMJ Case Reports May 2021Recurrent aphthous ulcers are the most prevalent oral mucosal disease, but the subset major aphthous ulcer is a less frequent type. These ulcers are refractory, may...
Recurrent aphthous ulcers are the most prevalent oral mucosal disease, but the subset major aphthous ulcer is a less frequent type. These ulcers are refractory, may persist for several weeks to months, and interfere with the normal state of health. The aetiology is multifactorial and so is the treatment. We present a case of an adolescent male patient reported with multiple oral ulcers. He developed three ulcers simultaneously and suffered for 10 months despite using topical medications prescribed by different dental practitioners. We executed a multidisciplinary treatment approach that resulted in a long-term disease-free state. The treatment methods followed in our case could be a successful model to implement by medical practitioners and oral physicians when the situation demands.
Topics: Adolescent; Dentists; Humans; Male; Oral Ulcer; Professional Role; Stomatitis, Aphthous
PubMed: 33986008
DOI: 10.1136/bcr-2020-241010 -
Brazilian Oral Research 2019The objective of this paper was to evaluate the current evidence reporting on the prevalence of peri-implantitis and to determine the influencing factors. An electronic... (Review)
Review
The objective of this paper was to evaluate the current evidence reporting on the prevalence of peri-implantitis and to determine the influencing factors. An electronic search for articles published until February 2019 reporting on the prevalence of peri-implantitis was performed in MEDLINE. Included criteria were published in international peer-reviewed journals, written in English language, reported on the prevalence of peri-implantitis, included implants with a minimum follow-up of one year after functional loading and used a clear definition for peri-implantitis and/or peri-implant mucositis with a clear cutoff for bone level changes according to the case definitions of Sanz and Chapple and Berglundh et al. 2018. Included papers were anaylized for factors affecting the reported prevalences for peri-implantitis. Twenty-five papers were included in the present review and a wide range for the reported prevalence of peri-implantitis was seen. Case definitions for peri-implantitis with various thresholds for bone loss together with the type of reporting on patient- or implant-level were the most significant factors that lead to a large variety of the occurrence of the disease. Additionally, follow-up time and the evaluation in a certain "convenience" population may have influenced the prevalence values. In conclusion, it can be stated that a wide range for reporting the prevalence of peri-implantitis can be found and no real estimation of the global burden of the disease can be made. Applying accurate case definitions for peri-implantitis is the most important factor for reporting the prevalence and should be strictly followed in future reports.
Topics: Humans; Peri-Implantitis; Prevalence; Risk Factors; Stomatitis
PubMed: 31576947
DOI: 10.1590/1807-3107bor-2019.vol33.0063 -
Journal of Feline Medicine and Surgery Aug 2023Feline chronic gingivostomatitis (FCGS) is a painful, immune-mediated, oral mucosal inflammatory disease in cats. The etiology of FCGS remains unclear, with evidence... (Review)
Review
Feline chronic gingivostomatitis (FCGS) is a painful, immune-mediated, oral mucosal inflammatory disease in cats. The etiology of FCGS remains unclear, with evidence pointing potentially toward a viral cause. Full-mouth tooth extraction is the current standard of care, and cats that are non-responsive to extraction therapy may need lifelong medical management and, in some cases, euthanasia. Adipose-derived mesenchymal stromal cells (adMSCs) have been demonstrated to have advantages in the treatment and potentially the cure of non-responsive FCGS in cats. Therefore, adMSCs have attracted a series of ongoing clinical trials in the past decade. AdMSC therapy immediately after full-mouth tooth extraction was not explored, and we postulate that it may benefit the overall success rate of FCGS therapy. Here, we aim to summarize the current knowledge and impact of adMSCs for the therapeutic management of FCGS and to suggest a novel modified approach to further increase the efficacy of FCGS treatment in cats.
Topics: Cats; Animals; Stomatitis; Stromal Cells; Cat Diseases
PubMed: 37548494
DOI: 10.1177/1098612X231185395