RESUMEN
This network meta-analysis aims to compare the clinical efficacy of seven non-surgical therapies for peri-implant disease, including laser treatment, photobiomodulation therapy (PBMT), photodynamic therapy (PDT), systemic antibiotics (SA), probiotics, local antimicrobials (LA), and air-powder polishing (APP) combined with mechanical debridement (MD). We conducted searches in four electronic databases, namely PubMed, Embase, Web of Science, and The Cochrane Library, to identify randomized controlled trials of non-surgical treatments combined with MD for individuals (aged at least 18 years) diagnosed with peri-implantitis or peri-implant mucositis with a minimum of 3 months follow-up. The outcomes of the study were the reduction in pocket probing depth (PPD) and bleeding on probing (BoP), plaque index (PLI), clinical attachment level (CAL), and marginal bone loss (MBL). We employed a frequency random effects network meta-analysis model to combine the effect sizes of the trials using standardized mean difference (SMD) and 95% confidence intervals (CIs). Network meta-analyses include network plots, paired comparison forest plots, league tables, funnel plots, surface under the cumulative ranking area (SUCRA) plots, and sensitivity analysis plots. The results showed that, for peri-implantitis, PBMT +MD demonstrated the highest effect in improving PPD (SUCRA = 75.3%), SA +MD showed the highest effect in improving CAL (SUCRA = 87.4%, SMD = 2.20, and 95% CI: 0.38 to 4.02) and MBL (SUCRA = 99.9%, SMD = 3.92, and 95% CI. 2.90 to 4.93), compared to MD alone. For peri-implant mucositis, probiotics +MD demonstrated the highest effect in improving PPD (SUCRA = 100%) and PLI (SUCRA = 83.2%), SA +MD showed the highest effect in improving BoP (SUCRA = 88.1%, SMD = 0.77, and 95% CI: 0.27 to 1.28), compared to MD alone. Despite the ranking established by our study in the treatment of peri-implant disease, decisions should still be made with reference to the latest treatment guidelines. There is still a need for more high-quality studies to provide conclusive evidence and especially a need for studies regarding direct comparisons between multiple treatment options.
Asunto(s)
Desbridamiento , Periimplantitis , Humanos , Periimplantitis/terapia , Desbridamiento/métodos , Metaanálisis en Red , Resultado del Tratamiento , Fotoquimioterapia/métodos , Probióticos/uso terapéutico , Antibacterianos/uso terapéutico , Implantes Dentales/efectos adversos , Estomatitis/terapia , Estomatitis/radioterapia , Estomatitis/etiología , Mucositis/terapia , Terapia por Láser/métodosRESUMEN
Plasma cell mucositis (PCM) is an unusual disorder most evident in the accessible mucosa and usually reported in the upper aerodigestive tract, although it is named according to its specific anatomical site of involvement such as plasma cell cheilitis, plasma cell gingivitis, plasma cell vulvitis, and Zoon's balanitis. PCM reflects a dense polyclonal rather than a monoclonal plasma cell proliferation of unclear and unknown etiology. This perplexing disorder tends to be treated by avoiding possible triggers and intralesional and/or systemic steroids. In this work, we provide a review and update on PCM, which often represents a clinical conundrum.
Asunto(s)
Mucositis , Células Plasmáticas , Humanos , Mucositis/terapia , Mucositis/etiología , Mucositis/diagnóstico , Células Plasmáticas/patologíaRESUMEN
Many clinical studies have now highlighted how the composition of the intestinal microbiota can regulate the effects of many oncological therapies. In particular, the modulation of microbial composition has been shown to enhance their efficacy and reduce potential side effects. Numerous adverse events induced by chemotherapy and radiotherapy appear to be strongly associated with an alteration in the intestinal microbiota caused by these treatments. This supports the hypothesis that the modulation or correction of the microbiota may decrease the toxic impact of therapies, improving patient compliance and quality of life. Among the most debilitating disorders related to oncological treatments is certainly mucositis, and recent clinical data highlight how the deficiency of short-chain fatty acids, especially butyrate, and specifically the lack of certain bacterial groups responsible for its production (butyrate producers), is strongly associated with this disorder. It is hypothesized that restoring these elements may influence the onset and severity of adverse events. Therefore, the intake of probiotics, especially butyrate producers, and specifically Clostridium butyricum (CBM588), currently the only cultivable and usable strain with a history of data proving its safety, could be a valuable ally in oncological therapies, reducing the associated discomfort and improving compliance, efficacy, and quality of life for patients.
Asunto(s)
Mucositis , Probióticos , Humanos , Butiratos/uso terapéutico , Mucositis/inducido químicamente , Mucositis/terapia , Calidad de Vida , Probióticos/farmacología , Quimioradioterapia/efectos adversosRESUMEN
BACKGROUND: This descriptive study aims to examine the complications that might develop in patients who receive enteral or parenteral nutrition treatment in intensive care unit in this process and to examine the nutritional status, oral mucositis, and gastrointestinal system symptoms among patients who receive enteral or parenteral nutrition treatment in intensive care unit. MATERIALS AND METHODS: A sample of this study consists of 104 patients who received enteral or parenteral nutrition treatment in intensive care units between January and June 2019. The data were collected face to face by using Sociodemographic Form, constipation severity scale, Mini Nutritional Assessment Scale, Mucositis Assessment Scale, visual analog scale, and gastrointestinal system Symptoms Scale. The results were calculated as numbers, percentage, SD, and mean values. RESULTS: Among the participating patients, 67.4% were older than 65 years, 55.8% were female, 42.3% were receiving treatment in internal medicine intensive care units, and 43.4% had severe mucositis. It was determined that 31.7% of the patients receiving treatment in intensive care units required nutrition treatment. It was determined that patients receiving parenteral nutrition had more symptoms such as gastrointestinal system symptoms, mucositis, constipation, and colonic inertia. CONCLUSIONS: It was determined that when compared to the patients receiving enteral nutrition, the patients receiving parenteral nutrition had higher scores in mucositis, visual analog scale pain, Mini Nutritional Assessment Test, constipation, obstructive defecation, colonic inertia, and gastrointestinal symptom total scores.
Asunto(s)
Mucositis , Estomatitis , Humanos , Femenino , Masculino , Estado Nutricional , Mucositis/etiología , Mucositis/terapia , Nutrición Parenteral/efectos adversos , Nutrición Parenteral/métodos , Unidades de Cuidados Intensivos , Estreñimiento/etiología , Estreñimiento/terapiaRESUMEN
OBJECTIVE: The objective of the study was to compare resolution of inflammation of naturally occurring peri-implant mucositis (PM) at tissue-level (TL) and bone-level (BL) implants after non-surgical mechanical debridement. MATERIALS AND METHODS: Fifty-four patients with 74 Implants with PM were allocated in two groups (39 TL and 35 BL implants) and treated by means of subgingival debridement using a sonic scaler with a plastic tip without adjunctive measures. At baseline and at 1, 3, 6 months, the full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), bleeding on probing (BOP), and modified plaque index (mPlI) were recorded. The primary outcome was BOP change. RESULTS: After 6 months, the FMPS, FMBS, PD, and number of implants with plaque decreased statistically significantly in each group (p < .05); however, no statistically significant differences were found between TL and BL implants (p > .05). After 6 months, 17 (43.6%) TL and 14 (40%) BL implants showed a BOP change in (17.9%) and (11.4%), respectively. No statistical difference was recorded between groups. CONCLUSIONS: Within the limitations of present study, the findings showed no statistically significant differences in terms of changes in clinical parameters following non-surgical mechanical treatment of PM at TL and BL implants. A complete resolution of PM (i.e., no BOP at all implant sites) was not achieved in both groups.
Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Humanos , Mucositis/terapia , Mucositis/tratamiento farmacológico , Implantes Dentales/efectos adversos , Estudios Prospectivos , Índice Periodontal , Periimplantitis/tratamiento farmacológicoRESUMEN
AIM: To answer the following PICO question: In systemically healthy humans with peri-implant mucositis, what is the efficacy of patient-performed or administered (by prescription) measures used adjunctively to submarginal instrumentation, as compared to submarginal instrumentation alone or combined with a negative control, in terms of reducing bleeding on probing (BOP), in randomized controlled clinical trials (RCTs) with at least 3 months of follow-up? MATERIALS AND METHODS: Three databases were searched until April 2022. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) and predictive intervals were calculated. RESULTS: Sixteen parallel RCTs corresponding to 14 studies with low/moderate risk of bias were included. Test groups showed greater reductions in BOP (%) than control groups (nstudies = 16; npatients = 650; WMD = 14.25%; 95% CI [9.06-19.45]; p < .001; I2 = 98.7%). The greatest WMD in BOP reductions (%) were obtained by antiseptics (ns = 5; np = 229; WMD = 22.72%; 95% CI [19.40-26.04]; p < 0.001; I2 = 94.8%), followed by probiotics (ns = 6; np = 260; WMD = 12.11%; 95% CI [3.20-21.03]; p = .008; I2 = 93.3%) and systemic antibiotics (ns = 3; np = 101; WMD = 5.97%; 95% CI [1.34-10.59]; p = .012; I2 = 58.1%). Disease resolution was scarcely reported (n = 6). CONCLUSIONS: Significant clinical improvements can be obtained when professional submarginal instrumentation is combined with patient-performed or administered (by prescription) adjunctive measures, although a complete disease resolution may not be achieved.
Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Estomatitis , Humanos , Estomatitis/etiología , Estomatitis/terapia , Mucositis/etiología , Mucositis/terapia , Periimplantitis/prevención & control , Atención OdontológicaRESUMEN
BACKGROUND: The recent publication of the new classification of periodontal and peri-implant disease has given clear indications on the parameters to be taken into consideration to correctly diagnose the different phases of these diseases. To date, however, there are no equally clear indications on the treatments to be implemented to solve these diseases. The objective of this Consensus Report is to provide guidance for the non-surgical management of peri-implant mucositis and peri-implantitis. For the drafting of the consensus, the most recent scientific literature was analysed. MATERIALS AND METHODS: A group of 15 expert Italian dental hygienists were selected by the Italian technical-scientific societies (AIDI, UNID and ATASIO) and, starting from the literature review, they formulated indications according to the GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation, a tool for rating the quality of evidence, used to draw up systematic reviews and clinical guidelines) on the treatment of peri-implant mucositis, peri-implantitis and on management of the various implanting surfaces. CONCLUSIONS: in accordance with the international literature, non-surgical therapy alone can resolve peri-implant mucositis, but not peri-implantitis. Several adjunctive therapies have been considered and some appear to be helpful in managing inflammation.
Asunto(s)
Mucositis , Periimplantitis , Humanos , Consenso , Higienistas Dentales , Mucositis/terapia , Higiene Bucal , Periimplantitis/terapiaRESUMEN
Plasma cell mucositis (PCM) is an unusual disorder most evident in the accessible mucosa and usually reported in the upper aerodigestive tract, although it is named according to its specific anatomical site of involvement, such as plasma cell cheilitis, plasma cell gingivitis, plasma cell vulvitis, and Zoon's balanitis. PCM reflects a dense polyclonal, rather than a monoclonal, plasma cell proliferation of unclear and unknown etiology. This perplexing disorder tends to be treated by avoiding possible triggers and intralesional and/or systemic steroids. Herein we review and provide an update on PCM, which often represents a clinical conundrum.
Asunto(s)
Mucositis , Células Plasmáticas , Humanos , Mucositis/terapia , Mucositis/etiología , Mucositis/diagnóstico , Células Plasmáticas/patologíaRESUMEN
Almost all cancer therapies lead to a wide array of side effects, owing to the disruption of normal physiological processes and alteration of immunological responses. Of these, mucositis is one of the most commonly encountered side effects, presenting in about 20-40% of all patients receiving chemotherapy and 80% of those being treated with radiotherapy for head and neck malignancies. This article provides a brief introduction and comprehensive overview of the various treatment modalities used in managing this complication. The key to management is a multidisciplinary approach, revolving around pain control, oral hygiene, nutritional support and management of superimposed infection. The scarcity of therapeutic options for prevention or treatment of mucositis has resulted in clinical difficulty in controlling it, which, in turn, seriously affects the patient's quality of life and cancer management, contributing to patient morbidity and mortality.
Asunto(s)
Antineoplásicos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Neoplasias de Cabeza y Cuello , Mucositis , Estomatitis , Antineoplásicos/efectos adversos , Neoplasias de Cabeza y Cuello/terapia , Humanos , Mucositis/inducido químicamente , Mucositis/terapia , Calidad de Vida , Estomatitis/inducido químicamente , Estomatitis/terapiaRESUMEN
PURPOSE: This study aimed to explore the practices of oncology nurses in the management of chemotherapy-related oral mucositis (OM) by MASCC/ISOO guidelines. METHODS: This descriptive and cross-sectional study was conducted between December 25, 2021, and January 31, 2022, with 157 oncology nurses in Turkey. Data were collected through OM Practices Assessment Form. RESULTS: The mean age of the nurses was 29.05 ± 7.40, the majority (90.4%) of them were female and 76.4% of them have a Bachelor's degree. More of the nurses (59.9%) had a written protocol for managing OM in their institutions, 38.9% of them used the MASCC/ISOO guideline, and 63.0% of them used an OM assessment scale. Most of the nurses (99.4%) recommended mouthwash to patients and 65.6% of them recommended mouthwash four times and more a day. 54.1% of the nurses recommended saline (%10.8) or carbonate (%36.9) or a mixture of saline and carbonate (%6.4) solutions for mouthwash. Despite the lack of sufficient evidence in the MASCC/ISOO guidelines regarding black mulberry syrup, 45.2% of the nurses recommended it for the prevention of OM and 43.3% of them suggested the treatment of mucositis. It was found that 82.0% of nurses who followed MASCC/ISOO guidelines recommended to patients implement oral care four times and more a day, while 55.2% of them who did not follow MASCC/ISOO guidelines recommended four times and more a day. The difference was found to be statistically significant (χ2 = 11.836; p = 0.01). CONCLUSION: It was determined that there were deficiencies in the implementation of written protocols for OM and the use of guidelines, and there were differences between the frequency of oral care, oral care products, and the practices of nurses in the prevention and treatment of OM.
Asunto(s)
Mucositis , Neoplasias , Estomatitis , Humanos , Femenino , Masculino , Estudios Transversales , Enfermería Oncológica , Antisépticos Bucales/uso terapéutico , Estomatitis/inducido químicamente , Estomatitis/tratamiento farmacológico , Estomatitis/prevención & control , Mucositis/terapiaRESUMEN
AIM: To evaluate the clinical outcome and the associated factors of a treatment protocol for peri-implant mucositis. MATERIALS AND METHODS: Patients were evaluated 30 months after a treatment protocol including professional mechanical debridement and modification of the prosthesis contours to improve access for biofilm control. Clinical performance was assessed by means of probing with an electronic pressure-calibrated periodontal probe. The possible impact of implant- and patient-level factors on the changes in peri-implant mucosal inflammation measured with the modified bleeding index (mBI) was evaluated. RESULTS: Twenty patients and 61 implants were included in the analysis. At the final visit, 50% of the patients presented bleeding on probing, with a mean mBI of 0.22 (SD 0.27). The adjusted linear regression model showed a significant association between patient's compliance with supportive care visits (p = .006) and mucosal inflammation. Similarly, at the implant level, modified plaque index (p < .001) and an irregular use of interdental brushes (p = .017) had a significant impact on final mBI. CONCLUSIONS: Prosthesis modification when needed in association with non-surgical treatment may be an important intervention in the treatment of peri-implant mucositis. Compliance with supportive care visits and the regular use of inter-dental brushes were identified as important factors to achieve mucosal inflammation control.
Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Estomatitis , Humanos , Mucositis/etiología , Mucositis/terapia , Desbridamiento , Estudios de Seguimiento , Estomatitis/etiología , Estomatitis/terapia , Implantes Dentales/efectos adversos , Periimplantitis/terapia , InflamaciónRESUMEN
BACKGROUND: The present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM. METHODS: Patients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01. RESULTS: Twenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2. CONCLUSIONS: The AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.
Asunto(s)
Implantes Dentales , Mucina 4 , Periimplantitis , Saliva , alfa-Amilasas Salivales , Estomatitis , Biomarcadores/análisis , Desbridamiento , Implantes Dentales/efectos adversos , Humanos , Mucina 4/análisis , Mucositis/etiología , Mucositis/metabolismo , Mucositis/terapia , Periimplantitis/etiología , Periimplantitis/metabolismo , Periimplantitis/terapia , Saliva/química , alfa-Amilasas Salivales/análisis , Estomatitis/etiología , Estomatitis/metabolismo , Estomatitis/terapiaRESUMEN
AIM: This randomized placebo-controlled clinical trial evaluated the effects of multispecies probiotic containing Lactobacillus rhamnosus HN001™, Lactobacillus paracasei Lpc-37®, and Bifidobacterium animalis subsp lactis HN019™ as an adjunct to mechanical debridement (MD) on changes in bleeding on probing (BOP) in edentulous patients with peri-implant mucositis (PiM). MATERIALS AND METHODS: Patients were randomly assigned to test (probiotic) or control (placebo) groups. All sites with PiM received MD and topical gel application (probiotic or placebo) at baseline and 12 weeks. After initial MD, patients consumed probiotic or placebo capsules twice a day for 12 weeks. Clinical (modified sulcus bleeding index [mSBI]; modified plaque index [mPI]; probing depth [PD]; and BOP) and immunological parameters were collected at baseline and after 12 and 24 weeks. Data were statistically analysed (p < .05). RESULTS: Thirty-six patients with PiM were recruited. The test group presented higher prevalence (p < .05) of cases of restored peri-implant health at 24 weeks than did the control group (72.2% and 33.3%, respectively). No significant difference was observed between test (n = 18) and control (n = 18) groups for mPI and PD. mSBI %-score 0 was higher in the test group than in the control group at 24 weeks (p < .05). When compared with baseline, both groups presented reduced BOP at 12 and 24 weeks (p < .05). BOP was lower in the test group than in the control group at 12 (mean difference = -14.54%; 95% confidence interval [CI] = -28.87 to 0.22; p = .0163) and 24 (mean difference = -12.56%; 95% CI = -26.51 to 1.37; p = .0090) weeks. At 24 weeks, only the test group presented lower levels of interleukin (IL)-1ß, IL-6, IL-8, and tumour necrosis factor (TNF)-α than those at baseline (p < .05). CONCLUSIONS: The multispecies probiotic (administered locally and systemically) containing L. rhamnosus HN001™, L. paracasei Lpc-37®, and B. lactis HN019™ as an adjunct to repeated MD promotes additional clinical and immunological benefits in the treatment of PiM in edentulous patients (ClinicalTrials.gov NCT04187222).
Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Probióticos , Implantes Dentales/efectos adversos , Índice de Placa Dental , Humanos , Mucositis/etiología , Mucositis/terapia , Periimplantitis/terapia , Probióticos/uso terapéuticoRESUMEN
The aim of this study was to evaluate in a cohort of patients with peri-implant mucositis: (a) the efficacy of professional mechanical debridement therapy assisted using Bioptron Hyperlight Therapy on the reduction in periodontal indexes and (b) the reduction in total oxidative salivary stress. Forty subjects with a diagnosis of peri-implant mucositis were enrolled and randomly assigned to the Study Group (mechanical debridement therapy assisted using Bioptron Hyperlight Therapy) or Control Group (mechanical debridement therapy alone). The study duration was 6 months. Data on plaque index (PI), bleeding on probing (BoP), probing pocket depth (PPD), and pain relief on Visual Analogue Scale (VAS) were recorded at T0, T1 (14 days), T2 (1 month), and T3 (6 months). Group differences were assessed using Student's t-test and Pearson's Chi-squared test of homogeneity. PI and PPD decreased in the Study Group at the [T0; T1] time interval and during the overall time of observation significantly more than in the Control Group; BoP and pain on VAS decreased significantly faster in the Study Group than in the Control Group. Differences in Salivary Antioxidant Test (SAT) changes were not significant at any time interval. Patients' gender and smoking habit were not correlated with the clinical outcomes. Clinical parameters related to peri-implant mucositis significantly improved in the Study Group, which demonstrated the clinical efficacy of the Bioptron Hyperlight Therapy as an adjunct to standard of care for the treatment of peri-implant mucositis. The RCT was registered at the US National Institutes of Health #NCT05307445.
Asunto(s)
Mucositis , Periimplantitis , Hemorragia , Humanos , Mucositis/terapia , Dolor , Nivel de Atención , Estados UnidosRESUMEN
While many clinicians are cognizant of the high survival rate of dental implants, the elevated prevalences of peri-implant mucositis and peri-implantitis post implant insertions may not be as well known. This underscores the need for greater awareness of the importance of continuous personal and professional peri-implant maintenance to facilitate implant success. The occurrence of peri-implant mucositis and peri-implantitis post implant insertions among patients ranges in studies from 46% to 63% and 19% to 23%, respectively. Individuals who undertake regular personal and professional maintenance therapy compared to patients who have irregular supportive therapy manifest reduced occurrences of peri-implant mucositis and peri-implantitis. The frequency of professional maintenance intervals usually ranges from 3 to 6 months, and its specific periodicity should be based on a patient's risk profile. Supportive care visits provide the clinician an opportunity to monitor peri-implant status. No long-term controlled clinical trials have evaluated the timing of maintenance intervals, but substantial evidence shows that professional supportive care enhances peri-implant health and the success rate of dental implants. A patient's informed consent form should include the responsibility to be compliant with personal and professional peri-implant supportive therapy.
Asunto(s)
Implantes Dentales , Mucositis , Periimplantitis , Estomatitis , Implantación Dental , Implantes Dentales/efectos adversos , Humanos , Mucositis/epidemiología , Mucositis/etiología , Mucositis/terapia , Periimplantitis/epidemiología , Periimplantitis/etiología , Periimplantitis/terapia , Prevalencia , Estomatitis/epidemiología , Estomatitis/etiología , Estomatitis/terapiaRESUMEN
OBJECTIVE: To provide an overview with the most up-to-date evidence on the management of cancer-treatment related mucositis. DATA SOURCES: Peer-reviewed articles, textbooks, and the internet. CONCLUSION: A multitude of new and innovative treatments for the management of mucositis exist. Mucositis guidelines have changed to reflect the current evidence, but more research is needed on emerging modalities. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have a primary role in the assessment and early identification of mucositis. Educating patients and recommending evidence-based guidelines is paramount in preventing and ameliorating this challenging side effect of treatment.
Asunto(s)
Mucositis , Neoplasias , Estomatitis , Humanos , Mucositis/diagnóstico , Mucositis/etiología , Mucositis/terapia , Neoplasias/complicaciones , Neoplasias/terapia , Estomatitis/diagnóstico , Estomatitis/etiología , Estomatitis/terapiaAsunto(s)
Mucositis , Estomatitis , Humanos , Mucositis/etiología , Mucositis/terapia , Estomatitis/etiología , Estomatitis/terapiaRESUMEN
Inflammatory bowel diseases, irritable bowel syndrome, and mucositis are characterized by intestinal inflammation, but vary according to their pathological mechanisms, severity, location, and etiology. Significant intestinal inflammation that occurs in these diseases induces weight loss, nutritional depletion, and gastrointestinal tract dysfunction. Nutritional support is important in alleviating symptoms and improving patients' quality of life. In this review, we summarize some nutritional components used to manage intestinal disorders. These include fatty acids, probiotics, parabiotics, postbiotics, prebiotics, synbiotics, and low FODMAP (LFD) diets. These components and LFD diets have been studied and clinical trials have been designed to develop new strategies to alleviate intestinal inflammation and improve the quality of life. Clinical trials on their use in intestinal inflammation do not allow firm conclusions to be drawn mainly because of the heterogeneity of the dose used and the study design or their inconclusive results. However, in the majority of cases, the use of omega-3, probiotics, parabiotics, postbiotics, prebiotics, synbiotics, and LFD improve the health.
Asunto(s)
Suplementos Dietéticos , Inflamación/terapia , Enfermedades Intestinales/terapia , Animales , Humanos , Inflamación/fisiopatología , Enfermedades Inflamatorias del Intestino/fisiopatología , Enfermedades Inflamatorias del Intestino/terapia , Enfermedades Intestinales/fisiopatología , Síndrome del Colon Irritable/fisiopatología , Síndrome del Colon Irritable/terapia , Mucositis/fisiopatología , Mucositis/terapia , Apoyo Nutricional/métodos , Calidad de VidaRESUMEN
Intestinal mucositis (IM) is a critical side-effect associated with antineoplastic therapy. Treatment available is only palliative and often not effective. However, alternative therapeutic strategies, such as probiotics, have attracted significant attention due to their immune-modulatory action in several diseases. Thus, the present study aims to elucidate the therapeutic potential of the probiotic strain Bifidobacterium longum 51A in a murine model of mucositis induced by irinotecan. Due to the scarcity of studies on dose-response and viability (probiotic vs paraprobiotic), we first evaluated which dose and cell viability would be most effective in treating mucositis. In this study, the oral pretreatment with viable B. longum 51A at a concentration of 1 × 109 CFU/mL reduced the daily disease activity index (p < 0.01), protected the intestinal architecture, preserved the length of the intestine (p < 0.05), and reduced intestinal permeability (p < 0.01), inflammation, and oxidative damage (p < 0.01) induced by irinotecan. Also, treatment with B. longum 51A increased the production of secretory immunoglobulin A (p < 0.05) in the intestinal fluid of mice with mucositis. Furthermore, B. longum 51A reversed the mucositis-induced increase in Enterobacteriaceae bacterial group in the gut (p < 0.01). In conclusion, these results showed that oral administration of B. longum 51A protects mice against intestinal damage caused by irinotecan, suggesting its use as a potential probiotic in therapy during mucositis.
Asunto(s)
Bifidobacterium longum , Microbioma Gastrointestinal/efectos de los fármacos , Enfermedades Intestinales , Irinotecán/efectos adversos , Mucositis , Probióticos/farmacología , Animales , Femenino , Enfermedades Intestinales/inducido químicamente , Enfermedades Intestinales/microbiología , Enfermedades Intestinales/terapia , Irinotecán/farmacología , Ratones , Ratones Endogámicos BALB C , Mucositis/inducido químicamente , Mucositis/microbiología , Mucositis/terapiaRESUMEN
This study hypothesized that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for the treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type 2 diabetic and nondiabetic patients over a 12-month follow-up period. Patients with and without type 2 diabetes were included. PM patients were categorized into 2 groups based on the treatment procedure: (1) nonsurgical + PT and (2) nonsurgical MD alone. Demographics and education statuses were recorded. Gingival index (GI) and plaque index (PI), crestal bone loss (CBL), and probing depth (PD) were measured at baseline and after 6 and 12 months. Significant differences were detected with P < .01. The hemoglobin A1c level was significantly higher in patients with diabetes at all time durations than in patients without type 2 diabetes (P < .001). Baseline GI, PI, PD, and CBL were comparable in all groups. In patients with type 2 diabetes, there was no difference in PI, GI, PD, and CBL at 6- and 12-month follow-up. In patients without type 2 diabetes, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01) at 6-month and 1-year follow-up as compared with baseline. In patients without type 2 diabetes, MD with or without adjunct PT reduced soft-tissue inflammatory parameters in patients with PM.