[The effect of four immunosuppressive drugs on oral manifestations after organ transplantation].

PURPOSE: To assess the prevalence of oral manifestations in a group of allogenic liver, kidney or haematopoietic stem cell transplantation recipients and patients, and analyze the possible oral manifestations associated with the use of 4 immunosuppressive drugs. METHODS: One hundred and eighteen patients submitted to liver, kidney and hematopoietic stem cell transplantation who used tacrolimus， sirolimus，cyclosporine or mycophenolate mofetil were enrolled. Through a questionnaire survey and oral examination, their oral manifestations were recorded, and the possible statistical associations with immunosuppressive drugs were analyzed using SPSS 21.0 software package. RESULTS: The prevalence of oral lichenoid lesions and cheilitis for the group of patients using tacrolimus after transplantation was significantly lower than the group of patients who did not used the agent(P＜0.01). The prevalence of oral lichenoid lesions for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P＜0.05), and the prevalence of cheilitis for the group of patients who used cyclosporine was significantly higher than the group of patients who did not used the drug(P＜0.01). The prevalence of oral lichenoid lesions and cheilitis for the group of patients who used tacrolimus was significantly lower than the group of patients who used cyclosporine(P＜0.01). The group of patients who used mycophenolate mofetil after transplantation had a significantly lower prevalence of dry mouth than the group of patients who did not used the drug(P＜0.01). The prevalence of oral manifestations in patients with sirolimus after transplantation was not significantly reduced. CONCLUSIONS: The use of tacrolimus improved the symptoms of oral lichenoid lesions and cheilitis and the effect was better than cyclosporine after transplantation. The use of mycophenolate mofetil improved dry mouth after organ transplantation.

Quantitative analysis of maxillary palatal masticatory mucosa thickness and anatomical morphology of palatal vault in Zhejiang province.

OBJECTIVE: To quantitatively analyze the maxillary palatal masticatory mucosa thickness and anatomical morphology of palatal vault in Zhejiang province. METHODS: Cone beam computed tomography (CBCT) images of 146 adult patients were collected from outpatients in Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine. The images were reconstructed by adjusting the reference line and analyzed on the sagittal plane of the measured teeth. The thickness of masticatory mucosa from maxillary canine to second molar area was measured at the level of 3, 6, 9, 12 mm from the gingival margin. At the same time, the height and width of the palatal vault were measured, the position of the greater palatal foramen relative to the second molar, and the distance from the greater palatal foramen to the mid-palatal suture and the alveolar crest were determined. Spearman correlation analysis and multiple regression analysis were used to explore the influencing factors of the maxillary masticatory mucosa thickness. One-way analysis of variance and LSD multiple comparisons were used to analyze the difference in palatal mucosal thickness of each tooth position in different age groups. The sample t-test was used to analyze the differences in the mucosal thickness of each tooth position and the distance from the greater palatal foramen to the mid-palatal suture and the alveolar crest in different anatomical forms of the palatal vault. RESULTS: The mean palatal masticatory mucosa thickness from maxillary canines, first premolars, second premolars, first molar and second molar areas were (2.94±0.48), (3.28±0.49), (3.43±0.53), (3.01±0.55), (3.49±0.70) mm, respectively. The mucosa thickness of canines, first premolars and second premolars areas showed increasing at first and then decreasing trend. The mucosal thickness of the canines area was greatest at 6 mm from the gingival margin, and the thickness of the first and second premolars areas was greatest at 9 mm from the gingival margin. Premolars are thickest at 9 mm from the gingival margin. The thickness of the mucosa of the first molars area increased with the increase of the distance from the gingival margin, and the thickness of the mucosa of the second molars area was the thinnest at 6 mm, and then increased with the increase of the distance from the gingival margin. The main influencing factors of the mucosal thickness of canines, first premolars and first molars areas were age and palatal vault aspect ratio, the main influencing factor of the mucosal thickness of second premolars area was age, and the main influencing factor of the mucosal thickness of second molars area was palatal vault aspect ratio. There was no significant colinearity among the variables ( VIF<10). The results of the further stratified analysis showed that the mucosal thickness of the maxillary canine to the first molar area was positively correlated with age, and mucosal thickening is more pronounced in people aged 45 years old and above. The thickness of the canine mucosa in the high palate vault group was greater than that in the low palate vault group ( P<0.05), and the thickness of the second molar mucosa was smaller than that in the low palate vault group ( P<0.05). The greater palatal foramen was mostly located in the distal region of the second molar crown. The distance from the greater palatal foramen to the alveolar crest in the high palatal vault group was greater than that in the low palatal vault group ( P<0.05), while there was no significant difference between the two groups in the distance from the foramen magnum to the mid-palatal suture ( P>0.05). CONCLUSION: The most suitable donor site for autologous soft tissue graft may be 3-9 mm from the gingival margin of the first and second premolars area.