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1.
Oral Health Prev Dent ; 18(4): 645-651, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32895647

RESUMO

PURPOSE: In the present randomised controlled trial (RCT), the authors hypothesise that herbal-based oral rinses are as effective as 0.12% chlorhexidine when used as adjuncts to non-surgical mechanical debridement (MD) in the management of peri-implant mucositis. The aim of the present RCT was to compare the efficacy of an herbal oral rinse with a 0.12% chlorhexidine-based oral rinse when used as adjuncts to non-surgical MD in the treatment of peri-implant mucositis. MATERIALS AND METHODS: Adult patients with peri-implant mucositis were included. Participants were randomly allocated into 3 groups. In group 1, patients only underwent non-surgical MD. In groups 2 and 3, patients underwent non-surgical MD with adjunct rinsing with an herbal- and 0.12% CHX-based oral rinse, respectively. Peri-implant plaque index (PI) and bleeding-on-probing (BOP) and probing-depth (PD) were assessed at baseline and at 3, 6, and 12 weeks. Group comparisons were done and p < 0.01 was considered statistically significant. RESULTS: Forty-eight patients with peri-implant mucositis (16, 16, and 16 in groups 1, 2 and 3, respectively) were included. At baseline, there was no difference in PI, PD, BOP in all groups. In group 1, there was no statistically significant difference in PI and BOP at 6, and 12 weeks of follow-up compared with baseline. In groups 2 and 3, PI (p < 0.01) and BOP (p < 0.01) were statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In group 1, there was no statistically significant difference in PD at all time intervals. In groups 2 and 3, PD was statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In groups 2 and 3, there was no statistically significant difference in PI, BOP and PD at all intervals. CONCLUSION: Herbal- and 0.12% CHX-based oral rinses are useful adjuncts to MD for the treatment of peri-implant mucositis.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Adulto , Clorexidina , Desbridamento , Humanos
2.
Oral Health Prev Dent ; 18(4): 765-772, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32895660

RESUMO

PURPOSE: Oral mucositis (OM) is the most frequent side effect of radiation. Selenium deficiency leads to increased levels of free oxygen radicals and the selenium level tends to fall during radiotherapy. Hence, in this double-blind randomised controlled clinical trial, the effect of selenium was assessed in patients receiving radiation. MATERIALS AND METHODS: Patients with head and neck cancer who were candidates to receive radiation were instructed to use selenium 200 mcg tablets twice daily. The grade of OM was evaluated by the World Health Organization (WHO) grading system on a weekly basis. The selenium level was measured at baseline and at the end of the radiation. RESULTS: Seventy-one patients with head and neck cancer (37 in the selenium group, 34 in the placebo group) were enrolled in the study. The cumulative incidence of OM (grade 1-4) was 97.3% in the selenium and 100% in placebo group (p value: 0.79), and difference in the mean serum selenium level at the end of radiation was not statistically significant between the two groups (p value 0.24) Conclusion: Selenium supplementation does not appear to affect the selenium level as well as the severity and duration of OM. It is supposed that higher doses may be effective in the prevention of RT-mucositis. This trial was registered in the Iranian Registry of Clinical Trials accessible at www.irct.ir (ID No. IRCT2014072718612N1).


Assuntos
Neoplasias de Cabeça e Pescoço , Mucosite , Lesões por Radiação , Selênio , Estomatite , Método Duplo-Cego , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Incidência , Irã (Geográfico)
3.
Med Oral Patol Oral Cir Bucal ; 25(5): e608-e615, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32683389

RESUMO

BACKGROUND: With greater number of implants being placed in clinical practice, incidence of peri-implant diseases are on the rise. It is not known whether chlorhexidine (CHX) improves outcomes in the management of peri-implant diseases. The aim of this systematic review and meta-analysis was to evaluate the role of CHX in improving outcomes with non-surgical management of peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS: An electronic search of PubMed, Scopus, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases up to 1st August 2019 was carried out to search for studies evaluating the efficacy of CHX for non-surgical management of peri-implant diseases. RESULTS: Seven studies were included. Four studies evaluated the role of CHX in peri-implant mucositis and three in peri-implantitis. Oral prophylaxis with mechanical cleansing of implant surface prior to CHX use was carried out in all seven studies. Meta-analysis indicated that use of CHX did not improve probing depths in peri-implant mucositis (SMD= 0.11; 95% CI: -0.16 to 0.38; p=0.42, I2= 0%). Similarly, CHX did not significantly reduce probing depths in patients with peri-implantitis (MD= 1.57; 95% CI: -0.88 to 4.0; p=0.21, I2= 98%). Results on the efficacy of CHX in reducing BOP in peri-implantitis are conflicting. CONCLUSIONS: Results of our study indicate that adjunctive therapy with CHX may not improve outcomes with non-surgical management of peri-implant mucositis. Conclusions with regards to its role in non-surgical management of peri-implantitis cannot be drawn. There is a need for more homogenous RCTs with large sample size to define the role of CHX in non-surgical management of peri-implant mucositis and peri-implantitis.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Clorexidina , Humanos
4.
Braz Dent J ; 31(3): 310-318, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32667525

RESUMO

Oral mucositis is a common inflammatory complication among patients with cancer. This study evaluated the histopathological, stereological, and antioxidant markers of 2% eucalyptus extract in induced oral mucositis in male golden hamsters. In this animal study, oral mucositis was induced in 30 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle once daily on days 3 and 4. On days 14-17, 2% eucalyptus hydroalcoholic extract gel and Calendula officinalis extract gel groups were treated and then compared with a non-treated control group. The histopathological and stereological scores and the pouch content of malondialdehyde, as well as the activities of glutathione and myeloperoxidase in the pouch tissue, were evaluated. Histopathologic scores of oral mucositis were lower in the eucalyptus gel group than those of the calendula and control groups (p<0.05). Also, a lower malondialdehyde level and higher myeloperoxidase and glutathione activities were detected in the eucalyptus group in comparison to the calendula and control groups (p<0.001). The thickness of the mucosa and submucosa increased in the eucalyptus group. The numerical density of the fibroblast and the volume density of the collagen significantly increased in the eucalyptus group. In conclusion, the use of eucalyptus hydroalcoholic extract may be associated with reduced intensity of oral mucositis, diminished concentration of malondialdehyde, increased activity of myeloperoxidase and glutathione, increased volume of mucosa and submucosa, increased fibroblast and collagen in the induced oral mucositis in golden hamsters undergoing 5-FU consumption.


Assuntos
Eucalyptus , Mucosite , Estomatite , Animais , Cricetinae , Fluoruracila , Masculino , Mesocricetus , Mucosa Bucal , Extratos Vegetais
5.
Artigo em Inglês | MEDLINE | ID: mdl-32667390

RESUMO

Capnocytophaga is a group of facultative anaerobic gram-negative bacteria present in the oral cavity of humans, dogs and cats, as part of their normal oral flora. Here, we described two cases of bloodstream infections (BSI) caused by Capnocytophaga in neutropenic autologous hematopoietic stem cell transplantation (auto-HSCT) patients with mucositis (Grade I and Grade III) identified by Maldi-Tof. They were successfully treated with ß-lactam (meropenem and piperacillin-tazobactam). The species C. sputigena was confirmed by 16S rRNA gene sequencing in one patient. The review of literature showed that C. ochraceae was the most frequent species causing BSI in auto-HSCT patients and that the patients usually presented mucositis and were neutropenic at the onset of the infection.


Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Capnocytophaga/isolamento & purificação , Infecções por Bactérias Gram-Negativas/diagnóstico , Transplante de Células-Tronco Hematopoéticas/métodos , Neutrófilos/imunologia , Adulto , Bacteriemia/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/imunologia , Humanos , Meropeném/uso terapêutico , Pessoa de Meia-Idade , Mucosite , Piperacilina/uso terapêutico , RNA Ribossômico 16S , Análise de Sequência de DNA , Tazobactam/uso terapêutico , Transplante Autólogo
6.
J Evid Based Dent Pract ; 20(1): 101414, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32381416

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The effect of supportive care in preventing peri-implant diseases and implant loss: A systematic review and meta-analysis. Lin C-Y, Chen Z, Pan W-L, Want H-L. Clin Oral Implants Res 2019;30(8):714-24. SOURCE OF FUNDING: University of Michigan Periodontal Graduate Student Research Fund. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Taxa de Sobrevida
7.
Int J Oral Implantol (Berl) ; 13(2): 123-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32424380

RESUMO

PURPOSE: To assess the effectiveness of different nonsurgical protocols for the treatment of peri-implant mucositis. MATERIALS AND METHODS: The identification of randomised clinical trials (RCTs) was systematically performed in three databases and supplemented by a thorough manual search of the literature in periodontics/implantology-related journals. Studies investigating the effect of mechanical and/or chemical plaque control agents aimed at preventing the development of peri-implant mucositis were excluded. When comparable trials were found, a meta-analysis was performed. RESULTS: Fourteen studies were included in the systematic review and three in the meta-analysis. None of the selected studies reported a complete resolution of the peri-implant mucositis lesions. A nonsurgical therapy alone showed an average reduction of: 0.57 mm (95% CI [0.30 to 0.83]) in probing pocket depth (PPD); 22.41% (95% CI [12.74 to 32.08]) in bleeding on probing (BOP); 17.28% (95% CI [3.99 to 30.58]) in the plaque index (PI); and 13.41% (95% CI [3.50 to 23.31]) in the bleeding index (BI). The meta-analysis failed to demonstrate significant improvements with the adjunct use of chlorhexidine disinfectant to nonsurgical mechanical debridement for PPD reduction (-0.07 mm; 95% CI [-0.33 to 1.15], P = 0.62), and relative attachment level (RAL) gain (-0.13 mm; 95% CI [-0.6 to 0.35]), P = 0.6). CONCLUSION: Conventional nonsurgical mechanical therapy alone may be considered the standard treatment for peri-implant mucositis as there is still a lack of evidence supporting the use of additional chemical/mechanical agents for clinical and/or microbiological improvement.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Índice Periodontal
8.
BMC Oral Health ; 20(1): 92, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228667

RESUMO

BACKGROUND: To assess long-term results of implants (XiVE/Frialit-2 Synchro) in a private periodontal practice according to survival and success rates (biological and technical complications) and to detect possible influencing factors, retrospectively. METHODS: Implant placement of at least one implant took place 10 years ±6 months before clinical and radiographic re-examination. Incidence of implant loss as main and incidence of mucositis/ peri-implantitis as secondary outcome were detected. Also, patient-related and implant-related influencing factors were determined by regression analyses. RESULTS: 100 patients (59.0% female) with 242 implants were included into analysis. Survival rate was 94.0% (XiVE: 97.7%; Frialit-2-Synchro: 66.7%). Mucositis was found in 77.6% of all patients, moderate/severe peri-implantitis in 16.3%. In logistic regression analyses statistically significant influencing factors for implant loss was implant type (p < 0.001), for mucositis a wider implant diameter (p = 0.0438) and a high modified Plaque Index (p = 0.0253), for peri-implantits number of implants per patient (p = 0.0075) and a wider implant diameter (p = 0.0079). Technical complications were found in 47 implants (19.4%). CONCLUSIONS: XiVE implants showed a high survival rate over a 10-year follow-up, on the other hand Frialit-2 Synchro implants had worse survival rates. Success rates regarding biological complications are in line with other implant systems.


Assuntos
Implantes Dentários/efeitos adversos , Falha de Restauração Dentária/estatística & dados numéricos , Mucosite/epidemiologia , Mucosite/cirurgia , Peri-Implantite/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/epidemiologia , Placa Dentária/microbiologia , Índice de Placa Dentária , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mucosite/etiologia , Peri-Implantite/etiologia , Estudos Retrospectivos , Análise de Sobrevida
9.
Lasers Med Sci ; 35(6): 1411-1417, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32304001

RESUMO

Peri-implant disease may affect survival of dental implants. The aim of the study is to analyze the effectiveness of diode laser as a supportive modality to the non-surgical conventional treatment of peri-implant mucositis (PiM) and initial peri-implantitis (PI). Twenty-three patients with single implants suffering from PiM or initial PI were selected and randomly divided into two groups; control group (CG) received non-surgical conventional treatment, and test group (TG) received non-surgical conventional treatment and diode laser application with wavelength of 980 nm. Probing pocket depth (PPD) and bleeding on probing (BOP) were recorded at baseline (T0) and at 3 months follow-up (T1). The average of PPD value for TG was 4.04 ± 0.54 mm at T0 and it was 2.98 ± 0.70 mm at T1. In the CG, PPD average was 3.8 ± 1.24 mm at T0 and was 3.54 ± 0.35 mm at T1. In TG, the BOP was positive in 44 sites at T0 and in 6 sites at T1. In CG, the BOP was positively observed in 52 sites at T0 and in 28 sites at T1. The 980-nm diode laser may be considered an adjunct to the conventional non-surgical treatments of PiM and initial PI.


Assuntos
Lasers Semicondutores/uso terapêutico , Mucosite/cirurgia , Peri-Implantite/cirurgia , Feminino , Seguimentos , Hemorragia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Mucosite/complicações , Peri-Implantite/complicações , Bolsa Periodontal/complicações
10.
Anticancer Res ; 40(4): 1789-1796, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234867

RESUMO

Pancreatic cancer is often diagnosed due to the patient seeking medical attention for abdominal pain. It is among the most painful cancers, with pain severity strongly correlating with prognosis. Perineural invasion is a prominent feature of pancreatic cancer and often the first route of metastasis resulting in neuropathic pain. While surgical pain is present, it is generally short-lived; chemo- and radio-therapy associated side effect pain is often longer lasting and more difficult to manage. Treatment-induced mucositis in response to chemotherapy occurs throughout the GI tract resulting in infection-prone ulcers on the lip, buccal mucosa, palate or tongue. Cisplatin treatment is associated with axonal neuropathy in the dorsal root ganglion, although other large sensory fibers can be affected. Opioid-induced hyperalgesia can also emerge in patients. Along with traditional means to address pain, neurolytic celiac plexus block of afferent nociceptive fibers has been reported to be effective in 74% of patients. Moreover, as cancer treatments become more effective and result in improved survival, treatment-related side effects become more prevalent. Here, pancreatic cancer and treatment associated pain are reviewed along with current treatment strategies. Potential future therapeutic strategies to target the pathophysiology underlying pancreatic cancer and pain induction are also presented.


Assuntos
Dor do Câncer/tratamento farmacológico , Mucosite/tratamento farmacológico , Manejo da Dor/efeitos adversos , Neoplasias Pancreáticas/tratamento farmacológico , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Bupivacaína/uso terapêutico , Dor do Câncer/patologia , Cisplatino/efeitos adversos , Cisplatino/uso terapêutico , Humanos , Mucosite/induzido quimicamente , Medição da Dor , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/patologia
11.
Life Sci ; 252: 117612, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32247004

RESUMO

AIMS: Intestinal mucositis is the most common side effect of 5-fluorouracil (5-Fu) treatment in cancer patients. Previous research suggested that andrographolide (Andro) attenuated the intestinal injury in colitis or diarrhea in mice. The present study was aimed at investigating the protective effect of Andro against 5-Fu induced intestinal mucositis and the underlying mechanism. MAIN METHODS: BALB/C mice were injected 5-Fu at a dose of 100 mg/kg for 5 days to induce intestinal mucositis. Andro at different doses (25, 50, 100 mg/kg/day) was administered. Weight loss, diarrhea score, cellular apoptosis and proliferation were evaluated. Apoptosis related proteins were detected by Western blotting. Then, NCM460 cells were used to explore the possible mechanism in vitro. The effect of Andro on the anti-tumor efficacy of 5-Fu was investigated in H22 tumor-bearing mice. KEY FINDINGS: Andro significantly ameliorated the 5-Fu induced weight loss and diarrhea. The apoptosis of intestinal cells was also attenuated by Andro treatment both in vivo and in vitro. Besides, Andro markedly down-regulated the 5-Fu-induced protein expression of caspase8/3, Bax and the phosphorylation of p38. Moreover, 5-Fu significantly reduced the viability of NCM460 cells, which was restored by the Andro pretreatment. Furthermore, asiatic acid, an agonist of p38 MAPK, reversed the anti-apoptotic effect of Andro in NCM460 cells. Andro did not weaken the anti-H22 tumor effect of 5-Fu in vivo. SIGNIFICANCE: We have demonstrated that p38 MAPK inhibition mediates anti-apoptotic effects of Andro against 5-Fu induced intestinal mucositis, suggesting that Andro may benefit the patients undergoing 5-Fu based chemotherapy.


Assuntos
Antimetabólitos Antineoplásicos/toxicidade , Diterpenos/administração & dosagem , Fluoruracila/toxicidade , Mucosa Intestinal/efeitos dos fármacos , Mucosite/prevenção & controle , Animais , Antimetabólitos Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Carcinoma Hepatocelular/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Diarreia/induzido quimicamente , Diarreia/prevenção & controle , Modelos Animais de Doenças , Diterpenos/farmacologia , Relação Dose-Resposta a Droga , Regulação para Baixo/efeitos dos fármacos , Fluoruracila/farmacologia , Humanos , Mucosa Intestinal/patologia , Neoplasias Hepáticas/tratamento farmacológico , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Mucosite/induzido quimicamente , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
12.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(2): 332-338, 2020 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-32306019

RESUMO

OBJECTIVE: To observe and investigate the effect of vertical soft tissue thickness on the peri-implant tissue condition and the prevalence of peri-implant disease in patients with history of periodontitis. METHODS: Among 210 patients who showed initial interest of implant therapy, 92 patients were included in this study and received implant surgery during 2010 and 2015. Sixty-six patients with 66 implants finally came back for T2 evaluation. Prior to the implant therapy, all the patients had received periodontal treatment. During the implant placement surgery, the distance from palatal soft tissue edge to the alveolar crest, which was defined as vertical soft tissue thickness (VT), was measured after the buccal full thickness flap was elevated. According to the cut off point which was adopted from the operating characteristic curve, 66 implants within 66 patients were divided into two groups, which were called normal group (VT≤4.5 mm) and thick group (VT>4.5 mm), respectively. Information of the patient's general status, periodontal situation and implant information were recorded. After a follow-up period of 42.9 months, the parameters of peri-implant tissue and condition of peri-implant disease were recorded. Mann-Whitney U test as well as Chi-square test were used to compare the parameters between two groups. Moreover, Kaplan-Meier method was chosen to draw the event(peri-implantitis)-free survival curve. RESULTS: The survival rate of the implants was 100%. At the end of the follow-up examination(T2), the parameters including max PDi, mean PDi, max BIi, mean BIi, mean MBL, MBL at distal side, MBL at mesial side, mean PLIi presented significantly higher values in thick group than in normal group (P < 0.05). Moreover, the prevalence of peri-implantitis and peri-implant disease (peri-implant mucositis & peri-implantitis) in thick group was respectively 34.8% and 73.9%, which was significantly higher than 2.3% and 48.8% respectively in normal group (P<0.05). The prevalence of peri-implant mucositis did not show significant difference in the two groups. In addition, Kaplan-Meier analysis showed that there was significant difference between the event-free survivals of the two groups. CONCLUSION: The vertical soft tissue thickness around implants in patients with periodontitis has a significant effect on the health of the peri-implant tissue. Excessive vertical soft tissue thickness may result in deeper peri-implant probing depth as well as more peri-implant marginal bone loss, and eventually increase the risk of peri-implant disease. The vertical remodeling of soft tissue may be a new direction to indicate the role of periodontitis in peri-implant tissue condition. Moreover, the biological mechanism of the association between soft tissue thickness and peri-implantitis risk as well as effective approaches to prevent the adverse effect of excessive soft tissue thickness on peri-implant tissue is necessary to be investigated.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Mucosite , Peri-Implantite , Periodontite , Dente , Processo Alveolar , Humanos
15.
Dent Clin North Am ; 64(2): 305-313, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32111270

RESUMO

With a very large number of endosseous dental implants placed by generalists and specialists, complications are to be expected. Among them are problems with the soft tissue interface and the hard tissue attachment. Peri-implant mucositis and peri-implantitis are not uncommon, but their prevalence and impact may be reduced with diagnosis and appropriate management, as can the likelihood of progression from mucositis to peri-implantitis. Successful implant dentistry does not end with integration and restoration, and both patient and professionally administered modalities are important for long-term implant maintenance.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Fatores de Risco
16.
Support Care Cancer ; 28(5): 2473-2484, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32052137

RESUMO

PURPOSE: To update the clinical practice guidelines for the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible. RESULTS: A total of 9 new papers were identified within the scope of this section, adding to the 62 papers reviewed in this section previously. A new Suggestion was made for topical 0.2% morphine for the treatment of OM-associated pain in head and neck (H&N) cancer patients treated with RT-CT (modification of previous guideline). A previous Recommendation against the use of sucralfate-combined systemic and topical formulation in the prevention of OM in solid cancer treatment with CT was changed from Recommendation Against to No Guideline Possible. Suggestion for doxepin and fentanyl for the treatment of mucositis-associated pain in H&N cancer patients was changed to No Guideline Possible. CONCLUSIONS: Of the agents studied for the management of OM in this paper, the evidence supports a Suggestion in favor of topical morphine 0.2% in H&N cancer patients treated with RT-CT for the treatment of OM-associated pain.


Assuntos
Analgésicos/uso terapêutico , Anestésicos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Mucosite/tratamento farmacológico , Estomatite/tratamento farmacológico , Adulto , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Guias como Assunto , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Masculino
17.
Support Care Cancer ; 28(5): 2457-2472, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32056010

RESUMO

OBJECTIVE: To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. RESULTS: A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. CONCLUSIONS: Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.


Assuntos
Mel , Mucosite/tratamento farmacológico , Plantas Medicinais , Probióticos/uso terapêutico , Saliva/metabolismo , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Goma de Mascar , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Saliva/efeitos dos fármacos
18.
JCO Oncol Pract ; 16(3): 111-112, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32048927
19.
Support Care Cancer ; 28(5): 2485-2498, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32080767

RESUMO

PURPOSE: To update the clinical practice guidelines for the use of growth factors and cytokines for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: recommendation, suggestion, and no guideline possible. RESULTS: A total of 15 new papers were identified within the scope of this section and were merged with 51 papers that were reviewed in the previous guidelines update. Of these, 14, 5, 13, 2, and 1 were randomized controlled trials about KGF-1, G-CSF, GM-CSF, EGF, and erythropoietin, respectively. For the remaining agents there were no new RCTs. The previous recommendation for intravenous KGF-1 in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) conditioned with high-dose chemotherapy and TBI-based regimens is confirmed. The previous suggestion against the use of topical GM-CSF for the prevention of OM in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation remains unchanged. CONCLUSIONS: Of the growth factors and cytokines studied for the management of OM, the evidence supports a recommendation in favor of KGF-1 and a suggestion against GM-CSF in certain clinical settings.


Assuntos
Citocinas/uso terapêutico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Mucosite/tratamento farmacológico , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Humanos , Masculino , Neoplasias/tratamento farmacológico , Guias de Prática Clínica como Assunto , Proteínas Recombinantes/uso terapêutico
20.
Int J Oral Maxillofac Surg ; 49(1): 44-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31248705

RESUMO

Acute radiation tongue mucositis has a profound effect on talking and eating. We examined whether the dose-volume histogram obtained from the tongue surface model correlates with mucositis severity, and whether it is useful for predicting acute radiation tongue mucositis in patients with head and neck cancer treated with intensity-modulated radiation therapy. Thirty-six patients who received intensity-modulated radiation therapy for head and neck cancer were analysed for acute radiation tongue mucositis according to the Common Terminology Criteria for Adverse Events, version 4.0, as well as the Radiation Therapy Oncology Group scoring systems. The corresponding high-dose locations in anatomical sub-regions in the tongue surface model and the development of high-grade acute radiation tongue mucositis were compared. The mucositis sites coincided with the high-dose anatomical sub-regions in the tongue surface model. There was a clear dose-response relationship between the mean dose to the tongue and the acute radiation tongue mucositis Radiation Therapy Oncology Group grade. According to the dose-volume histogram, patients receiving 16.0-73.0 Gy to the tongue were susceptible to grade 2-3 toxicity. The tongue surface model can predict the site and severity of acute radiation tongue mucositis. In future, radiation treatment plans ccould be optimized using this model.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Mucosite , Radioterapia de Intensidade Modulada , Humanos , Dosagem Radioterapêutica , Língua
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