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Ardila CM. Addressing mucosal ulcers during orthodontic treatment: An urgent call for preventive strategies. World J Clin Cases 2024; 12:6420-6424. [DOI: 10.12998/wjcc.v12.i30.6420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/20/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
Mucosal ulcers are a common yet often overlooked complication during orthodontic treatment, significantly impacting patient comfort and compliance. This letter aims to highlight the prevalence, potential causes, and management strategies for mucosal ulcers in orthodontic patients. By reviewing recent literature and clinical observations, we underscore the necessity for proactive measures and tailored interventions to mitigate the incidence and severity of these lesions. Emphasizing the role of patient education and the use of protective devices, we call for a multidisciplinary approach to enhance patient care and treatment outcomes. This discussion is particularly relevant in the context of evolving orthodontic techniques and materials, which necessitate continuous adaptation of clinical practices to ensure patient safety and well-being.
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Affiliation(s)
- Carlos M Ardila
- Basic Sciences, Biomedical Stomatology Research Group, Universidad de Antioquia U de A, Medellín 050010, Colombia
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Ono K, Ueno T, Kido MA, Hitomi S, Naniwa M, Nakatomi C, Yoshimoto RU, Sawada T, Kato T. Recent advances in the treatment of oral ulcerative mucositis from clinical and basic perspectives. J Oral Biosci 2024; 66:504-510. [PMID: 38866365 DOI: 10.1016/j.job.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Oral ulcerative mucositis (OUM) is common in patients with cancer, particularly in those undergoing chemoradiation therapy. The effective management of OUM is crucial for continuous cancer care and patient well-being. Recent studies have advanced our understanding of the causes, leading to clinical trials toward novel treatments. This review focuses on the contemporary therapeutic landscape, and provides the latest insights into the mechanisms of mucosal healing and pain. HIGHLIGHTS Management strategies for OUM in patients with cancer include maintaining good oral hygiene, reducing mucosal irritation against radiation, and using various topical analgesic treatments, including herbal medicines. However, the current management practices have limitations that necessitate the development of more efficacious and novel treatments. Molecular research on transient receptor potential (TRP) channels in the oral mucosa is crucial for understanding the mechanisms of wound healing and pain in patients with OUM. Targeting TRPV3 and TRPV4 can enhance wound healing through re-epithelialization. The suppression of TRPV1, TRPA1, and TRPV4 may be effective in alleviating OUM-induced pain. CONCLUSION Research advancements have improved our understanding and potentially led to novel treatments that offer symptomatic relief. This progress highlights the importance of collaborations between clinical researchers and scientists in the development of innovative therapies.
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Affiliation(s)
- Kentaro Ono
- Division of Physiology, Kyushu Dental University, Fukuoka, Japan.
| | - Takao Ueno
- Dentistry, National Cancer Center Hospital, Tokyo, Japan
| | - Mizuho A Kido
- Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Japan
| | - Suzuro Hitomi
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Mako Naniwa
- Department of Oral Health Sciences, Kyushu University of Nursing and Social Welfare, Kumamoto, Japan
| | - Chihiro Nakatomi
- Division of Physiology, Kyushu Dental University, Fukuoka, Japan
| | - Reiko U Yoshimoto
- Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Japan
| | - Takeshi Sawada
- Department of Anatomy and Physiology, Faculty of Medicine, Saga University, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Nguyen THV, Chiu KC, Shih YH, Liu CJ, Bao Quach TV, Hsia SM, Chen YH, Shieh TM. Protective Effect of Electroacupuncture on Chemotherapy-Induced Salivary Gland Hypofunction in a Mouse Model. Int J Mol Sci 2023; 24:11654. [PMID: 37511411 PMCID: PMC10380826 DOI: 10.3390/ijms241411654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Radiotherapy and chemotherapy can impair salivary gland (SG) function, which causes xerostomia and exacerbate other side effects of chemotherapy and oral infection, reducing patients' quality of life. This animal study aimed to assess the efficacy of electroacupuncture (EA) as a means of preventing xerostomia induced by 5-fluorouracil (5-FU). A xerostomia mouse model was induced via four tail vein injections of 5-FU (80 mg/kg/dose). EA was performed at LI4 and LI11 for 7 days. The pilocarpine-stimulated salivary flow rate (SFR) and salivary glands weight (SGW) were recorded. Salivary immunoglobulin A (SIgA) and lysozyme were determined via enzyme-linked immunosorbent assay (ELISA). SG was collected for hematoxylin and eosin staining to measure acini number and acinar cell size. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and aquaporin 5 (AQP5) mRNA expressions in SG were quantified via RT-qPCR. 5-FU caused significant decreases in SFR, SGW, SIgA, lysozyme, AQP5 expression, and acini number, while TNF-α and IL-1β expressions and acinar cell size were significantly increased. EA treatment can prevent 5-FU damage to the salivary gland, while pilocarpine treatment can only elevate SFR and AQP5 expression. These findings provide significant evidence to support the use of EA as an alternative treatment for chemotherapy-induced salivary gland hypofunction and xerostomia.
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Affiliation(s)
- Thanh-Hien Vu Nguyen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan
- School of Dentistry, China Medical University, Taichung 40402, Taiwan
| | - Kuo-Chou Chiu
- Division of Oral Diagnosis and Family Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yin-Hwa Shih
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Chung-Ji Liu
- Department of Oral and Maxillofacial Surgery, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | | | - Shih-Min Hsia
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Yi-Hung Chen
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
- Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan
| | - Tzong-Ming Shieh
- School of Dentistry, China Medical University, Taichung 40402, Taiwan
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Hori Y, Kondo Y, Nodai T, Masaki C, Ono K, Hosokawa R. Xerostomia aggravates ligation-induced peri-implantitis: A preclinical in vivo study. Clin Oral Implants Res 2021; 32:581-589. [PMID: 33629453 DOI: 10.1111/clr.13727] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/17/2020] [Accepted: 02/17/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Previous studies have indicated that xerostomia is a critical factor affecting periodontitis; nonetheless, it is controversial whether xerostomia impairs peri-implant tissue. The objective of this experimental study was to evaluate the effect of xerostomia on the peri-implant hard and soft tissues in the rat model. MATERIALS AND METHODS Implants were placed in bilateral maxillae of male Wistar rats. The animals underwent submandibular and sublingual gland resection on both sides (DRY group) or sham operation (CTR group). Silk ligatures were placed around one side of abutments, which were randomly selected in each animal. The effects of xerostomia were assessed using micro-CT, histological analysis, real-time PCR, and 16S rRNA-based metagenomic analysis. RESULTS Ligation with silk thread caused bone resorption around implants. Although xerostomia itself did not induce bone resorption, it significantly enhanced silk ligature-mediated bone resorption around implants. Histological analysis and real-time PCR indicated that xerostomia induced inflammation and osteoclastogenesis around implants with silk ligatures. Furthermore, it altered the microbiota of the plaque on the silk thread around implants. CONCLUSION Xerostomia accelerates mucosal inflammation and osteoclastogenesis, which aggravates bone resorption around implants.
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Affiliation(s)
- Yusuke Hori
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Yusuke Kondo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Tomotaka Nodai
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Chihiro Masaki
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
| | - Kentaro Ono
- Division of Physiology, Kyushu Dental University, Kitakyushu, Japan
| | - Ryuji Hosokawa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Kitakyushu, Japan
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Ellender G, Coveney J. Flavor alterations in cancer treatment: Extrinsic factors as a means of augmentation. Clin Nutr ESPEN 2021; 43:76-89. [PMID: 34024568 DOI: 10.1016/j.clnesp.2021.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 01/13/2023]
Abstract
Flavor, comprising taste, smell and somatosensory inputs, is commonly altered in patients undergoing chemotherapy resulting in malnutrition leading to cachexia. A narrative review considered taste and smell alterations associated with malignancies treated using chemotherapy and the various interventions proffered to lessen alterations. Many of the currently used interventions directed towards enhancing intrinsic factors of food appeared ineffective in encouraging intake of adequate nutrition to ward off complications of malnutrition. Counselling is used in some cases with positive results. The use of extrinsic influences commensurate with the principles of food behavior and gastronomy are considered as a means of providing purpose to patients to accommodate flavor loss which when integrated with counseling and appropriate intrinsic factors are potentially a means of curtailing malnutrition and enhancing the psychological status of the patient. The close association between the cephalic phase responses (CPRs) and the control of eating and digestive behaviors is multifaceted, and when the influences of taste and smell are diminished, other contributing factors guiding CPRs may compensate a deficit. The need for the application of a consistent lexicon is essential when describing taste and smell alterations.
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Affiliation(s)
- Graham Ellender
- Adelaide Dental School, The University of Adelaide, South Australia 5000, Australia.
| | - John Coveney
- Global Food, Culture and Health, Flinders University, Bedford Park, South Australia 5042, Australia.
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Ligtenberg AJM, Bikker FJ, Bolscher JGM. LFchimera: a synthetic mimic of the two antimicrobial domains of bovine lactoferrin. Biochem Cell Biol 2021; 99:128-137. [PMID: 33560169 DOI: 10.1139/bcb-2020-0285] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Saliva is essential for the maintenance of oral health. When salivary flow is impaired, the risk of various oral diseases such as caries and candidiasis increases drastically. Under healthy conditions, saliva provides effective protection against microbial colonization by the collaborative action of numerous host-defense molecules. This review describes how saliva has been the guideline for the design and characterization of a heterodimeric antimicrobial construct called LFchimera. This construct mimics the helical parts of two antimicrobial domains in the crystal structure of bovine lactoferrin. It shows high antimicrobial activity against a broad spectrum of Gram-positive and Gram-negative bacteria, fungi, and parasites including biowarfare agents such as Bacillus anthracis, Burkholderia pseudomallei, and Yersinia pestis. Further, sublethal concentrations of LFchimera inhibited biofilm formation, the invasiveness of HeLa cells by Yersinia spp., and prevented haemolysis of enteropathogenic Escherichia coli, demonstrating the versatility of these peptides.
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Affiliation(s)
- A J M Ligtenberg
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands.,Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands
| | - F J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands.,Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands
| | - J G M Bolscher
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands.,Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, G. Mahlerlaan 3004, 1081LA Amsterdam, the Netherlands
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Hitomi S, Kokabu S, Matsumoto KI, Shoji Y, Ujihara I, Ono K. Expression of Ascorbate Peroxidase Derived from Cyanidioschyzon merolae in Mammalian Cells. In Vivo 2020; 34:2437-2441. [PMID: 32871770 DOI: 10.21873/invivo.12058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Ascorbate peroxidase (APX) derived from Cyanidioschyzon merolae, a primitive red alga living in high temperature and acidic environments, has greater anti-oxidative capacity than similar peroxidases occurring in other plants. In the present study, we examined whether expression of Cyanidioschyzon merolae-derived APX (cAPX) in mammalian cells increases cellular anti-oxidative capacity. MATERIALS AND METHODS The cAPX gene was introduced into the mouse fibroblast-like cell line C3H10T1/2. Production of reactive oxygen species (ROS) and/or cell viability was assessed after heat, H2O2 and acid stimulation. RESULTS Heat and H2O2 stimulation resulted in ROS production. cAPX-expressing cells were more tolerant to oxidative stress induced by heat, H2O2 and acid stimulations than control cells lacking cAPX. CONCLUSION Introduction of cAPX increases the anti-oxidative capacity in mammalian cells.
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Affiliation(s)
- Suzuro Hitomi
- Division of Physiology, Kyushu Dental University, Fukuoka, Japan
| | - Shoichiro Kokabu
- Division of Molecular Signaling and Biochemistry, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Ken-Ichiro Matsumoto
- Quantitative RedOx Sensing Group, Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, Quantum Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yoshimi Shoji
- Quantitative RedOx Sensing Group, Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, Quantum Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Izumi Ujihara
- Division of Physiology, Kyushu Dental University, Fukuoka, Japan
| | - Kentaro Ono
- Division of Physiology, Kyushu Dental University, Fukuoka, Japan
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Singh V, Singh AK. Oral mucositis. Natl J Maxillofac Surg 2020; 11:159-168. [PMID: 33897175 PMCID: PMC8051654 DOI: 10.4103/njms.njms_10_20] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/21/2020] [Accepted: 07/13/2020] [Indexed: 01/02/2023] Open
Abstract
Oral mucositis is one of the most common complications of cancer therapy. It is a nonhematologic complication of cytotoxic chemotherapy and radiotherapy and reduces the quality of life. It is estimated that 40% the cases on standard chemotherapy may develop oral mucositis. Patients receiving radiation, especially in the cases of head and neck cancer, have 30%-60% chances of developing mucositis. Chemotherapy and radiotherapy interfere with the normal turnover of epithelial cells, leading to mucosal injuries. These injuries can also occur due to indirect invasion of Gram negative bacteria and fungi as most of the chemo-therapeutic agents will cause neutropenia and will give a favorable environment for the development of mucositis. The patient-related factors are also responsible for developing mucositis in chemo-induced and radiation-induced mucositis. Poor oral hygiene may also be responsible for bacterial super infection followed by chemotherapy. Mucositis is of two kinds: direct and indirect mucositis. Direct mucositis - The epithelial cells of the oral mucosa undergo rapid turnover in usually 7-14 days due to which these cells are more susceptible to the effect of the cytotoxic therapy which results in oral mucositis. Indirect mucositis - it can develop due to the infection caused by Gram-negative bacteria and fungal infection. There will be a greater risk for oral infection due to neutropenia. The onset of mucositis secondary to mylo-suppression varies depending upon the timing of the neutrophil count associated with chemotherapy agents but they typically develop around 10-21 days after chemotherapy administration.
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Affiliation(s)
- Vibha Singh
- Department of Oral and Maxillofacial Surgery, K.G. Medical University, Lucknow, Uttar Pradesh, India
| | - Akhilesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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