ABSTRACT
Abstract Oral mucositis is a painful condition that occurs in patients who have undergone haematopoietic stem-cell transplantation (HSCT) and has a huge impact on their quality of life. The objective of this study was to examine the extent to which interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) are associated with oral health quality of life among patients who underwent HSCT. A. C. Camargo Cancer Center patients were evaluated over 20 months at 4 different time-points: a) at patient admission (M1); b) on the day of infusion of HSC (M2); c) 12 and 20 days after the first day of the conditioning regimen for autologous and allogeneic transplantation, respectively (M3); and d) 30 days after the first day of the conditioning regimen (M4). Mucositis clinical evaluations were performed using World Health Organization (WHO) criteria. Oral health quality of life was measured using the Oral Health Impact Profile short form (OHIP-14), Oral Mucositis Quality of Life (OMQoL) and Patient-Reported Oral Mucositis Symptom (PROMS) scales. Correlations between clinical data and quality of life scores were examined. STATA 11.0 was used to perform the statistical analyses (5% level of significance). Eighty-two patients participated in the study; 62.2% were male, 28.05% had multiple myeloma, and the mean age was 48.49 years (SD 13.76). Higher scores (worse quality of life) were observed as mucositis scores increased, but the results were not significant. The OMQoL had a high correlation with OHIP-14 (0.8377), but the correlation between the PROMS scale and the OHIP-14 was lower (0.6643). Higher concentrations of IL-6 and TNF-α were associated with worse quality of life, according to all indices (p < 0.05). Oral mucositis was associated with quality of life scores (p < 0.01).
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Quality of Life , Stomatitis/etiology , Stomatitis/pathology , Oral Health/statistics & numerical data , Sickness Impact Profile , Hematopoietic Stem Cell Transplantation/adverse effects , Saliva/chemistry , Severity of Illness Index , Enzyme-Linked Immunosorbent Assay , Surveys and Questionnaires , Analysis of Variance , Interleukin-6/analysis , Tumor Necrosis Factor-alpha , Statistics, Nonparametric , Middle AgedABSTRACT
Em todo ato cirúrgico para instalação de implanttes dentários ocorre uma contaminação inerente ao procedimento que pode prejudicar a cicatrização. Este projeto foi proposto para encontrar uma forma de reduzir a microbiota da área peri-implantar com a terapia fotodinâmica (PDT, do inglês photodynamic therapy). Após triagem (critérios de inclusão: normorreativos, com espaço intercalar superior, sem histórico de doença periodontal grave), cinco pacientes foram selecionados e reabilitados com implantes Standard Plus da Straumann®. Ao término da cirurgia, uma primeira coleta microbiológica peri-implantar foi efetuada (controle). Aplicou-se o corante azul de metileno a 0,005% por 5 minutos. Em seguida, a área peri-implantar foi irradiada com laser diodo de baixa potência (AsGaAl, 660 nm, 40mW), por 2 minutos, totalizando 120 J/cm(2) de densidade de energia, dividida em 4 pontos (2 na vestibular e 2 na palatina). Ao término da PDT, outra coleta microbiológica foi realizada (teste). Todo o material coletado passou pelo seguinte processo: diluições seriadas; semeadura em meios de cultura; incubação em meio anaeróbio por sete dias e contagem do número de unidades de colônias totais (UFC). O teste estatístico de Wilcoxon mostrou haver diferença significante (p < 0,001) na redução bacteriana para as UFC, tendo como mediana dessa redução 93,67%. Os resultados permitem afirmar que a PDT é um método eficaz de descontaminação da área cirúrgica no pós-operatório imediato de implantes dentários.