Photobiomodulation for Oral Mucositis - A Microcosting and Budget Impact Analysis from a Brazilian Perspective

ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil's Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario.

Atividade antifúngica de nanofibras de policaprolactona/nistatina: estudo in vitro e in vivo / Antifungal activity of polycaprolactone/nystatin nanofibers: in vitro and in vivo study

Este estudo avaliou a eficácia in vitro e in vivo de mantas de nanofibras (NF) de policaprolactona (PCL) incorporadas com nistatina (NIS) no tratamento da estomatite protética (EP) em modelos animais. NF foram sintetizadas com diferentes concentrações de NIS, totalizando quatro soluções: PCL puro, PCL/NIS 0,045 g, PCL/NIS 0,090 g e PCL/NIS 0,225 g. A liberação da NIS foi analisada por espectroscopia Ultravioleta-Visível. A capacidade das mantas de inibirem o biofilme de Candida albicans, principal fator etiológico da EP, dividindo-se cinco grupos (N=5) compostos por um grupo com controle de células de C. albicans e com PCL puro, além das três concentrações de NIS. A seguir, foi analisada a viabilidade celular em queratinócitos humanos (HaCat) por meio do teste colorimétrico de resazurina. Cinco grupos foram divididos (N=10): controle celular, PCL puro e as três concentrações de NIS. Em modelos animais de ratos Wistar albinos (N=18), dispositivos palatinos (DP) de resina acrílica foram confeccionados simulando próteses totais e utilizados para a indução da EP. Para isso, DP contaminados com C. albicans foram cimentados na região molar da cavidade bucal dos animais e permaneceram em boca por 48 h. Após esse período, os DP foram removidos e os animais foram divididos em três grupos: (C) controle; (B1) com tratamento por mantas de PCL/NIS 0,045 g e (B2) PCL/NIS 0,225 g, com N=6. Então novos DP, livres de contaminação, foram cimentados na cavidade oral dos animais e permaneceu por mais 48 h. Após esse período, os animais foram eutanasiados, a contagem de UFC/ mL foi realizada e os palatos foram coletados para a análise histológica. A curva padrão de NIS obtida apresentou R2 de 0,99. As três concentrações de NF apresentaram liberação de NIS, com pico no tempo de 6 h e valores de 66,26 µg/ mL para PCL/NIS 0,045 g, de 333,87 µg/ mL para PCL/NIS 0,090 g e 436,51 µg/ mL para PCL/NIS 0,225 g, constantes até o fim do experimento. Os grupos com NIS reduziram em 2,5 log10 de crescimento do biofilme fúngico em relação aos grupos sem tratamento, Controle e PCL, sem diferença estatística significativa. Não foi observada citotoxicidade nas células HaCat, com viabilidade celular de 93,7% para PCL/NIS 0,045 g, 72,6% para PCL/NIS 0,090 g e 72,4% para PCL/NIS 0,225 g. A indução da EP nos três grupos foi possível e, porém, sem redução significativa na contagem de UFC/ mL de C. albicans nos grupos B1 e B2. Na análise histológica do grupo C pôde-se observar infiltração de hifas de Candida na camada queratinizada, presença de células inflamatórias formando micro abscessos e um discreto infiltrado inflamatório no tecido conjuntivo subjacente ao epitélio infectado. Nos grupos B1 e B2 não foram encontradas alterações epiteliais, concluindo-se que as NF demonstraram atividade antifúngica in vitro e foram efetivas na prevenção da penetração de hifas no tecido palatino de animais com DP (AU)

This study evaluated the in vitro and in vivo efficacy of nanofiber (NF) mats of polycaprolactone (PCL) incorporated with nystatin (NIS) in the treatment of denture stomatitis (DS) in animal models. NFs were synthesized with different concentrations of NIS, totaling four solutions: pure PCL, PCL/NIS 0.045 g, PCL/NIS 0.090 g, and PCL/NIS 0.225 g. The release of NIS was analyzed by Ultraviolet-Visible spectroscopy. The ability of the mats to inhibit Candida albicans biofilm, the main etiological factor of DS, was assessed by dividing five groups (N=5) composed of a group with C. albicans cell control and with pure PCL, in addition to the three concentrations of NIS. Next, cell viability in human keratinocytes (HaCat) was analyzed using the resazurin colorimetric test. Five groups were divided (N=10): cell control, pure PCL, and the three concentrations of NIS. In albino Wistar rat animal models (N=18), palatal devices (PD) made of acrylic resin were fabricated to simulate total prostheses and used to induce DS. For this, PD contaminated with C. albicans were cemented in the molar region of the animals' oral cavity and remained in the mouth for 48 hours. After this period, the PDs were removed, and the animals were divided into three groups: (C) control; (B1) treated with PCL/NIS 0.045 g mats, and (B2) PCL/NIS 0.225 g, with N=6. Then new, uncontaminated PDs were cemented in the animals' oral cavity and remained for another 48 hours. After this period, the animals were euthanized, UFC/ mL counts were performed, and the palates were collected for histological analysis. The standard NIS curve obtained showed an R2 of 0.99. The three concentrations of NF showed NIS release, with a peak at 6 h and values of 66.26 µg/ mL for PCL/NIS 0.045 g, 333.87 µg/ mL for PCL/NIS 0.090 g, and 436.51 µg/ mL for PCL/NIS 0.225 g, remaining constant until the end of the experiment. The groups with NIS reduced fungal biofilm growth by 2.5 log10 compared to the untreated groups, Control and PCL, with no significant statistical difference. No cytotoxicity was observed in HaCat cells, with cell viability of 93.7% for PCL/NIS 0.045 g, 72.6% for PCL/NIS 0.090 g, and 72.4% for PCL/NIS 0.225 g. Induction of DS in the three groups was possible; however, there was no significant reduction in UFC/ mL counts of C. albicans in groups B1 and B2. Histological analysis of group C revealed infiltration of Candida hyphae in the keratinized layer, presence of inflammatory cells forming micro abscesses, and a discreet inflammatory infiltrate in the connective tissue underlying the infected epithelium. No epithelial alterations were found in groups B1 and B2, concluding that NFs demonstrated in vitro antifungal activity and were effective in preventing hyphal penetration into palatal tissue in animals with PD.(AU)

Childhood lichenoid granulomatous stomatitis: a case report and literature review / 口腔疾病防治

Objective@#To investigate the classification, clinical manifestations, diagnosis, differential diagnosis and treatment of oral lichenoid lesions and provide a reference for clinical practice.@*Methods@#Hospital ethical approval and patient informed consent were obtained. We report a case of oral lichenoid lesion in children and review the diagnosis and treatment of oral lichenoid damage in the literature.@*Results@#The patient experienced repeated rupture of the dorsal surface of the tongue with pain for more than 3 years. There was a large area of tongue back surface erosion with an irregular shape, surrounded by pearly-white lines. The left erosive area was accompanied by tissue hyperplasia, which was approximately 1.5 cm × 2.0 cm, with tough texture and broad masses. The pathological diagnosis of the patient was oral lichenoid lesion. After biopsy of the dorsal surface of the tongue, the pathological diagnosis of the patient was granulomatous inflammation. The final diagnosis of lichenoid granulomatous stomatitis was made on the basis of the patient's intraoral damage features, systemic history, medication history and histopathological findings. A review of the literature suggests that oral lichenoid lesions have an unknown etiology and need to be clinically differentiated from oral lichen planus, oral lichenoid drug reactions, oral lichenoid contact damage and chronic ulcerative stomatitis. The clinical treatment of oral lichen planus is based on the topical and/or systemic use of glucocorticoids.@*Conclusion@#There are still no uniform criteria for the classification and diagnosis of oral lichenoid lesions. They rely mainly on history taking, clinical manifestations and histopathological findings, and the treatment is mainly based on the topical and/or systemic use of glucocorticoids.

Láser de baja frecuencia para aftas mayores recurrentes. Caso Clínico / Low frequency laser for major recurrent aphthous stomatitis. Clinical case

La estomatitis aftosa recurrente (menor, mayor o herpética) es una de las enfermedades bucodentales más frecuentes, de etiología multifactorial y con predisposición genética. Para esta patología su diagnóstico es clínico, y tomando como base la historia clínica se puede discriminar con otras patologías ulcerativas. La terapia con láser de baja potencia (LLLT) se propone como un tratamiento no invasivo, actuando como un fotomodulador celular, por lo que reduce el dolor, la inflamación, y estimula la regeneración tisular, previniendo daños. En el presente artículo se reporta a un niño de 11 años con una herida dolorosa de 4 meses en el borde posterior de la lengua que apareció tras una mordedura, en el que a la exploración clínica se encontró una lesión amarillenta con zonas enrojecidas, rodeada de un halo blanquecino de bordes redondeados. Para el tratamiento se utilizó LLLT, luego de una semana disminuyó el dolor, el paciente comenzó a comer correctamente, a los 15 días se observó una reducción de los bordes rojizos de la lesión, pasado el mes la lesión había remitido casi por completo. La LLLT se describe como un tratamiento eficaz, no invasivo, reduciendo los síntomas, y mejorando la calidad de vida del paciente al promover la curación de las lesiones.

Recurrent aphthous stomatitis (minor, major or herpetic) is one of the most frequent bucodental diseases, of multifactorial etiology and with genetic predisposition. The diagnosis of this pathology is clinical, and based on the clinical history it can be discriminated with other ulcerative pathologies. Low power laser therapy (LLLT) is proposed as a non-invasive treatment, acting as a cellular photo modulator, which reduces pain, inflammation, and stimulating tissue regeneration, preventing damage. This article reports an 11-year-old boy with a 4-month-old painful wound on the posterior edge of the tongue that appeared after a bite, in which clinical examination revealed a yellowish lesion with reddened areas, surrounded by a whitish halo with rounded edges. LLLT was used for the treatment, after one week the pain decreased, the patient started to eat properly, after 15 days a reduction of the reddish edges of the lesion was observed, after one month the lesion had almost completely remitted. LLLT is described as an effective, non-invasive treatment, which reduces symptoms and improves the patient's quality of life promoting the healing of the lesions.

Angina bolhosa hemorrágica: características clínicas, histopatológicas, diagnóstico e estratégias terapêuticas

Introdução: A angina bolhosa hemorrágica (ABH) é uma condição rara, benigna e geralmente assintomática, caracterizada pelo surgimento súbito de bolhas preenchidas com sangue nas superfícies mucosas da cavidade oral e orofaringe. Objetivo: Este trabalho tem como propósito fornecer uma análise abrangente das características clínicas, etiológicas e histopatológicas da angina bolhosa hemorrágica, além de abordar métodos de diagnóstico e opções de tratamento. Materiais e métodos: Foi realizada uma busca por artigos científicos publicados de 2010 a 2023, nas bases de dados Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) e ScienceDirect. Foram coletados artigos em inglês e português utilizando as palavras-chave "angina bolhosa hemorrágica", "estomatite bolhosa hemorrágica benigna", "hemorrhagic bullous angina" e "benign hemorrhagic bullous stomatitis". Conclusão: A ABH é escassamente documentada na literatura, com muitos dados ausentes ou subnotificados. Embora seja uma condição benigna com rápida evolução espontânea, o procedimento diagnóstico deve ser rigoroso para descartar outras possíveis lesões.

Introduction: Hemorrhagic bullous angina (ABH) is a rare, benign and generally asymptomatic condition, characterized by the sudden appearance of blisters filled with blood on the mucous surfaces of the oral cavity and oropharynx. Objective: This work aims to provide a comprehensive analysis of the clinical, etiological and histopathological characteristics of hemorrhagic bullous angina, in addition to addressing diagnostic methods and treatment options. Materials and methods: A search was carried out for scientific articles published from 2010 to 2023, in the Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) and ScienceDirect databases. Articles were collected in English and Portuguese using the keywords "hemorrhagic bullous angina", "benign hemorrhagic bullous stomatitis", "hemorrhagic bullous angina" and "benign hemorrhagic bullous stomatitis". Conclusion: ABH is scarcely documented in the literature, with many data missing or underreported. Although it is a benign condition with rapid spontaneous evolution, the diagnostic procedure must be rigorous to rule out other possible lesions.

Eficacia del bórax en el tratamiento de la estomatitis aftosa

Fundamento: la estomatitis aftosa es una enfermedad crónica caracterizada por la ulceración de la mucosa bucal no queratinizada, que se presenta de forma aguda y dolorosa. Objetivo: evaluar la eficacia del bórax en el tratamiento de la estomatitis aftosa. Métodos: se realizó un estudio analítico, longitudinal prospectivo, en el Departamento de Estomatología del Policlínico Norte, Ángel del Castillo Agramonte, del municipio de Florida, en el período comprendido de diciembre del 2019 hasta abril del 2021. El universo estuvo constituido por 139 pacientes, y la muestra quedó conformada por 70 pacientes seleccionados por un método aleatorio simple. La misma quedó dividida en dos grupos: uno de estudio y otro de control a los que se le aplicó un tratamiento homeopático con bórax y un tratamiento convencional, respectivamente. Resultados: el rango de edad más afectado fue el de 21- 30 años, y el sexo femenino fue el más representado; los labios constituyeron el sitio de mayor afectación y prevaleció la estomatitis aftosa en su forma menor. En cada visita de control se observó una mejor evolución del dolor, el ardor y la cicatrización de las lesiones con el tratamiento homeopático, que con el convencional; se observó una efectividad de un 100 % en los pacientes tratados con bórax y la mayoría de los pacientes se mostró satisfecha con el tratamiento homeopático recibido. Conclusiones: el bórax resulta eficaz para el tratamiento de la estomatitis aftosa.

Background: aphthous stomatitis is a chronic disease characterized by the non-keratinized oral mucosa ulceration, which presents acutely and painfully. Objective: to evaluate the efficacy of borax in the aphthous stomatitis treatment. Methods: an analytical, longitudinal prospective study was carried out in the North Polyclinic Stomatology Department, Ángel del Castillo Agramonte, in the Florida municipality, from December 2019 to April 2021. 139 patients were studied and the sample was made up of 70 patients selected by a simple random method. It was divided into two groups: a study group and a control group to which a homeopathic treatment with borax and a conventional treatment were applied, respectively. Results: the most affected age range was 21-30 years old, and the female sex was the most represented; the lips were the most affected site and aphthous stomatitis prevailed in its minor form. At each control visit, a better evolution of pain, burning, and healing of the lesions was observed with the homeopathic treatment than with the conventional one; an effectiveness of 100% was observed in the patients treated with borax and the majority of the patients were satisfied with the homeopathic treatment received. Conclusions: borax is effective for the treatment of aphthous stomatitis.

Tratamiento con radiación láser de baja potencia en pacientes con estomatitis aftosa recurrente

Fundamento entre las urgencias periodontales que requieren atención inmediata está la estomatitis aftosa recurrente, debido a las molestias o complicaciones que ocasiona al paciente. El empleo de la radiación láser de baja potencia puede resultar efectivo en el tratamiento de esta entidad. Objetivo determinar el efecto terapéutico del tratamiento con radiación láser de baja potencia en pacientes con diagnóstico de estomatitis aftosa recurrente. Métodos estudio descriptivo, transversal, realizado en el periodo mayo/2019-mayo/2021, en el servicio estomatológico del policlínico Dr. Enrique Barnet, del municipio de Lajas, provincia de Cienfuegos, que incluyó a 46 pacientes con diagnóstico de estomatitis aftosa recurrente. Se empleó el análisis de documentos, la observación y el cuestionario; además del examen bucal como método diagnóstico. Los pacientes recibieron tratamiento con radiación láser de baja potencia. Se aplicó el programa EPIDAT 3.1 para el procesamiento estadístico de los datos. Resultados predominó el sexo femenino, la edad entre 19-34 años, así como las úlceras aftosas menores. Las lesiones se localizaron principalmente en labio. El 97,83 % de los pacientes refirió remisión de la lesión al quinto día de tratamiento. Todos los pacientes tratados evolucionaron favorablemente hacia la cicatrización. Solo un paciente presentó reacciones adversas. Conclusiones los resultados permitieron constatar los beneficios terapéuticos de la terapia con láser de baja potencia en el tratamiento de la estomatitis aftosa recurrente.

Background among the periodontal emergencies that require immediate attention is the RAS, due to the inconvenience or complications that it causes to the patient. The use of low power laser radiation can be effective in the treatment of this entity. Objective to determine the therapeutic effect of treatment with low-power laser radiation in patients diagnosed with recurrent aphthous stomatitis. Methods descriptive, cross-sectional study, carried out from May/2019 to May/2021, in the Dr. Enrique Barnet polyclinic's dental service, in Lajas municipality, Cienfuegos province, which included 46 patients diagnosed with recurrent aphthous stomatitis. Document analysis, observation and questionnaire were used; in addition to the oral examination as a diagnostic method. Patients received treatment with low-power laser radiation. The EPIDAT 3.1 program was applied for the statistical data processing. Results the female sex predominated, the age between 19-34 years, as well as minor aphthous ulcers. The lesions were located mainly on the lip. 97.83% of the patients reported remission of the lesion on the fifth day of treatment. All treated patients evolved favorably towards healing. Only one patient presented adverse reactions. Conclusions the results allowed us to verify the therapeutic benefits of low power laser therapy in the treatment of recurrent aphthous stomatitis.

Research progress on neutrophil extracellular traps in oral infectious diseases / 口腔疾病防治

@#Eutrophils are the first innate immune cells to reach the site of inflammation. Neutrophils produce neutrophil extracellular traps (NETs) that can quickly capture and limit the spread of pathogens, facilitating the removal of pathogens and their debris. Neutrophils in the oral cavity are specifically transformed from circulating neutrophils in the blood, and the number of NETs released by oral neutrophils is much higher than that of circulating neutrophils, thus better maintaining the balance of the oral microenvironment. As a bimorphic fungus, only the mycelium phase of Candida albicans can induce NETs, which is related to the neutrophils' ability to sense the size of pathogenic microorganisms through neutrophil elastase. However, spherical Staphylococcus aureus are much smaller than Candida albicans, and they can still induce NETs. Porphyromonas gingivalis, as one of the microorganisms in the periodontitis complex, induces fewer NETs than Streptococcus oralis and Actinomycetes, which are two common oral microorganisms, and there may be a mechanism allowing them to escape neutrophilic immunity in the early stage of periodontitis. Although the two main pathways of NET production have been studied in detail, the mechanisms involved in the induction of NETs by different microorganisms, especially from oral neutrophils, are not well understood. This review describes the mechanism of the immune effects of pathogenic microorganisms on neutrophil NETs in the oral cavity, providing a reference for the search for therapeutic targets and the development of key drugs for treating oral infectious diseases.

Crioterapia en pacientes geriátricos con estomatitis subprótesis

Introducción: En la actualidad se emplean nuevas alternativas no invasivas para la remoción de diversos procesos inflamatorios del epitelio mucoso bucal, siendo la crioterapia una técnica fisioterapéutica basada en la aplicación del frío intenso con nitrógeno líquido para producir en la piel o mucosas del organismo una congelación y destrucción local de células y tejidos afectados de forma controlada. Objetivo: Evaluar los efectos terapéuticos de la criocirugía en pacientes geriátricos portadores de estomatitis subprótesis. Métodos: Se efectuó un estudio descriptivo y transversal de 50 pacientes adultos mayores, de ambos sexos, diagnosticados con estomatitis subprótesis y asistidos en la consulta estomatológica del Policlínico de Especialidades referente al Hospital Clinicoquirúrgico Universitario Saturnino Lora Torres de la provincia Santiago de Cuba, en el periodo comprendido desde marzo de 2022 hasta igual mes de 2023. Resultados: Se evidenció que las congelaciones entre 20 y 30 segundos y los deshielos entre 91 y 120 segundos fueron los más eficaces en la destrucción de la mucosa palatina dañada, logrando la regeneración tisular en un tiempo mínimo con la indicación de uno a tres ciclos de enfriamientos rápidos y deshielos lentos en una sesión terapéutica. La ausencia de síntomas fue lo más relevante en la evolución postquirúrgica. Conclusiones: La crioterapia demostró ser un método eficaz e inocuo para regenerar los tejidos lesionados al realizar congelaciones rápidas con deshielos lentos. Este método crioquirúrgico, fácil de aplicar y atraumático, logró una óptima reparación y reepitelización de los tejidos bucales dañados con excelentes respuestas terapéuticas, evitando complicaciones postquirúrgicas como la infección y el sangramiento local.

Introduction: At present, new non-invasive alternatives are used for the removal of various inflammatory processes of the oral mucous epithelium; being cryotherapy a physiotherapeutic technique based on the application of intense cold with liquid nitrogen to produce freezing on the skin or mucous membranes of the organism and local destruction of affected cells and tissues in controlled manner. Objective: To evaluate the therapeutic effects of cryotherapy in geriatric patients with sub-prosthesis stomatitis. Methods: A descriptive and cross-sectional study of 50 older adult patients, of both sexes, clinically diagnosed with subprosthesis stomatitis and assisted in the dentistry consultation of the Specialties Polyclinic referring to the Saturnino Lora Torres University Clinical Surgical Hospital in the city of Santiago de Cuba, in the period from March 2022 to the same month of 2023. Results: It was evidenced that freezing between 20 and 30 seconds and thawing between 91 and 120 seconds were the most effective in the destruction of the damaged palatal mucosa, achieving tissue regeneration in a minimum time with the performance of 1 to 3 cycles of rapid cooling and slow thawing in a therapeutic session. The absence of symptoms was the most relevant in the post-surgical evolution. Conclusions: Cryotherapy proved to be an effective and innocuous method to regenerate injured tissues when fast freezing with slow thawing. This cryosurgical method, easy to apply and atraumatic, achieved optimal repair and re-epithelization of damaged oral tissues with excellent therapeutic responses, avoiding post-surgical complications such as infection and local bleeding.

Influence of low-level laser on oral mucositis treatment in young cancer patients undergoing chemotherapy: a systematic review / Influência do laser de baixa intensidade no tratamento da mucosite oral em pacientes jovens com câncer em tratamento quimioterápico: uma revisão sistemática

ABSTRACT Perform a systematic review of the literature to seek scientific evidence on the effect of low-level laser therapy on duration, degree and pain of chemotherapy-induced oral mucositis in young patients with cancer. Methods: A bibliographic search was performed using the PubMed, Scopus and Web of Science databases to identify relevant scientific studies, found through the descriptors "laser therapy", "phototherapy", "oral mucositis", "pediatric patient" and "children" to evaluate this association. Information regarding the degree of mucositis, pain associated with patients, toothbrushing and laser were analyzed characteristics. Results: Of the nine studies, one did not obtain significant results on the healing action of LLLT on oral mucositis and of the eight remaining studies, 83. 3% showed significant evidence of a decrease in the degree of oral mucositis and consequently its duration. With regard to pain, 100% of the studies confirmed its decrease. Conclusion: Low-level laser therapy is considered an efficient instrument for the treatment of oral mucositis on young patients with cancer due to its analgesic, anti-inflammatory and healing effects.

RESUMO Realizar uma revisão sistemática da literatura para buscar evidência científica sobre o efeito da terapia a laser de baixa intensidade sobre a duração, grau e dor da mucosite oral induzida pela quimioterapia em pacientes jovens oncológicos. Realizou-se uma pesquisa bibliográfica utilizando as bases de dados PubMed, Scopus e Web of Science para identificar estudos científicos relevantes, encontrados através dos descritores "laser therapy", "phototherapy", "oral mucositis", "pediatric patient" e "children", que avaliassem esta associação. Foram analisadas informações referentes ao grau de mucosite, a dor associada aos pacientes, a escovação e as características do laser. Dos nove estudos incluídos, um não obteve resultados significativos sobre a ação cicatrizante da LLLT na mucosite oral e dos oito estudos restantes, 83,3% mostraram evidências significativas na diminuição do grau da mucosite oral e, consequentemente, na duração da mesma. Com relação a dor, 100% dos estudos comprovaram sua diminuição. A laserterapia de baixa intensidade é considerada um instrumento eficiente para o tratamento da mucosite oral em pacientes oncológicos jovens devido aos seus efeitos analgésicos, anti-inflamatórios e cicatriciais.

Oral Mucositis in Children with Leukemia Undergoing Chemotherapy: A Case Series

ABSTRACT Objective: To report nine cases of pediatric patients with Acute Lymphoid Leukemia (ALL) or Acute Myeloid Leukemia who developed severe oral mucositis (SOM) at the first week of chemotherapy. Material and Methods: The cases were selected from a sample of 105 children followed for 10 consecutive weeks. Hematological and personal data were obtained from the patient's medical records. The oral cavity was examined weekly using the modified Oral Assessment Guide. Results: More of the patients were male (55.6%), had black/brown skin (55.6%), with ALL (66.7%), and the mean age was 5.55. Two patients had values below normal for leukocytes, platelets, and creatinine over the follow-up. However, all patients showed changes in the normality of hematological data in most weeks. The most used chemotherapeutic agents were aracytin, etoposide, and methotrexate, known for their high stomatotoxic potential. Patients had 2 to 6 (mean of 4) episodes of SOM and 4 to 7 (mean of 5.5) episodes of OM. One patient at week 7, one patient at week 5, and one patient at weeks 2 and 10 did not have OM. Saliva (84 times) and lips (44 times) were the most affected items. Conclusion: The patients showed oscillations in the severity of oral mucositis and hematological parameters over the follow-up. All patients were exposed to stomatotoxic drugs during the initial phase of cancer treatment.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Mucosite oral quimioinduzida: aspectos clínicos, laboratoriais, qualidade de vida, ansiedade e depressão / Chemotherapy-induced oral mucositis: clinical and laboratory aspects, quality of life, anxiety, and depression

O presente estudo é fundamentado em três objetivos: 1. sintetizar informações sobre ansiedade/depressão de indivíduos em regimes antineoplásicos que desenvolveram mucosite oral por meio de uma revisão sistemática da literatura; 2. avaliar o perfil de citocinas inflamatórias e a formação de redes extracelulares de neutrófilos em amostras de saliva de pacientes em quimioterapia e suas associações com mucosite oral; e 3. investigar ansiedade/depressão e qualidade de vida e associações com mucosite oral quimioinduzida. No primeiro estudo, buscas eletrônicas foram realizadas em cinco bases de dados, complementadas por escrutínio manual e pesquisas na literatura cinzenta. Oito estudos observacionais foram incluídos e a amostra analisada foi de 954 indivíduos. Sete instrumentos diferentes foram aplicados para mensurar ansiedade e/ou depressão. Associações de ansiedade e/ou depressão com a gravidade da mucosite oral foram observadas em 75,0% dos estudos. Os outros dois estudos foram análises longitudinais prospectivas com indivíduos adultos com diagnóstico de doenças hematolinfóides e em tratamento quimioterápico e/ou condicionamento para transplante de células-tronco hematopoiéticas no Hospital das Clínicas da Universidade Federal de Minas Gerais. Os níveis de citocinas inflamatórias (IL-1, IL-6, IL-8, TNF-α e TGF-ß1) e a formação de redes extracelulares de neutrófilos foram analisados por ELISA e identificação do complexo mieloperoxidase-DNA, respectivamente. As coletas de saliva foram realizadas em quatro momentos: dias D0, D3, D10 e D15. Dos 60 pacientes avaliados, 26 (43,3%) desenvolveram algum grau de mucosite oral. Os níveis de concentração de citocinas revelaram diferenças entre indivíduos com e sem mucosite oral. Concentrações significativamente maiores de IL-6 e TNF-α e menores concentrações de TGF-ß1 foram identificadas naqueles que desenvolveram mucosite oral. Houve uma diminuição na formação das redes extracelulares de neutrófilos entre aqueles que tiveram mucosite oral. Entretanto, não foram identificadas diferenças estatísticas entre as concentrações de citocinas e a formação de redes extracelulares de neutrófilos com variáveis clínicas e gravidade da mucosite oral. No terceiro estudo, os instrumentos Hospital Anxiety and Depression Scale, World Health Organization Quality of Life-BREF e Oral Health Impact Profile (versão abreviada ­ OHIP-14) foram aplicados a 37 pacientes nos dias D0 e D15. Aproximadamente 38% (n=14) dos indivíduos desenvolveram mucosite oral e obtiveram escores mais altos de ansiedade/depressão no início da análise. A mucosite oral teve um impacto negativo na qualidade de vida relacionada à saúde bucal, particularmente nas dimensões limitação funcional, dor física e incapacidade física. Em conjunto, os dados deste estudo contribuem para medidas preventivas e redução de comorbidades em pacientes com mucosite oral induzida por esquemas quimioterápicos. As citocinas inflamatórias participam do desenvolvimento da mucosite oral e podem ser úteis como biomarcadores na predição e monitoramento. Ademais, sintomas de ansiedade e depressão estão associados à mucosite oral que, por sua vez, afetam a saúde geral e a qualidade de vida relacionada à saúde bucal.

The present study is based on three purposes: 1. to synthesize by means of a systematic literature review information about anxiety/depression in individuals undergoing antineoplastic therapy who developed oral mucositis; 2. to evaluate the profile of inflammatory cytokines and neutrophil extracellular trap formation in salivary samples from patients undergoing chemotherapy and its associations with oral mucositis; and 3. to investigate anxiety/depression and quality of life and their associations with chemotherapy-induced oral mucositis. In the first study, electronic searches were conducted on five databases, complemented by manual scrutiny and grey literature searches in three other databases. Eight observational studies conducted on 954 individuals were included. Seven different instruments were applied to measure anxiety and/or depression. Associations of anxiety and/or depression with the severity of oral mucositis were observed in 75.0% of the studies. The other two studies were prospective longitudinal analyses of adult individuals diagnosed with hematolymphoid diseases and undergoing chemotherapy treatment and/or conditioning for hematopoietic stem-cell transplantation at the Hospital das Clínicas of Universidade Federal de Minas Gerais. The levels of inflammatory cytokines (IL-1, IL-6, IL-8, TNF-α, and TGF-ß1) and neutrophil extracellular trap formation were analyzed by ELISA and by the identification of the myeloperoxidase-DNA complex, respectively. Saliva sampling was performed at four time-points, i.e. days D0, D3, D10, and D15. Of the 60 patients evaluated, 26 (43.3%) developed some degree of oral mucositis. Cytokine concentration levels revealed differences between individuals with and without oral mucositis. Significantly higher concentrations of IL-6 and TNF-α and lower concentrations of TGF-ß1 were identified in those who developed oral mucositis. There was a decrease in neutrophil extracellular trap formation among those who experienced oral mucositis. However, no statistical differences were identified between cytokine concentrations or neutrophil extracellular trap formation and clinical variables or severity of oral mucositis. In the third study, the Hospital Anxiety and Depression Scale, World Health Organization Quality of Life-BREF and Oral Health Impact Profile (short-form ­ OHIP-14) were the instruments applied to 37 patients on days D0 and D15. Nearly 38% (n=14) of individuals developed oral mucositis and had higher anxiety/depression scores at baseline. Oral mucositis had a negative impact on quality of life related to oral health, particularly functional limitation, physical pain, and physical disability. Taken together, the data from this study contribute to the application of preventive measures and the reduction of comorbidities in patients with chemotherapy-induced oral mucositis. Inflammatory cytokines participate in the development of oral mucositis and may be useful as biomarkers in prediction and monitoring. Moreover, anxiety and depressive symptoms are associated with oral mucositis, affecting, in turn, overall health and oral health-related quality of life

Desafios terapêuticos da mucosite oral em oncopediatria / Therapeutic challenges of oral mucositis in pediatric oncology

O Neuroblastoma (NB) é uma neoplasia do sistema nervoso simpático, e o segundo tumor sólido maligno extracraniano mais comum da infância. Na terapia antineoplásica, complicações orais podem ser observadas, dentre elas a mucosite oral (MO). Trata-se de uma inflamação aguda da mucosa, proveniente da toxicidade dos quimioterápicos. Este relato de caso enfatiza o manejo da MO, bem como sua influência na condição sistêmica e qualidade de vida. Paciente do sexo feminino, nove anos, apresentou recidiva de NB metastático, após tratamento de primeira linha. Admitida na unidade hospitalar para tratamento oncológico na enfermaria de pediatria oncológica, queixando-se de dor intensa em cavidade bucal e orofaringe, associada a pancitopenia severa febril. Ao exame físico apresentava disfagia e déficit ponderal grave, que debilitava a deglutição da própria saliva. O exame intraoral revelou lesões de MO grau 3, segundo a Organização Mundial de Saúde (OMS), em lábios, gengiva anterior e orofaringe. O tratamento consistiu em remoção de debris local, higiene da cavidade bucal com clorexidina 0,12% e utilizando haste flexível de algodão estéril tipo "Swab", visando controle microbiano local, diariamente. Além disso, foi aplicado no leito eritematoso e hemorrágico fotobiomodulação (660 nm, 50 mW, 2 J/cm2, 90 segundos) pontualmente nas áreas do leito da lesão e em varredura na região de orofaringe (sessões intercaladas). Foi prescrito acetato de racealfatocoferol (vitamina E) para ação antioxidante e hidratação dos lábios. Concomitante a mucosite, a paciente apresentou pancitopenia febril severa, sendo necessário uso de cefepima 150 mg/kg/dia, com coleta prévia de hemoculturas, fator estimulador de colônias de granulócitos, Fluconazol, hidratação e suporte nutricional. As hemoculturas foram negativas. As consequências da mucosite contribuíram para desnutrição e piora da qualidade de vida. Conclui-se que a intervenção odontológica em interdisciplinaridade, possibilitou o restabelecimento físico e emocional, possibilitando melhor uma qualidade de vida da paciente (AU).

Neuroblastoma (NB) is a neoplasia of the sympathetic nervous system and the second most common extracranial malignant solid tumor in childhood. In antineoplastic therapy, oral complications can be observed in antineoplastic therapy, among them oral mucositis (OM). It is an acute mucosa inflammation resulting from the toxicity of chemotherapy drugs. This case report emphasizes the management of OM and its influence on the systemic condition and quality of life. A female patient, nine years old, presented a recurrence of metastatic NB after first-line treatment. She was admitted to the hospital unit for oncological therapy in the pediatric oncology ward, complaining of severe pain in the oral cavity and oropharynx associated with severe febrile pancytopenia. On physical examination, she presented dysphagia and severe weight deficit, which weakened the swallowing of her saliva. According to the World Health Organization (WHO), the intraoral exam revealed third-grade OM lesions on the lips, anterior gum, and oropharynx. Treatment consisted of removing local debris, cleaning the oral cavity with 0.12% chlorhexidine, and using a flexible, sterile cotton swab, aiming for daily local microbial control. In addition, photobiomodulation (660 nm, 50 mW, 2 J/cm2, 90 seconds) was applied to the erythematous and hemorrhagic bed, punctually in the areas of the lesion and sweeps in the oropharynx region (interspersed sessions). Racealphatocopherol acetate (vitamin E) was prescribed for antioxidant action and lip hydration. Concomitant with mucositis, the patient had severe febrile pancytopenia, requiring cefepime 150 mg/kg/day, with previous collection of blood cultures, granulocyte colony-stimulating factor, fluconazole, hydration, and nutritional support. Blood cultures were negative. The consequences of mucositis contributed to malnutrition and worsened quality of life. It is concluded that the interdisciplinary dental intervention enabled physical and emotional restoration, enabling a better quality of life for the patient (AU).

Construction and verification of recombinant chimeric vesicular stomatitis virus expressing rabies virus G protein / 中国生物制品学杂志

@#Objective To construct recombinant chimeric vesicular stomatitis virus(VSV)expressing G protein of rabies virus(RV)using VSV as vector.MethodsTo rescue the recombinant virus,G gene of VSV antigenome was replaced with G gene of RV vaccine CTN-1 strain,and co-transfected into 293T cells with helper plasmids coding T7 RNA polymerase and proteins N,P and L of VSV. The expression of RV G gene and G protein was detected by RT-PCR,immunofluorescence assay and Western blot. The recombinant virus was subcultured in Vero cells,the virus titer of different generations was detected and the virus growth curve was drawn.ResultsThe recombinant virus VSV-RVG was successfully rescued. RTPCR results demonstrated that the RV G gene was successfully inserted into the genome of the recombinant virus,and the expression of RVG protein was detected by immunofluorescence assay and Western blot. The recombinant virus was continuously passaged for 5 generations,and the virus titer was stable within 7. 5 ～ 8. 5 lgTCID50/mL.ConclusionThe recombinant chimeric VSV expressing RV G protein was successfully constructed with good genetic stability,which lays a foundation of the construction of reverse genetics technology platform based on VSV vector.

Research progress on clinical manifestations and mechanism of radiation-induced taste dysfunction in head and neck cancers / 中华放射肿瘤学杂志

Taste is a critical sensory function for human as it supports sustenance and alerts the body to toxins. Taste dysfunction is a common side effect of radiotherapy for the head and neck cancers, which is often accompanied by oral mucositis in the early stage. It is associated with anorexia, anxiety and depression, leading to declined quality of life and treatment tolerance. The incidence of radiation-induced taste dysfunction is high, and its clinical manifestations include increased taste threshold, tastelessness, and persistent bitter, sour or metallic taste, which exert significant effect upon the quality of life. At present, effective therapeutic measures for radiation-induced taste dysfunction are still lacking. In this article, research progresses on clinical characteristics and the potential mechanisms of radiation-induced taste dysfunction were reviewed, aiming to provide reference for the mechanism, prevention and treatment for taste dysfunction.

Manejo odontológico integral de una paciente con disostosis cleidocraneal. Reporte caso / Integral dental management of a patient with cleidocraneal dysplasia. Case report

Introducción: la disostosis cleidocraneal (CCD) es una enfermedad genética rara que compromete el desarrollo óseo normal, causada por la alteración en el gen RUNX2 del cromosoma 6p (brazo corto). Sus consecuencias incluyen alteraciones óseas por anomalías en la osificación intramembranosa que, a su vez, conllevan a modificaciones en el desarrollo de huesos craneales, claviculares, a múltiples efectos sobre el número, erupción y recambio dental, y a dificultades funcionales, además de cambios en la conducta psicosocial por el deterioro en la calidad de vida. Objetivo: describir el manejo integral de una paciente con disostosis cleidocraneal, a través de la revisión de caso clínico y el reporte de hallazgos en su mejoramiento, como consecuencia de tratamientos quirúrgicos, rehabilitación y el apoyo interdisciplinario, aspecto de gran importancia para este tipo de pacientes. Caso clínico: paciente femenina de 31 años con diagnóstico de CCD que asistió a la Unidad Estomatológica de la Universidad de Cartagena ­ Colombia, y fue remitida desde Genética por presentar inconformidad funcional y dolor leve durante la masticación de los alimentos por movilidad dental severa en dientes antero-inferiores; además, manifestó permanencia de órganos dentarios deciduos, la cual fue tratada en fases. Al tratamiento se le dio un enfoque multidisciplinar, lo que mejoró, de forma sustancial, la autopercepción e interrelación de la paciente en la sociedad.

Background: Cleidocranial dysostosis (CCD) is a rare genetic disease that compromises normal bone development, caused by the alteration in the RUNX2 gene of chromosome 6p (short arm), which causes bone alterations due to abnormalities in intramembranous ossification that leads to alterations in the development of cranial and clavicular bones and multiple efects on the number, eruption and dental turnover, which leads to functional difculties, in addition to behavior and alterations in psychosocial behavior and the deterioration of their quality of life, Objective: To describe the comprehensive management of a patient with cranial Cleido dysostosis, through a clinical case review, reporting among the fndings the improvement of the patient through surgical treatments, rehabilitation and interdisciplinary support, of great importance for this type of patient. Clinical case: A 31-year-old female patient with a diagnosis of CCD, who attended the Stomatology Unit of the University of Cartagena - Colombia, referred by the treating geneticist, due to functional discomfort and mild pain during chewing food due to severe dental mobility. in anterior-inferior teeth, also showing permanence of deciduous dental organs, which was treated in phases in which a multidisciplinary approach was given to its management, which substantially improved its self-perception and its interrelation in society.

Systemic immune inflammation index in patients with recurrent aphthous stomatitis / Índice de inflamação imune sistêmica em pacientes com estomatite aftosa recorrente

Abstract Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019-2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4. HIGHLIGHTS RAS is a chronic, idiopathic, ulcerative oral mucosal disease. SII is a new and inexpensive biomarker that can easily be calculated using the platelet, neutrophil, and lymphocyte count. SII may be a valuable marker to demonstrate the role of systemic inflammation in RAS etiopathogenesis. Vascular, thrombotic, and inflammatory processes are thought to have a role in RAS activation.

Resumo Objetivo: A estomatite aftosa recorrente (EAR) é uma doença crônica idiopática da mucosa oral. Embora sua etiologia e patogênese não sejam totalmente conhecidas, acredita-se que a inflamação possa desempenhar um papel importante. O objetivo deste estudo é demonstrar o papel da inflamação sistêmica entre os possíveis fatores etiológicos da estomatite aftosa recorrente e encontrar uma possível correlação diagnóstica com o índice de inflamação imunológica sistêmica, SII. Método: Foram analisados retrospectivamente pacientes avaliados no ambulatório de otorrinolaringologia e diagnosticados com estomatite aftosa recorrente entre 2019-2021. A relação neutrófilos/linfócitos, a relação plaquetas/linfócitos e os valores de SII foram calculados com base nos resultados do hemograma completo. Parâmetros demográficos e hematológicos dos grupos controle e de pacientes foram comparados. O nível de significância estatística foi considerado como <0,05. Resultados: Não houve diferença estatisticamente significante entre os grupos controle e com estomatite aftosa recorrente quanto à distribuição por sexo e idade (p = 0,566 e p = 0,173, respectivamente). Os valores de SII, a relação neutrófilos/linfócitos e a relação plaquetas/linfócitos foram significantemente maiores no grupo de pacientes em relação aos controles (p <0,001, p <0,001 e p = 0,001, respectivamente). Foi detectada uma correlação muito forte entre SII e relação neutrófilos/linfócitos, uma correlação moderadamente forte entre SII e relação plaquetas/linfócitos e uma correlação moderada entre valores da relação neutrófilos/linfócitos e relação plaquetas /linfócitos (ρ: 0,813, 0,719, 0,532 respectivamente; p-valores <0,001). Conclusão: SII, relação neutrófilos/linfócitos e relação plaquetas/linfócitos apresentam níveis significantemente maiores no grupo com estomatite aftosa recorrente quando comparados ao grupo controle, o que corrobora o papel da inflamação sistêmica na sua etiopatogênese. Além disso, os resultados mostram que o SII é um marcador inflamatório valioso. Nível de evidência: 4. HIGHLIGHTS A estomatite aftosa recorrente é uma doença ulcerativa crônica idiopática da mucosa oral. O SII (do inglês Systemic Immune Inflammation Index) é um biomarcador novo e de baixo custo que pode ser facilmente calculado que usa a contagem de plaquetas, neutrófilos e linfócitos. O SII pode ser um marcador valioso para demonstrar o papel da inflamação sistêmica na etiopatogênese da estomatite aftosa recorrente. Acredita-se que processos vasculares, trombóticos e inflamatórios tenham um papel na ativação da estomatite aftosa recorrente.

Efectividad del Tysuacril en la estomatitis aftosa / Effectiveness of Tysuacril in aphthous stomatitis

RESUMEN Introducción: el Tisuacryl es un biomaterial empleado en la cirugía general y bucal, así como en el tratamiento de la estomatitis aftosa, considerada un proceso multifactorial y actualmente la enfermedad ulcerosa más común de la cavidad oral. Objetivo: determinar la efectividad del Tisuacryl con respecto a la terapia convencional en el tratamiento de la estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. Métodos: se realizó un estudio observacional analítico de casos y controles a 90 pacientes con estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. La información se obtuvo de las historias clínicas individuales de Periodoncia al obtener el consentimiento oral y escrito de los pacientes o sus tutores. Los resultados se obtuvieron por análisis estadístico que incluyó el porciento y la prueba no paramétrica de Cochran Q. Resultados: predominó el sexo femenino y el grupo etario de 10 a 19 años para el 46,7 % en grupo estudio y el 42,2 % en grupo control; la disminución del dolor y la cicatrización iniciaron en el mayor número de pacientes a las 72 horas de tratamiento con Tisuacryl para el 91,1 % y el 55,6 % respectivamente; a los cinco días de aplicación del medicamento la totalidad de ellos estaban asintomáticos y casi todas las aftas bucales cicatrizadas. Conclusiones: las lesiones aftosas en la cavidad bucal evolucionaron satisfactoriamente con la aplicación del Tisuacryl al ser esta una alternativa efectiva de tratamiento en comparación con la terapia convencional.

ABSTRACT Introduction: Tisuacryl is a biomaterial used in general and oral surgery, as well as in the treatment of aphthous stomatitis, considered a multifactorial process and currently the most common ulcerative disease of the oral cavity. Objective: to determine the effectiveness of Tisuacryl with respect to conventional therapy in the treatment of aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Methods: an analytical observational case-control study was conducted on 90 patients with aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Information was obtained from individual Periodontics medical records by obtaining oral and written consent from patients or their guardians. Results were obtained by statistical analysis including percent and Cochran Q nonparametric test. Results: female sex and age group from 10 to 19 years old predominated for 46,7 % in the study group and 42,2 % in the control group; the decrease of pain and healing started in most patients 72 hours after treatment with Tisuacryl for 91,1 % and 55,6 % respectively; being five days after application of the drug all of them asymptomatic and almost all the oral aphthae healed. Conclusions: aphthous lesions in the oral cavity evolved satisfactorily with the application of Tisuacryl being an effective treatment alternative in comparison with conventional therapy.

Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study

ABSTRACT BACKGROUND: There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health. OBJECTIVE: To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition. DESIGN AND SETTING: Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center. METHODS: Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed. RESULTS: Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan). CONCLUSION: Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.