Salivary molecules of bone remodeling and tissue repair after head and neck radiotherapy

Abstract Head and neck radiotherapy causes quantitative and qualitative changes in saliva. The objective of this case-control study was to evaluate the salivary biomarkers associated with bone remodeling and tissue repair in patients submitted to radiotherapy for head and neck cancer treatment, compared with non-irradiated individuals. Total unstimulated saliva was collected for ELISA assay analysis of receptor activator for nuclear factor κ B (RANK) and its ligand (RANK-L), osteoprotegerin, matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor, and epidermal growth factor. Statistics were performed, and revealed that salivary RANK (p = 0.0304), RANK-L (p = 0.0005), matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2 (p = 0.0067), vascular endothelial growth factor (p = 0.0060), and epidermal growth factor (p < 0.0001) were reduced in patients, compared with the control group. Osteoprotegerin did not differ between the groups (p = 0.3765). Salivary biomarkers did not differ according to radiotherapy completion time (p > 0.05). In conclusion, the lower output of the salivary molecules - essential for bone remodeling and tissue repair - may disrupt tissue homeostasis and play a role in the pathogenesis of the radiotherapy-induced deleterious effects in the oral cavity.

Revisões integrativas: conceitos, planejamento e execução / Integrative reviews: concepts, planning, and execution

Objetivo: Fornecer um guia no formato de checklist para auxiliar pesquisadores na condução de revisões integrativas em Odontologia. Métodos:O guiapara revisões integrativas em Odontologiafoi construído a partir do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (The PRISMA Statement). Resultados:Para o delineamento de revisões integrativas em Odontologia é preciso percorrer etapas distintas: 1. Identificação do tema (elaboração da pergunta de pesquisa); 2. Estabelecimento dos critérios de elegibilidade de estudos; 3. Busca sistematizada em diversas fontes de informação; 4. Coleta de dados; 5. Análise dos dados; 6. Discussão; 7. Apresentação da revisão/síntese do conhecimento. Os erros mais comuns ao realizar uma revisão integrativa estão relacionados à descrição incompleta ou não realização de etapas importantes, tais como: 1. Processo de seleção das evidências; 2. Estratégia de busca reprodutível; 3. Detalhes relacionados à busca, seleção e inclusão de estudos; 4. Aplicação dos critérios de elegibilidade; 5. Processo de extração dos dados (definição clara dos dados a serem extraídos, número de revisores envolvidos); 6. Apresentação do processo de seleção de estudos no formato de fluxograma; 7. Avaliação da qualidade dos estudos; 8. Síntese dos resultados. Conclusão:O guia para revisões integrativas em Odontologia apresenta utilidade na redução de equívocos metodológicos frequentemente observados nesse desenho de estudo, bem como estimula a condução de trabalhos com delineamentos robustos.

Aim: To provide a checklist to assist researchers in conducting integrative reviews in Dentistry. Methods: This guideline for integrative reviews in Dentistry was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (The PRISMA Statement). Results: Planning integrative reviews in Dentistry involves different stages: 1. Identification of the theme (elaboration of the research question); 2. Establishment of eligibility criteria; 3. Systematized search in several databases and other data sources; 4. Data collection; 5. Data analysis; 6. Discussion; 7. Report on the review/summary of findings. The most common errors when conducting an integrative review are related to incomplete description or failure to perform important steps, such as: 1. Evidence synthesis; 2. A reproducible search strategy; 3. Details related to studies' search, screening, selection; 4. Clear state eligibility criteria; 5. Data extraction process (clear definition of the data to be extracted, number of reviewers involved); 6. Presentation studies' screening and selection process in a flowchart format; 7. Evaluation of the quality of the studies; 8. Summary of the findings. Conclusion:A guideline for integrative reviews in Dentistry intends to reduce methodological issues frequently observed in this study design, as well as to encourage researchers to conduct studies with a robust design.