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Stolley JM, Scott MC, Joag V, Dale AJ, Johnston TS, Saavedra F, Gavil NV, Lotfi-Emran S, Soerens AG, Weyu E, Pierson MJ, Herzberg MC, Zhang N, Vezys V, Masopust D. Depleting CD103+ resident memory T cells in vivo reveals immunostimulatory functions in oral mucosa. J Exp Med 2023; 220:e20221853. [PMID: 37097449 PMCID: PMC10130744 DOI: 10.1084/jem.20221853] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/15/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023] Open
Abstract
The oral mucosa is a frontline for microbial exposure and juxtaposes several unique tissues and mechanical structures. Based on parabiotic surgery of mice receiving systemic viral infections or co-housing with microbially diverse pet shop mice, we report that the oral mucosa harbors CD8+ CD103+ resident memory T cells (TRM), which locally survey tissues without recirculating. Oral antigen re-encounter during the effector phase of immune responses potentiated TRM establishment within tongue, gums, palate, and cheek. Upon reactivation, oral TRM triggered changes in somatosensory and innate immune gene expression. We developed in vivo methods for depleting CD103+ TRM while sparing CD103neg TRM and recirculating cells. This revealed that CD103+ TRM were responsible for inducing local gene expression changes. Oral TRM putatively protected against local viral infection. This study provides methods for generating, assessing, and in vivo depleting oral TRM, documents their distribution throughout the oral mucosa, and provides evidence that TRM confer protection and trigger responses in oral physiology and innate immunity.
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Affiliation(s)
- J. Michael Stolley
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Milcah C. Scott
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Vineet Joag
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Alexander J. Dale
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Timothy S. Johnston
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Flavia Saavedra
- School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Noah V. Gavil
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Sahar Lotfi-Emran
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Andrew G. Soerens
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Eyob Weyu
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Mark J. Pierson
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Mark C. Herzberg
- School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Nu Zhang
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Vaiva Vezys
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - David Masopust
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
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Jena S, Hasan S, Panigrahi R, Das P, Mishra N, Saeed S. Chemotherapy-associated oral complications in a south Indian population: a cross-sectional study. J Med Life 2022; 15:470-478. [PMID: 35646189 PMCID: PMC9126462 DOI: 10.25122/jml-2021-0342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/20/2021] [Indexed: 11/09/2022] Open
Abstract
Over the years, chemotherapy (CT) has evolved as an essential therapeutic modality for cancer, with oral manifestations frequently encountered as complications of cancer CT. Our study aimed to assess the prevalence of oral complications during CT and evaluate the significance of independent risk factors (age, gender, socio-economic status, oral hygiene practices etc). A cross-sectional study was carried out in a tertiary cancer hospital in Bhubaneswar, Odisha, India, in which a total of 138 hospitalized patients undergoing CT and fulfilling the inclusion and exclusion criteria were included. Comprehensive history and rigorous clinical examination eliciting the oral manifestations were carried out. Around 60% of patients exhibited oral manifestations. Xerostomia and lichenoid reactions were the highest and lowest recorded manifestations. Higher frequencies of oral lesions occurred in patients with breast cancer, TNM stage III, and with the administration of the docetaxel. Also, patients in the older age group, poor socio-economic status, poor quality of life, poor oral hygiene practices, and longer CT duration demonstrated more oral lesions. Individuals subjected to a dental evaluation either before or during CT exhibited a reduction in the number of oral features. Several oral complications were reported in the present study. All patients undergoing chemotherapy must receive reinforcement of oral hygiene instructions and dental evaluation before, during, and after chemotherapy treatment. The study also emphasizes the importance of oral health physician inclusion in the multidisciplinary cancer treatment team.
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Affiliation(s)
- Suvranita Jena
- Department of Oral Medicine and Radiology, SCB Dental College and Hospital, Cuttack, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha' O' Anusandhan University, Bhubaneswar, India
| | - Pinali Das
- Department of Oral Medicine and Radiology, SCB Dental College and Hospital, Cuttack, India
| | - Namrata Mishra
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha' O' Anusandhan University, Bhubaneswar, India
| | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida, India,Corresponding Author: Shazina Saeed, Amity Institute of Public Health, Amity University, Noida, India. E-mail:
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3
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Saleh W, Katz J. Periodontal diseases, caries, and dental abscesses prevalence in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2020; 56:720-722. [PMID: 32948828 DOI: 10.1038/s41409-020-01057-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/14/2020] [Accepted: 09/07/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Wafaa Saleh
- Oral and Maxillofacial Diagnostic Sciences Department, College of Dentistry, University of Florida, Gainesville, FL, USA. .,Oral Medicine and Periodontology Department,Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Joseph Katz
- Oral and Maxillofacial Diagnostic Sciences Department, College of Dentistry, University of Florida, Gainesville, FL, USA
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Comorbid conditions are a risk for osteonecrosis of the jaw unrelated to antiresorptive therapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:140-150. [DOI: 10.1016/j.oooo.2018.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/23/2018] [Accepted: 09/23/2018] [Indexed: 02/06/2023]
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5
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Villafuerte KRV, Martinez CDJH, Dantas FT, Carrara HHA, dos Reis FJC, Palioto DB. The impact of chemotherapeutic treatment on the oral microbiota of patients with cancer: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:552-566. [DOI: 10.1016/j.oooo.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/31/2018] [Accepted: 02/10/2018] [Indexed: 01/01/2023]
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6
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Nuñez-Aguilar J, Fernández-Olavarría A, Oliveros-López LG, Torres-Lagares D, Serrera-Figallo MA, Gutiérrez-Corrales A, Gutiérrez-Pérez JL. Evolution of oral health in oral cancer patients with and without dental treatment in place: Before, during and after cancer treatment. J Clin Exp Dent 2018; 10:e158-e165. [PMID: 29670734 PMCID: PMC5899789 DOI: 10.4317/jced.54608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 01/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background This study aims to evaluate the influence of two dental treatment protocols, outpatient non-regulated treatment versus supervised hospital treatment, on the oral health of patients undergoing oral cancer (only radiochemotherapy treatment, not surgical) treatment. Material and Methods The study used a quasi-experimental approach justified on ethical grounds. A total of 41 patients were included in the control group (outpatient non-regulated treatment) and 40 patients in the experimental group (in-hospital supervised treatment). The patients were treated only with chemotherapy (not surgical treatment was made) for oral cancer. This decision was taken by the oncology committee of the hospital without being influenced by this study. Data regarding plaque index, daily brushing habits, appearance of new cavities, need for extractions, appearance of candidiasis and use of prosthetics in both groups were collected at three points throughout the study: before starting cancer treatment, during treatment and after treatment. The values obtained using the Student’s t-test and chi-squared were compared. Results Based on similar patient backgrounds, throughout cancer treatment the intervention under study resulted in a decrease in plaque index, necessary extractions, and incidence of decay, as well as an increase in daily brushing among other improvements in oral health observed in the experimental group versus the control group. Conclusions From our data, we can confirm that supervised dental treatment performed during oral cancer treatment produced an improvement in the oral health of patients with oral cancer. Key words:Oral cancer, dental treatment, quality of life, oncology, dentistry.
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Affiliation(s)
| | | | | | - Daniel Torres-Lagares
- PhD, DDS, MSc. Professor of Oral Surgery. Chairman of Oral Surgery. Department of Stomatology. University of Seville
| | | | | | - Jose-Luis Gutiérrez-Pérez
- PhD, DMD, Professor of Oral Surgery. Chairman of Oral Surgery. Department of Stomatology. University of Seville
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7
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de Souza RF, Khiyani MF, Chaves CAL, Feine J, Barbeau J, Fuentes R, Borie E, Crizostomo LC, Silva-Lovato CH, Rompre P, Emami E. Improving practice guidelines for the treatment of denture-related erythematous stomatitis: a study protocol for a randomized controlled trial. Trials 2017; 18:211. [PMID: 28476133 PMCID: PMC5420092 DOI: 10.1186/s13063-017-1947-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/11/2017] [Indexed: 11/12/2022] Open
Abstract
Background Denture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy. The objective of this study is to validate these pilot results by means of a randomized controlled trial (RCT) and provide a practice guideline for clinicians. Methods/design A pragmatic, two-parallel-arm, multicenter RCT will be conducted in Canada, Brazil, and Chile. Fifty-two adult complete denture wearers presenting with moderate to severe DES will be allocated randomly to two groups: the Intervention arm will consist of palatal brushing and standard oral and denture hygiene measures, while the Control arm will include only standard oral and denture hygiene measures. The study outcome will be the oral Candida carriage. Participants will be assessed at baseline, and at 3 and 6 months post intervention. Descriptive, bivariate, and mixed models with repeated measures will be performed following the intention-to-treat principle. Discussion This pragmatic RCT will serve to provide a clinical practice guideline regarding the use of preventive measures in the treatment of biofilm-mediated oral diseases. Moreover, it will have a great impact on reducing the harm of antifungal overtreatment on patients suffering from DES. Trial registration ClinicalTrials.gov, NCT02686632. Registered on 15 February 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1947-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raphael F de Souza
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Dental Materials and Prosthetics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Jocelyne Feine
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Jean Barbeau
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - Ramón Fuentes
- Research Centre in Dental Sciences (CICO), Faculty of Dentistry, Universidad de la Frontera, Temuco, Chile
| | - Eduardo Borie
- Research Centre in Dental Sciences (CICO), Faculty of Dentistry, Universidad de la Frontera, Temuco, Chile
| | - Luciana C Crizostomo
- Department of Dental Materials and Prosthetics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Claudia H Silva-Lovato
- Department of Dental Materials and Prosthetics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Pierre Rompre
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada. .,School of Public Health, Public Health Institute, University of Montréal's Hospitals Research Center, Université de Montréal, C.P. 6128, succursale centre-ville, Montréal, QC, H3C 3J7, Canada.
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The Two-Way Association of Periodontal Infection with Systemic Disorders: An Overview. Mediators Inflamm 2015; 2015:793898. [PMID: 26339142 PMCID: PMC4539125 DOI: 10.1155/2015/793898] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 11/29/2022] Open
Abstract
Oral cavity that harbors diverse bacterial populations could also act as a site of origin for spread of pathogenic microorganisms to different body sites, particularly in immunocompromised hosts, patients, the elderly, or the underprivileged. A number of recent publications have advocated that patients with periodontal diseases are more susceptible to metabolic endotoxemia, inflammation, obesity, type 2 diabetes, and other related systemic complications, concluding that periodontal diseases could be a potential contributing risk factor for a wide array of clinically important systemic diseases. However, despite a significant increase in the prevalence of periodontal infections and systemic diseases in the past few decades, the fundamental biological mechanisms of connection between these ailments are still not fully explicated. Consequently, the mechanisms by which this bidirectional damage occurs are being explored with a concentric vision to develop strategies that could prevent or control the complications of these ailments. This paper attempts to summarize and hypothesize the diverse mechanisms that hint to a certain connection between the two prevalent chronic situations.
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Fillmore WJ, Leavitt BD, Arce K. Dental extraction in the neutropenic patient. J Oral Maxillofac Surg 2014; 72:2386-93. [PMID: 25218884 DOI: 10.1016/j.joms.2014.06.443] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 06/17/2014] [Accepted: 06/17/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To identify risks of dental extraction in patients with mild, moderate, and severe neutropenia. MATERIALS AND METHODS The authors undertook an observational study of 116 patients diagnosed with neutropenia and undergoing dental extractions in the Mayo Clinic Division of Oral and Maxillofacial Surgery. Absolute neutrophil count (ANC) was no higher than 1,500/μL. Predictors were ANC, age, diagnosis, number of teeth removed, type and location of extraction, length of antibiotic use, presence and type of bacteremia at the time of consultation or extraction, reason for consultation, indication for extraction, and use of any granulocyte colony-stimulating factor (GCSF). Primary outcomes were total complications, surgical site infections, delayed healing, and prolonged postoperative pain. Descriptive and bivariate analyses were undertaken, with statistical significance set at a P value less than or equal to .05. RESULTS One hundred sixteen patients underwent extraction while neutropenic. The overall complication rate was 8.6% (n=10). All were minor complications requiring simple interventions, if any. Complications were delayed healing, surgical site infection, and prolonged postoperative pain. Delayed healing was not associated with ANC. GCSF and related medications did not appear to affect outcomes in these patients. CONCLUSION The results of this preliminary study suggest that extraction of teeth in patients at all stages of neutropenia can be conducted safely. Complications of extraction were few and should be easily controlled. Further studies are required to clarify and stratify risk for future patients.
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Affiliation(s)
- W Jonathan Fillmore
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.
| | - Bryce D Leavitt
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN
| | - Kevin Arce
- Consultant and Instructor in Surgery, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN
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10
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Oral complications in hematopoietic stem cell recipients: the role of inflammation. Mediators Inflamm 2014; 2014:378281. [PMID: 24817792 PMCID: PMC4003795 DOI: 10.1155/2014/378281] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/27/2014] [Indexed: 11/30/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis.
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11
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Oral complications and management strategies for patients undergoing cancer therapy. ScientificWorldJournal 2014; 2014:581795. [PMID: 24511293 PMCID: PMC3910370 DOI: 10.1155/2014/581795] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/19/2013] [Indexed: 12/22/2022] Open
Abstract
With cancer survival rate climbing up over the past three decades, quality of life for cancer patients has become an issue of major concern. Oral health plays an important part in one's overall quality of life. However, oral health status can be severely hampered by side effects of cancer therapies including surgery, chemotherapy, radiotherapy, and hematopoietic stem cell transplantation. Moreover, prevention and treatment of these complications are often overlooked in clinical practice. The present paper aims at drawing health care professionals' attention to oral complications associated with cancer therapy by giving a comprehensive review. Brief comments on contemporary cancer therapies will be given first, followed by detailed description of oral complications associated with cancer therapy. Finally, a summary of preventive strategies and treatment options for common oral complications including oral mucositis, oral infections, xerostomia, and dysgeusia will be given.
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Fernandes LLD, Torres SR, Garnica M, de Souza Gonçalves L, Junior AS, de Vasconcellos ÁC, Cavalcanti W, Maiolino A, de Barros Torres MCM. Oral status of patients submitted to autologous hematopoietic stem cell transplantation. Support Care Cancer 2013; 22:15-21. [DOI: 10.1007/s00520-013-1940-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 08/05/2013] [Indexed: 10/26/2022]
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13
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Shinozaki S, Moriyama M, Hayashida JN, Tanaka A, Maehara T, Ieda S, Nakamura S. Close association between oral Candida species and oral mucosal disorders in patients with xerostomia. Oral Dis 2012; 18:667-72. [DOI: 10.1111/j.1601-0825.2012.01923.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Gürgan CA, Özcan M, Karakuş Ö, Zincircioğlu G, Arat M, Soydan E, Topcuoglu P, Gürman G, Bostancı HS. Periodontal status and post-transplantation complications following intensive periodontal treatment in patients underwent allogenic hematopoietic stem cell transplantation conditioned with myeloablative regimen. Int J Dent Hyg 2012; 11:84-90. [DOI: 10.1111/j.1601-5037.2012.00550.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
DATA SOURCES PubMed and EMBASE were searched for articles published between 1 January 1990 and 31 December 2008. STUDY SELECTION Eligible studies were those that included dental caries and periodontal disease and pre-cancer dental clearance protocols in cancer patients undergoing head and neck radiotherapy, chemotherapy or combined treatment modalities. Rather than any study inclusion criteria this review had a number of exclusion criteria instead: systematic and non-systematic reviews; microbiology studies; growth and development studies; organ transplant studies; studies eliciting dental complications through questionnaires, studies reporting data from previous publications; phase I and II studies; opinion papers and case reports; articles published before 1990. All reports also had to be in English. DATA EXTRACTION AND SYNTHESIS Each article was reviewed by two authors independently with pilot-tested data collection forms. No quality assessment was pre-specified. RESULTS Sixty-four articles were included. Forty-six of these were observational (24 cohort, eight case control, 14 cross-sectional), and 18 were interventional studies. It is unclear how many participants this included. A weighted prevalence of caries was reported but it is unclear how the weighting was calculated. Overall the weighted prevalence was 28.1%. The overall DMFT for patients who were post-antineoplastic therapy was 9.19 (SD, 7.98; n=457). The overall plaque index for patients who were post-antineoplastic therapy was 1.38 (SD, 0.25; n=189). CONCLUSIONS Patients who were post-radiotherapy had the highest DMFT compared to those who were post-chemotherapy and healthy controls.
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Affiliation(s)
- Marisol Michelet
- Oral Medicine Department, FUNDALEU- Foundation to Fight against Leukemia, Hospitalization and Clinical Research Center, Buenos Aires, Argentina
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16
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Tewari S, Tewari S, Sharma RK, Abrol P, Sen R. Necrotizing stomatitis: a possible periodontal manifestation of deferiprone-induced agranulocytosis. ACTA ACUST UNITED AC 2009; 108:e13-9. [DOI: 10.1016/j.tripleo.2009.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Revised: 06/23/2009] [Accepted: 06/27/2009] [Indexed: 10/20/2022]
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Epstein JB, Raber-Durlacher JE, Raber-Drulacher JE, Wilkins A, Chavarria MG, Myint H. Advances in hematologic stem cell transplant: an update for oral health care providers. ACTA ACUST UNITED AC 2009; 107:301-12. [PMID: 19217013 DOI: 10.1016/j.tripleo.2008.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 10/30/2008] [Accepted: 12/02/2008] [Indexed: 12/20/2022]
Abstract
Oral supportive care is critical in the management of patients receiving hematopoietic cell transplantation (HCT). Advances in HCT, such as the use of stem cells isolated from peripheral blood instead of bone marrow, have resulted in more rapid engraftment and thus a shorter duration of pancytopenia. Reduced-intensity conditioning regimens, associated with less toxicity, make HCT available to older patients and patients with comorbidities. These new developments have led to increased transplant rates and an altered spectrum of therapy-related complications, such as mucositis, and to shifts in the prevalence and pattern of occurrence of infections and graft-versus-host disease. The purpose of this paper is to review the main principles of HCT and to update dental providers on new technologies being applied to transplantation that may influence oral complications and oral care.
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Affiliation(s)
- Joel B Epstein
- Department of Oral Medicine and Diagnostic Sciences, University of Illinois, and Illinois Masonic Hospital, Chicago, Illinois 60612, USA.
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Affiliation(s)
| | - Athena S. Papas
- Tufts University School of Dental Medicine, Boston, Massachusetts
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19
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Fischer DJ, Klasser GD, Epstein JB. Cancer and Orofacial Pain. Oral Maxillofac Surg Clin North Am 2008; 20:287-301, vii. [DOI: 10.1016/j.coms.2007.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Raber-Durlacher JE, Barasch A, Peterson DE, Lalla RV, Schubert MM, Fibbe WE. Oral Complications and Management Considerations in Patients Treated with High-Dose Chemotherapy. ACTA ACUST UNITED AC 2004; 1:219-29. [DOI: 10.3816/sct.2004.n.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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22
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Belfield PM, Dwyer AA. Oral complications of childhood cancer and its treatment. Eur J Cancer 2004; 40:1035-41; discussion 1042-4. [PMID: 15093579 DOI: 10.1016/j.ejca.2003.09.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2003] [Revised: 09/19/2003] [Accepted: 09/29/2003] [Indexed: 10/26/2022]
Affiliation(s)
- P M Belfield
- Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Abstract
Immunocompromised individuals present a challenge to oral health care providers. As the spectrum of patients with dysfunctional immune responses continues to broaden, practitioners should be able to identify these patients, understand the potential for complications, and manage their dental care safely and effectively. This article reviews various immune deficiencies, addresses complications that may result from an individual's immune status, and discusses dental considerations for these patients.
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Affiliation(s)
- Ernesta Parisi
- Division of Oral Medicine, University of Medicine and Dentistry of New Jersey, 110 Bergen Street, D-860, Newark, NJ 07103, USA.
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Abstract
BACKGROUND Hemopoietic stem cell transplantation, or HSCT, is an important tool in modern cancer treatment. Refinement of transplantation techniques and supportive care has resulted in increased posttransplantation survival rates. Dental care is a key supportive element in both pretransplantation and posttransplantation care of this patient population. METHODS The authors provide an overview of HSCT transplantation, emphasizing the oral complications and required supportive dental care. CONCLUSIONS It is critical that transplantation candidates undergo dental screenings and be treated adequately before transplantation, that their care be closely managed during the transplantation process, and that they be given dental support as soon as their recovery permits. Dentists should consult with the patient's oncologist or primary health provider to identify the appropriate timing and intensity of dental support. CLINICAL IMPLICATIONS Because of improved transplantation survival rates, more patients may seek supportive outpatient dental care after transplantation, which requires special management considerations. Dental professionals need to be knowledgeable about modern HSCT.
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Affiliation(s)
- Steven D Westbrook
- Department of Veterans Affairs, South Texas Veterans Health Care System, USA.
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25
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Staffileno H, Reeder L. Oral, dental, and supportive care in the cancer patient. Cancer Treat Res 2003; 114:353-70. [PMID: 12619550 DOI: 10.1007/0-306-48060-3_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Abstract
Oral Mucositis (OM) is a frequent cause of severe morbidity in patients receiving chemotherapy and/or radiotherapy. The pathophysiology of OM involves direct cytotoxic effects, local inflammatory responses, and alterations in oral microflora. There are currently no approved agents for the prevention or treatment of OM. In this review we briefly describe current knowledge of the pathophysiology, clinical presentation, and management of OM. We then discuss investigational agents being studied in OM with a particular focus on local antimicrobial agents, hemopoietic growth factors, and cytokines. Measures to reduce the incidence of OM and/or alleviate its clinical sequelae should be incorporated into all chemotherapy or radiotherapy studies.
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Affiliation(s)
- Yesid Alvarado
- Department of Leukemia, M.D. Anderson Cancer Center, Box 428, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA
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27
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Affiliation(s)
- J A Ship
- Department of Oral Medicine and The Bluestone Center for Clinical Research, New York University College of Dentistry, New York 10010-4046, USA.
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28
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Torres SR, Peixoto CB, Caldas DM, Silva EB, Akiti T, Nucci M, de Uzeda M. Relationship between salivary flow rates and Candida counts in subjects with xerostomia. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:149-54. [PMID: 11862202 DOI: 10.1067/moe.2002.119738] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study evaluated the relationship between salivary flow and Candida colony counts in the saliva of patients with xerostomia. STUDY DESIGN Sialometry and Candida colony-forming unit (CFU) counts were taken from 112 subjects who reported xerostomia in a questionnaire. Chewing-stimulated whole saliva was collected and streaked in Candida plates and counted in 72 hours. Species identification was accomplished under standard methods. RESULTS There was a significant inverse relationship between salivary flow and Candida CFU counts (P =.007) when subjects with high colony counts were analyzed (cutoff point of 400 or greater CFU/mL). In addition, the median sialometry of men was significantly greater than that of women (P =.003), even after controlling for confounding variables like underlying disease and medications. Sjögren's syndrome was associated with low salivary flow rate (P =.007). There was no relationship between the median Candida CFU counts and gender or age. There was a high frequency (28%) of mixed colonization. Candida albicans was the most frequent species, followed by C parapsilosis, C tropicalis, and C krusei. CONCLUSIONS In subjects with high Candida CFU counts there was an inverse relationship between salivary flow and Candida CFU counts.
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Affiliation(s)
- Sandra R Torres
- Depatment of Oral Pathology and oral Diagnostic, School of Dentistry, Universidade Federal do Rio de Janeiro, Brazil.
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29
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Donnelly JP. Infection in the neutropenic and haematopoietic stem cell transplant recipient. Curr Opin Infect Dis 2000; 13:337-342. [PMID: 11964799 DOI: 10.1097/00001432-200008000-00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patterns of bacterial infection have remained fairly static with Gram-positive bacteria predominating, although this varies between institutions and between patient populations. Similarly, antimicrobial resistance rates differ widely and reflect antibiotic use and exposure. Hence, each institution should devote microbiological resources to maintain surveillance and employ vigilance so that antimicrobial treatment protocols can be adapted to meet any new challenges. Most changes are being seen in the diagnosis of fungal infections, particularly aspergillosis, and the way in which it is being incorporated into treatment strategies.
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Affiliation(s)
- J. Peter Donnelly
- Department of Haematology, University Medical Center, St Radboud, Nijmegen, The Netherlands
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