BackgroundWe describe the risk indicators for oral mucositis (OM) in paediatric oncology patients hospitalised in the Institut Gustave Roussy (Villejuif-Paris) and treated with alkylant chemotherapy with autologous peripheral blood progenitor cells.MethodsThe sample was selected using PIGAS software. Three groups of subjects received different chemotherapy regimens: A. Melphalan, B. Busulfan and C. other alkylant protocols. The degree of mucositis was recorded by CTC version 2.0 (Common Toxicity Criteria). Descriptive statistics were performed. The association between mucositis and risk indicator variables was tested using a χ2 test. The association between case status and covariates was tested using unconditional logistic regression analysis.ResultsOf the 337 children enrolled, 241 showed mucositis (group 1) and 96 did not show mucositis (group 2) during alkylant chemotherapy. There was a higher prevalence of male patients in both groups. The three different chemotherapy regimen groups are correlated with the appearance of oral mucositis (χ2 = 22.42, p < 0.01). Weight loss was higher in group 1 (χ2 = 6.31, p = 0.01). The duration of aplasia was lower in the Busulfan protocol (7.5 days) than in the Melphalan group (9.3 days) or the other regimens (8.6 days). The use of Bufulfan® was directly associated with case status (presence of oral mucositis): odds ratio [OR] = 2.1 and confidence interval [95%CI] = 1.3–3.0. Also, occurrences of germinal tumours and secondary bacterial infections were directly linked with case status: [OR] = 1.4 and 1.8, confidence interval [95%CI] = 1.2 – 1.7 and 1.1 – 2.5, respectively.ConclusionThe presence of OM was associated with the three different chemotherapy regimens considered; in particularly patients treated with Busulfan had the highest prevalence.
Our data failed to demonstrate the association between periodontitis and an adverse pregnancy outcome such as preterm birth, low birth weight, preeclampsia, intrauterine growth restriction, and premature rupture of membranes.
The purpose of this investigation was to determine the oral status in a group of patients with thalassemia major (TM). Eighteen TM patients (15 M, three F) and 18 healthy controls randomly matched for age and sex were examined for dental caries using the decayed, missing, and filled teeth (DMFT) index and for oral hygiene conditions using the oral hygiene index (OHI)-S. Spontaneous saliva was collected from each subject, and the biochemical composition (calcium, phosphorous, potassium, sodium, urea) was determined. Furthermore, salivary Streptococcus mutans levels were evaluated. Statistical analysis (Student's t-test) were performed for means comparison, while independence among categorical variables was assessed using the chi(2) test. Fisher's exact test was used when expected cell values were less than 5. Dental status (DMFT index) was almost equal in the two groups (10.3 in TM vs 9.4 in controls, P=0.34). The occurrence of plaque (OHI-S 2) was higher in the control group, but no statistically significant association was observed between oral hygiene conditions in the two groups (Fisher's exact test 0.47, P=0.79). Biochemical saliva composition was very similar in the two groups; only the urea concentration was lower in TM, and this difference was statistically significant ( P=0.002). The TM patients had an increased presence of mutans streptococci at detectable levels. Our findings confirm that, although no substantial differences were found between the two observed groups, further investigations are needed to determine the theoretical risk of oral diseases in thalassemic patients.
The short term (up to 14 days after restoration) release of selected ions (i.e., Hg(2+), Cu(2+) and Zn(2+)) from Dispersalloy into artificial saliva has been evaluated in regards to the nature of the saliva (Fusayama and McCarty and Shklar's solutions), the amount of amalgam, the time of contact and the periodical renewal (every 48 h interval) of artificial saliva. The evaluation of the ionic fraction of such metals has been accomplished by using anodic stripping methods (i.e., Differential Pulse Anodic Stripping Voltammetry, DPASV) with a 7 microm graphite disk microelectrode as a working electrode. Data obtained in this work are almost unprecedented in the literature due the fact that such analytical method exclude metals in non-ionic forms (e.g., metals or organometallic compounds). The high concentrations measured in every experimental condition confirm the concern for the short-term release of metals from amalgam into saliva.
Oral lesions may be found in patients with Crohn’s disease (CD), in a percentage up to 20%. The aim of this study was to investigate a possible relationship between Mycobacterium avium subsp. paratuberculosis (MAP) and oral lesions in CD patients. 23 oral biopsies were examined performing IS900 Nested PCR; 9 of them were positive: 8 from CD patients and 1 from a control. Our purpose is to go on with this study, amplifying the number of subjects examined and testing subjects with oral lesions related to diseases other than CD to verify the specific association between MAP and oral lesions in CD patients.
Aim: To analyze the knowledge and experience of dentists with private practices in the Sassari district with regard to eating disorders and clinical stomatology manifestations. Methods: A questionnaire to investigate dentists' knowledge and experience was created and submitted to a random sample of dentists. Data were collected and analysed using the Stata SE 10 software. Results: In total, 150 dentists were enrolled (a representative sample). After questionnaire evaluation, the following results were obtained: 80.7% (121) of the participants had a degree in dentistry and 19.3% (29) had degrees in medicine with a dentistry master of science diploma, 46% (69) were males and 54% (81) were females, their age range was 25-62 (mean, 36.1) years, and the average work experience was 11.5 (range, 1-36) years. More than 90% of the participants defined eating disorders only as bulimia and anorexia. Of the dentists, 77.3% (116) correctly identified Western populations as the most affected, whereas 52.7% identified only whites as the most affected people. In total, 80% of the dentists recognised dental erosion and abrasion as typical oral manifestations. Only 62% stated that salivary pH decreases in these conditions, and 63% did not recognise parotid gland tumefaction as a clinical sign. Regarding operator experience, 60.7% (91 dentists) had clinical experience of patients with eating disorders: 43.9% of them had made diagnoses from oral manifestations, 51.3% (77) were not able to treat these patients, and 69.3% (104) would refer patients to specialized centres for treatment. Moreover, 119 (79.3%) considered that a dental hygienist was a valid collaborator for the treatment of oral cavity manifestations. Regarding prophylaxis, 16.7% (25) suggested fluoride prophylaxis and 21.3% (32) oral hygiene education. Only 1.3% indicated the use of bicarbonate to change salivary pH values, suggested conservative or prosthetic restorations, suggested the use of saliva substitutes, or the sealing of permanent teeth. Difficulties in clinically treating these patients were related to a lack of knowledge for 72% (108) of participants. Of them, 36.7% (55) had studied the clinical aspects of this pathology while attending dental school and 24.7% (37) after their degree. In total, 94.7% (142) expressed the need for further information and only 2% (3) considered they had sufficient clinical knowledge. Conclusions: It is evident that there is a lack of knowledge regarding the problem and there would seem to be an urgent need to provide more training programs and to establish guidelines for the diagnosis and treatment of eating disorders among dentists. In our opinion, the acquisition of such knowledge will change the approach to related pathology, improving clinical skills, and subsequently diagnosis and treatment.
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