• Title/Summary/Keyword: Oral mucositis

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Short-term, Multi-center Prospective Clinical Study of Short Implants Measuring Less Than 7mm

  • Kim, Young-Kyun;Yi, Yang-Jin;Kim, Su-Gwan;Cho, Yong-Seok;Yang, Choon-Mo;Liang, Po-Chin;Chen, Yu-Yal;I, Lee-Long;Sim, Christopher;Tan, Winston;Ser, Go Wee;Yue, Deng;Yi, Man;Ping, Gong
    • Journal of Korean Dental Science
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    • v.3 no.1
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    • pp.11-16
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    • 2010
  • Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

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THE CHANGES OF SALIVARY MICROORGANISM COMPOSITION AFTER THERAPEUTIC RADIATION FOR ORAL CANCER PATIENTS (구강암 환자에서 방사선 조사에 따른 타액의 세균학적 조성변화에 대한 연구)

  • Lee, Jong-Ho;Kim, Myung-Jin;Choung, Pill-Hoon;Choi, Jin-Young;Seo, Byoung-Moo;Song, Ro-Heun;Ahn, Kang-Min;Kim, Jong-Won;Nam, Il-Woo;Kim, Soo-Kyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.18-23
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    • 2000
  • The changes of the microorganism composition after therapeutic radiation for oral cancer patients are not well known and the long-term follow-up data are not reported. To obtain basic data for understanding of pathogenesis and prevention and treatment of dental caries and mucositis occuring after radiation therapy, 7 of the oral cancer patients presented at the Seoul National University Oral & Maxillofacial Department between 1997 and 1998 whose treatment plan included radiation therapy were recruited to investigate the changes in bacterial composition(total aerobic count, Candida, Staphylococci, Lactobacilli, S. mutans, and S. salivarius (mitis, sanguis)) of the saliva before, during, and after radiation therapy. The basic data obtained from this study on identification and composition change of the bacteria in saliva of patients treated with radiation therapy can be used (1) as a reference for deciding on the ideal anti-microbial spectrum of the oral rinsing agent to be used in patients treated with radiation therapy for malignant tumor of the head and neck region. (2) to enhance the understanding of increase of opportunistic infection after immunochemical changes of the saliva and its relation to specific bacterial infection. (3) as a reference in prescribing prophylactic antibiotics in immunodepressed patients after radiation therapy.

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Recent advances in topical anesthesia

  • Lee, Hyo-Seol
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.237-244
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    • 2016
  • Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.

Late side effects of radiation treatment for head and neck cancer

  • Brook, Itzhak
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.84-92
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    • 2020
  • Patients undergoing radiation therapy for head and neck cancer (HNC) experience significant early and long-term side effects. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Late side effects include: permanent loss of saliva; osteoradionecrosis; radiation recall myositis, pharyngoesophageal stenosis; dental caries; oral cavity necrosis; fibrosis; impaired wound healing; skin changes and skin cancer; lymphedema; hypothyroidism, hyperparathyroidism, lightheadedness, dizziness and headaches; secondary cancer; and eye, ear, neurological and neck structures damage. Patients who undergo radiotherapy for nasopharyngeal carcinoma tend to suffer from chronic sinusitis. These side effects present difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. This review presents these side effects and their management.

Management of Gastrointestinal Side Effect During Chemotherapy (항암화학요법에서 발생하는 소화기 부작용의 관리)

  • Jin Tae Jung
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.76-81
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    • 2015
  • Gastrointestinal side effects including nausea and vomiting, diarrhea, constipation, oral mucositis and colitis, and hepatotoxicity are common occurrence during chemotherapy. Often they result in unplanned admission and interruption of scheduled therapy. Additionally they have a negative influence on patient's therapeutic outcome and quality of life. The assessment of gastrointestinal side effects is dependent on clinician assignment of a grade established by the National Cancer Institute Common Terminology Criteria for Adverse Events. Continued interest of gastrointestinal side effects has allowed identifying patients at higher risk and providing effective treatments to relieve painful symptom. Finally, proper prevention and management of chemotherapy-induced gastrointestinal side effects will be needed to improve patient's survival and quality of life.

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Chemical burns of the oral mucosa caused by Policresulen: report of a case (Policresulen 오용에 의한 구강 궤양의 발병 증례 및 화학화상에 대한 고찰)

  • Jung, Jung-Woo;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.109-114
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    • 2013
  • Chemical burn on the oral mucosa is caused by contact with various chemical products and manifests with localized mucositis, keratotic white lesions, bleeding, and painful tissue surface due to the coagulation of the tissue. Policresulen ($Albothyl^{(R)}$) is a topical antiseptic, commonly used over-the-counter drug for vaginitis, thrush and stomatitis. This drug is highly acidic with pH 0.6, and can act as a strong corrosive agent to oral mucosa. When inadvertently used in oral cavity, it may cause chemical burns of oral mucosa, resulting necrosis and bleeding surface resembling to erythema multifome. A 56 years old female patient presented with the chief complaints of painful ulcerations on the tongue, the upper and lower lips. On intraoral examination, an erythromatous, erosive or ulcerative surface covered with inflammatory exudates or bleeding crust is observed on the anterior half of the tongue and the upper and lower lips. She has occasionally applied the policresulen solution topically on the tongue to relieve pain from recurrent focal glossitis for about 10 years. In this time she applied it broadly and repeatedly to the tongue, the upper and lower lips for the purpose of pain relief by herself without instruction by physician or dentist. After cessation of policresulen application, the oral mucosa was rapidly recovered with use of topical steroids. In 2 weeks the lesions subsided completely. In summary, inadvertent use of $Albothyl^{(R)}$ on oral mucosa may result in chemical burn, causing mucosal erosion, ulceration and inflammation. It can be recovered by topical use of corticosteroid for 2 weeks after cessation of using $Albothyl^{(R)}$.

Development and Evaluation of Symptom Management Guidelines for Cancer Patients (암환자 증상관리지침 개발 및 평가)

  • Lee, Eun Ok;Kim, Jeongeun;Park, Hyeoun-Ae;Kwon, In-Gak;Lee, Eun Hyun
    • Korean Journal of Adult Nursing
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    • v.17 no.2
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    • pp.208-218
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    • 2005
  • This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management. Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.

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The Effects of Mouth Care with Sterile Normal Saline on Chemotherapy-induced Stomatits (멸균생리식염수를 이용한 구강 간호가 항암요법을 받는 환자의 구내염 발생에 미치는 영향)

  • 박혜자;신혜숙
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.5-16
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    • 1995
  • The effects of the mouth care using cool sterile normal saline on oral stomatitis were investigated in 59 patients on chemotherapy. The subjects were divided into two groups, one was experimental group(N=31) in which the subjects were provided mouth care 4 times a day (after meals, before bedtime)with cool normal saline, the other was the control group(N=28), The Oral Assessment Guide(OAG) which it includes eight items(voice, swallowing, lips, tongue, salivation, oral mucous membrane, gingiva & teeth) was used to assess oral status six times(once in the Prechernotherapy Period, and on the third, 5th, 7th, 10th & 14th day postchemotherapy). The means of the total scores at each time were analyzed by repeated ANOVA The results are as follows : 1. The incidence of stomatitis was higher in the control group than in experimental group. The incidence of third grade stomatitis characterized by bleeding, sore, infection & severe pain was 3.3% in the experimental group, and while 21.4% in the control group(p=0.01). 2. The number of stomatitis sites which were occurred in the experimental group were significantly lower than in the control group(p=0.046). 3. The grade of stomatitis(mean of total score) for patients in the control group was significantly higher than for patients in the experimental group (p=0.005). 4. In the control group, voice change increased in the period between the seventh and tenth day after chemotherapy (p=0.04). 5. In the control group, swallowing difficulty was mest severe in the period between seventh and tenth day(p=0.05), and decreased by the fourteenth day(p=0.01). 6. Changes in the lips gradually increased after chemotherapy in the control group(p=0.0025), while they were significantly lower in the experimental group(p=0.0002). 7. The increment of tongue changes started on the third day after chemotherapy reached a peak on the tenth day and decreased by the fourteenth day in both groups(p=0.0016). 8. Driness of the mouth reached a peak on the seventh day after chemotherapy in the control group (p=0.05). 9. The degree of oral mucositis was significantly higher in the control group than in the experimental group(p=0.02) . In the control group, the mucosal change started three days after chemotherapy and reached a peak on the tenth day(p=0.03). 10. Changes in the gingia were significantly higher in the control group(p=0.03). In control group, the degree of gingivitis reached a peak on the tenth day. In conclusion, meuth care with normal saline four times a day could reduce the incidence and grade of stomatitis. Stomatitis was shown to begin on the third day after chemetherapy, reach a peak on the tenth day and be reduced by fourteenth day.

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In situ dental implant installation after decontamination in a previously peri-implant diseased site: a pilot study

  • Kim, Young-Taek;Cha, Jae-Kook;Park, Jung-Chul;Jung, Ui-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.42 no.1
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    • pp.13-19
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    • 2012
  • Purpose: The aim of this study was to examine whether a previous peri-implantitis site can affect osseointegration, by comparing implant placement at a site where peri-implantitis was present and at a normal bone site. A second aim of this study was to identify the tissue and bone reaction after treating the contaminated implant surface to determine the optimal treatment for peri-implant diseases. Methods: A peri-implant mucositis model for dogs was prepared to determine the optimal treatment option for peri-implant mucositis or peri-implantitis. The implants were inserted partially to a length of 6 mm. The upper 4 mm part of the dental implants was exposed to the oral environment. Simple exposure for 2 weeks contaminated the implant surface. After 2 weeks, the implants were divided into three groups: untreated, swabbed with saline, and swabbed with $H_2O_2$. Three implants from each group were placed to the full length in the same spot. The other three implants were placed fully into newly prepared bone. After eight weeks of healing, the animals were sacrificed. Ground sections, representing the mid-buccal-lingual plane, were prepared for histological analysis. The analysis was evaluated clinically and histometrically. Results: The untreated implants and $H_2O_2$-swabbed implants showed gingival inflammation. Only the saline-swabbed implant group showed re-osseointegration and no gingival inflammation. There was no difference in regeneration height or bone-to-implant contact between in situ implant placement and implant placement in the new bone site. Conclusions: It can be concluded that cleaning with saline may be effective in implant decontamination. After implant surface decontamination, implant installation in a previous peri-implant diseased site may not interfere with osseointegration.

THE EFFECTS OF CHEMORADIATION THERAPY FOR NEUROBLASTOMA ON DENTAL CARIES ACTIVITY (신경모세포종의 화학 및 방사선요법이 치아우식활성도에 미치는 영향)

  • Lee, Ji-Hyun;Park, Ki-Tae;Sung, Ki-Woong;Kim, Ji-Yeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.352-358
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    • 2010
  • Chemotherapy or radiotherapy used for the treatment of pediatric cancer may have many adverse effects on the oral cavity. Oral mucositis, reduced salivary flow, oral infection, hypodontia, microdontia, arrested root development, and enamel hypoplasia are common oral complications. The aim of this study is to evaluate the effects of cancer therapy on dental caries activities. The children who had been treated for neuroblastoma in the department of pediatrics, Samsung Medical Center, were included and healthy children served as controls. The salivary flow rate, salivary buffering capacity, and Streptococcus mutans counts of both groups were evaluated using Dentocult$^{(R)}$ SM and Dentobuff$^{(R)}$ Strip. The dental caries activity related to the age at the start of treatment and the time elapsed since treatment completion were also evaluated. As a result, neuroblastoma patients had significantly lower salivary flow rate than the controls, while there were no significant differences between two groups as for salivary buffering capacity and Streptococcus mutans counts. The dental caries activities related to the age at the start of treatment and the time elapsed since treatment completion were not significantly different.