• Journal of Korean Academy of Nursing
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• v.44 no.5
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• pp.542-551
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• 2014

Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.89-101
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• 2022

Objectives: The purpose of this systematic review was to evaluate the effects of herbal medicine on Chemo-Radiotherapy-induced oral mucositis. Methods: Electronic databases were used to search for studies published through 10 years until October 2022, and a randomized controlled study was conducted to evaluate efficacy of herbal medicine on chemo-radiotherapy-induced oral mucositis. Study quality was assessed using the Cochran's risk bias tool. Results: Two-hundred and three articles were initially searched, and 11 studies (head and neck cancer, breast cancer, colorectal cancer, esophageal cancer etc. undergoing radio-chemotherapy were included in analysis. The effect of herbal medicine on chemo-radiotherapy-induced oral mucositis, 9 studies reported that herbal medicine was more effective than the placebo group or conventional treatment. One study reported that the effect of the herbal compound treatment group was similar to that of the conventional herbal medicine, and one study reported that there was no difference in effect between the two herbal medicines and the group without treatment. Conclusion: This study suggests that herbal medicine effectively relieves the symptoms of chemo-radiotherapy-induced oral mucositis. However, there is limited evidence that herbal medicine may relief chemo-radiotherapy-induced oral mucositis, so further investigation is needed.

• Journal of Oral Medicine and Pain
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• v.25 no.4
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• pp.365-369
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• 2000

Oral mucositis or stomatitis produced by stomatotoxic chemotherapy and/or radiation therapy are painful, restrict oral intake and, importantly, act as sites of secondary infection and potals of entry for the endogenous oral microflora often leading to bacteremias or sepsis. A number of clinical observations and studies of animal model suggests a pathophysiological complexity in the development of mucositis. The condition appears to represent a sequential interaction of the oral mucosal cells and tissues, pro-inflammatory cytokines, and local environmental factors in the mouth. This article discussed and reviewed biological process of the mucositis and, the role of cytokines as initiators and amplifiers of the process. The recognition that the pathophysiology of mucositis is a multifactorial process has presented opportunities for intervention based upon biological attenuation.

• Medical Lasers
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• v.10 no.3
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• pp.138-145
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• 2021

Low-level laser therapy or photobiomodulation (LLLT/PBM) therapy has been widely applied to enhance and accelerate the recovery of oral mucositis. This study investigates the documented effect of LLLT on oral mucositis caused by chemotherapy. This review appraises 6 animal studies and 12 clinical studies published in the Pubmed database during the past 10 years, related to the application of LLLT for the treatment of mucositis. Despite varied parameters and diverse conditions, the assessed articles indicate that application of LLLT on oral mucositis using near-infrared wavelengths is prophylactic, reduces pain, and enables a rapid recovery. Various combined treatments were also identified among the published papers, which further establishes the efficacy of LLLT as a viable treatment.

• Journal of Periodontal and Implant Science
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• v.50 no.3
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• pp.183-196
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• 2020

Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.

• Journal of Oral Medicine and Pain
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• v.40 no.2
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• pp.82-87
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• 2015

Methotrexate (MTX) is a chemotherapeutic agent that is used to treat a host of malignancies. But recently, MTX has also been used as a therapeutic agent for chronic inflammatory disorders such as rheumatoid arthritis, psoriasis, and systemic lupus erythematosus. However, MTX is an antimetabolite that affects rapidly dividing normal cells such as oral mucosal epithelial cells, gastrointestinal epithelial cells, and bone marrow cells-which explains why oral mucositis is often an initial manifestation of MTX toxicity. Because oral lesions are frequently initially presented in dental clinics, dentists should consider the possibility of adverse drug reactions in the differential diagnoses of oral lesions through a meticulous collection of patients' medical histories. In this report, we examine patients who suffered from oral ulcerative lesions upon diagnosis of MTX-induced oral mucositis. Then, we suggest approaches for the diagnosis and treatment of MTX-induced oral mucositis through a review of literature.

• Journal of Korean Biological Nursing Science
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• v.12 no.3
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• pp.148-156
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• 2010

Purpose: Oral mucositis (OM) is a serious consequence of chemotherapy that cancer patients must undergo. The objectives of this study were to find out reliability and validity of patients self-reported daily questionnaires on OM, and the impact OM makes on daily functions. Method: To test the reliability of oral mucositis daily questionnaire (OMDQ), internal consistency of the instrument (Cronbach's ${\alpha}$ and correlation between items) and test-retest reliability were analyzed. Criterion validity and discriminative validity were evaluated using WHO, oral assessment guide, and Nicolatou assessment tool. Forty-eight acute leukemic patients under chemotherapy were enrolled in this study. Result: The Cronbach's ${\alpha}$ coefficient indicated sufficient internal consistency. Correlations of Mouth and throat soreness (MTS) and MTSActivity Limitations (MTS-AL) were statistically significant. MTS and MTS-AL scores on consecutive days were highly correlated (days13,14=.84-.96; test-retest reliability). OMDQ scale had high criterion validity and discriminative validity. Patients with more severe WHO OM grades had higher MTS mean scores. Conclusion: Oral mucositis in acute leukemic patients under going chemotherapy can be easily quantified by patient self-administered OMDQ with reliability and validity.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.98-103
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• 2021

Plasma cell mucositis is a very rare benign disease characterized by dense lymphoplasmacytic infiltration in the submucosa layer. It appears as a reddish ulcer on the mucous membrane or as a cobblestone or nodular mass on the affected mucosa. When it involves the pharynx or larynx, the patient presents with dysphagia, voice change and dyspnea. Clinically, it is important to differentiate with malignant diseases such as extramedullary plasmacytoma, amyloidosis and sarcodosis. Several cases of mucositis in the larynx have been reported in English literature, but none have been reported in Korea. We report a case of plasma cell mucositis in the larynx with a review of literature.

• The Journal of Korean Academic Society of Nursing Education
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• v.3 no.2
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• pp.193-206
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• 1997

Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.

• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.1-9
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• 2016

Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.