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  1. Article ; Online: Mechanisms of Bone Resorption in Periodontitis.

    Hienz, Stefan A / Paliwal, Sweta / Ivanovski, Saso

    Journal of immunology research

    2015  Volume 2015, Page(s) 615486

    Abstract: Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is mediated by the host immune and inflammatory response to the microbial challenge. However, ... ...

    Abstract Alveolar bone loss is a hallmark of periodontitis progression and its prevention is a key clinical challenge in periodontal disease treatment. Bone destruction is mediated by the host immune and inflammatory response to the microbial challenge. However, the mechanisms by which the local immune response against periodontopathic bacteria disturbs the homeostatic balance of bone formation and resorption in favour of bone loss remain to be established. The osteoclast, the principal bone resorptive cell, differentiates from monocyte/macrophage precursors under the regulation of the critical cytokines macrophage colony-stimulating factor, RANK ligand, and osteoprotegerin. TNF-α, IL-1, and PGE2 also promote osteoclast activity, particularly in states of inflammatory osteolysis such as those found in periodontitis. The pathogenic processes of destructive inflammatory periodontal diseases are instigated by subgingival plaque microflora and factors such as lipopolysaccharides derived from specific pathogens. These are propagated by host inflammatory and immune cell influences, and the activation of T and B cells initiates the adaptive immune response via regulation of the Th1-Th2-Th17 regulatory axis. In summary, Th1-type T lymphocytes, B cell macrophages, and neutrophils promote bone loss through upregulated production of proinflammatory mediators and activation of the RANK-L expression pathways.
    MeSH term(s) Alveolar Bone Loss/immunology ; Animals ; Bone Resorption/immunology ; Humans ; Inflammation/immunology ; Osteoclasts/immunology ; Periodontitis/immunology ; RANK Ligand/immunology
    Chemical Substances RANK Ligand
    Language English
    Publishing date 2015
    Publishing country Egypt
    Document type Journal Article ; Review
    ZDB-ID 2817541-4
    ISSN 2314-7156 ; 2314-8861
    ISSN (online) 2314-7156
    ISSN 2314-8861
    DOI 10.1155/2015/615486
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  2. Article ; Online: Prevalence of clinically relevant oral mucositis in outpatients receiving myelosuppressive chemotherapy for solid tumors.

    Wuketich, Stefan / Hienz, Stefan A / Marosi, Christine

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

    2011  Volume 20, Issue 1, Page(s) 175–183

    Abstract: Purpose: Chemotherapy-induced oral mucositis (CIOM) is a common side effect of cancer therapy that may lead to significant morbidity and interfere with the treatment plan. The present prospective, cross-sectional study intended to describe the ... ...

    Abstract Purpose: Chemotherapy-induced oral mucositis (CIOM) is a common side effect of cancer therapy that may lead to significant morbidity and interfere with the treatment plan. The present prospective, cross-sectional study intended to describe the prevalence of clinically relevant CIOM (CRCIOM) in outpatients receiving chemotherapy for solid tumors.
    Methods: Intra-oral assessments were performed on 298 consecutively recruited patients, who had undergone at least 14 days of chemotherapy for solid tumors in our outpatient oncology department. The presence of CIOM was evaluated using the Oral Mucositis Assessment Scale. CRCIOM was defined as the presence of ulcers (≥ 1 cm(2)), severe erythema, and/or inability to eat solid foods (WHO grades 2-4). Furthermore, the current levels of oral hygiene and oral health were measured.
    Results: A low prevalence (18 patients, 6%) of CRCIOM was found in the investigated patient collective, including 1% of patients with severe (WHO grade 3/4) CIOM. In the CRCIOM group, 16 patients were male, and two were female; 8 patients with CRCIOM had received head and neck radiotherapy. A higher prevalence of CRCIOM was found in smoking patients (12.7% vs. 4.5%, p < 0.05) and in the patients who have not had a dental checkup within the preceding 12 months (11.2% vs. 3.0%, p < 0.01). Diabetes mellitus and low WBC appeared not to be associated with higher CRCIOM rates. The plaque and gingival indexes were significantly increased (p < 0.01) in the CRCIOM group.
    Conclusions: Although CRCIOM was a rare event in the investigated patient population, our results emphasize that pre-treatment dental therapy and primary preventive measures (including oral hygiene instructions) can be improved. Before starting chemotherapy, increased awareness of individual risk factors, such as male sex, tobacco smoking, low dental checkup frequency, poor oral hygiene, and a reduced oral health status, could help to prevent CRCIOM.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/drug therapy ; Oral Health ; Oral Hygiene ; Prevalence ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Smoking/adverse effects ; Stomatitis/chemically induced ; Stomatitis/epidemiology ; Stomatitis/pathology ; Young Adult
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2011-02-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1134446-5
    ISSN 1433-7339 ; 0941-4355
    ISSN (online) 1433-7339
    ISSN 0941-4355
    DOI 10.1007/s00520-011-1107-y
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