Low-level laser therapy in the prevention and treatment of oral mucositis

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Manas Dave takes a look at this review evaluating the prophylactic and therapeutic effects of low-level laser therapy (LLLT) in patients who might or have developed oral mucositis during chemotherapy or radiotherapy.

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Osteoradionecrosis and denture use in head and neck cancer patients

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This review assessing the evidence of the impact of replacing missing teeth with dentures on the development of osteoradionecrosis in patients who have radiotherapy for head and neck cancer only identified 3 case-controlled studies of very low quality.

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Osteoradionecrosis of the jaws: Prevention in adult patients with head and neck cancer

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This Cochrane review of interventions for preventing osteoradionecrosis of the jaws in adults with head and neck cancer undergoing curative or adjuvant (i.e. non-palliative) radiotherapy included 4 RCTs. The limited quality of the available studies means evidence regarding the interventions evaluated in this review is uncertain.

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Oral mucositis in cancer patients: the effect of oral supplementation

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This review of of the effects of oral supplementation on the prevention and/or treatment of oral mucositis in patients with cancer undergoing chemotherapy and/or radiotherapy included 12 RCTs and suggest that Zinc supplements may be beneficial.

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Drugs to prevent salivary gland damage following radiotherapy to the head and neck

This Cochrane review of drugs for the prevention of radiation-induced salivary gland dysfunction included 39 studies, while a range of agents was tested the evidence found is not sufficient to highlight much promise in terms of effective preventative treatments.

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Oral Mucositis: can honey reduce its severity?

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This review of the use of honey to educe the severity of radio/chemotherapy-induced oral mucositis identified 7 low quality RCTs that suggest that use of honey may reduce the severity of oral mucositis.

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Dental Implants: survival rate in irradiated patients

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40 studies were identified for this review of dental implants in irradiated patients. While survival rates were good, they were lower than in non-irradiated areas. As the majority of the included studies were retrospective the findings should be viewed cautiously.

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Oral cryotherapy reduces oral mucositis in patients receiving 5FU-based treatment for solid cancers

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This Cochrane review looked at cryotherapy (ice chips) for preventing oral mucositis in patients with cancer. 14 RCTS involving 1280 patients were included providing evidence that oral cryotherapy leads to large reductions in oral mucositis of all severities in adults receiving 5FU for solid cancers. However there was less confidence confident in the ability of oral cryotherapy to reduce oral mucositis in adults receiving high-dose melphalan before haematopoietic stem cell transplantation (HSCT).

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Oral cancer- monoclonal antibodies combined with standard treatment may improve outcomes

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12 trials were included in this Cochrane review of molecularly targeted therapies and immunotherapies as adjuncts to standard treatments for oral cancer. Moderate evidence was found that standard therapy plus epidermal growth factor receptor monoclonal antibody (EGFR mAb) reduced mortality and locoregional failures.

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Parasympathomimetic drugs for dry mouth after radiotherapy

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The update of a 2007 Cochrane review of parasympathomimetic drugs for dry mouth after radiotherapy did not identify an new studies. The 3 RCTs identified in the previous version provide limited evidence to support the use of pilocarpine hydrochloride in the treatment of radiation-induced xerostomia.

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