| Introduction:Oral and maxillofacial malignant tumor with cancer as the most, sarcoma is less, in which the majority with squamous cell carcinoma, followed by gland carcinoma, etc. Oral squamous cell cancer treatment is the same as other malignant tumors. A single treatment is not receiving good treatment effect, to give priority to with surgical resection, combined with radiotherapy and chemotherapy. It can also be combined with a variety of methods, such as biological treatment. The chemotherapy is an important treatment in oral and maxillofacial malignant tumor. Current chemotherapy drugs often have cell toxicity, which can inhibit malignant tumor of rapidly dividing cells and destroy them split process, but these drugs will also effect on normal cells, has certain influence to the body. The treatment of malignant tumors often can cause other problems, such as microsites, taste disorders, sensory nerve and the quantity of saliva. Many reports have confirmed that chemotherapy can cause oral and dental disease. Before the treatment, therefore, it is necessary to prevent such complications. Especially the reduction of saliva lead to increase in the number of bacteria in the mouth, and with the change of the diet. Chemotherapy is conducive to the occurrence of dental caries and periodontal disease.Periodontal disease is a common oral diseases, it is the main reason of adult tooth loss. With the continuous progress of medical research to make sure the periodontal disease not only affects the mouth system but also has a high correlation with the whole body, such as cardiovascular disease, diabetes, low birth weight premature infants and the respiratory infection.The development process of periodontitis is very complex.Interleukins-1beta(IL-1β) is the main regulating mediated inflammatory factor. It can promote bone absorption; inhibit bone formation and inhibition of metalloproteinase, lead to connective tissue disintegration and edema formation. And defensin as part of the body’s immune system is a kind of peptides, can kill bacteria, fungi, viruses and other microbes and have antitumor activity.Human beta-defense-2(HBD-2) is one of the main antibacterial peptide in the human body, the gram-negative bacteria and fungi have obvious effect, HBD-2 expression in oral cavity is closely related to the oral health status.We do the periodontal treatment for oral and maxillofacial malignant tumor patients with postoperative chemotherapy, comparison of periodontal clinical indexes, expression level of IL-1β and HBD-2 before and after the treatment. Through the quality of life scales assessment of patients with oral and maxillofacial malignant tumor undergoing chemotherapy after the effects of periodontal status. Objective:1.To evaluate the periodontal clinical index in patients with oral and maxillofacial malignant tumor with chemotherapy after periodontal treatment.2.To observe the expression level of IL-1β and HBD-2 expression in patients with oral and maxillofacial malignant tumor with chemotherapy after periodontal treatment.3.To evaluate the quality of life in patients with oral and maxillofacial malignant tumor with chemotherapy after periodontal treatment. Methods:1.The observation time is divided into three time points.First: before chemotherapy(D1 for baseline),second: one month after chemotherapy(D2), third: six months after chemotherapy(D3).In D2 and D3 time points for patients with oral health education and periodontal treatment. In three different time points do the periodontal examination including the plaque indexes(PLI), bleeding of probe(BOP), Probing pocket depth(PD) and clinical attachment level(CAL).2.In three different time point using the sterile filter paper to get the gingival crevicular fluid(GCF). The expression of IL-1β and HBD-2 using enzyme-linked immunosorbent assay(ELISA) for detection.3.Patients completed OHIP-14 and UW-QOL scales in D1 time point and D3 time point, to assess the oral health status in patients with oral and maxillofacial malignant tumor undergoing chemotherapy. Results:1.After the periodontal treatment,the prevalence of periodontitis in D1 time point was 65.71%, and the incidence of periodontitis in D2 and D3 time points had no significant difference,but all of the patients clinical periodontal indexes improved, statistically significant compared with the baseline.2.After the periodontal treatment,the expression level of IL-1β in different time points significantly decreased(D1/ D2(P <0.05),D2/ D3(P <0.05)),and the expression level of HBD-2 in D2 time point significantly increased(D1/ D2(P <0.05)).3.In D1 and D3 point to evaluate the patients’ quality of life,OHIP-14 scale evaluation result:different time points in psychological discomfort(47.80± 11.31VS35.02±11.53,P<0.05)and physiological disorder( 52.73±10.92VS41.02 ±13.81,P <0.05)had significantly differences, the rest of the five items did not show significant difference. UW-QOL scale evaluation results: different time points in the energy(54.33±8.22VS74.01±10.32,P<0.05)and chew( 34.80±8.82VS45.12±7.43,P <0.05)had significantly differences. The rest of the 10 items did not show significant difference. Conclusion:Periodontal treatment can effectively reduce the oral and maxillofacial malignant tumor after chemotherapy in patients with PD, PLI, BOP indexes and the expression level of IL-1β, improve the patients’ quality of life. |
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