| Objective To evaluate the clinical efficacy of triamcinolone acetonide and salvia miltiorrhiza in the treatment of oral submucous fibrosis via the OHIP system.Observing the expression of wnt1in saliva、 GCF and buccal tissue of OSF patients,to explore the effect of wnt1on the occurrence and development of OSF and provide a new method and sight on the treatment effect evaluation in OSF.Methods20patients with OSF were randomly divided into2groups, the first group(10cases) were treated with triamcinolone acetonide combined with sal via miltiorrhiza,the second group(10cases) were treated with triamcinolone acetonide, subcutaneous injection for4weeks, once a week, checked at pre-treatment and after5weeks observed VAS and the maximum mouth opening degree, filled out OHIP-14questionnaire, detected the expression of wnt1in saliva and GCF by ELISA, using real-time fluorescent quantitative PCR to detect the expression of wntl mRNA in OSF buccal tissues.Results(1) Compared with baseline data, at5weeks, the first group’s mouth opening degree increased from26.97±7.31mm to31.39±8.12mm, VAS declined from71.00±19.69to38.00±25.73, OHIP-14score declined from19.80±9.22to13.60±8.80, P<0.01. The second group’s mouth opening degree increased from25.61±7.23mm to30.11±6.86mm, VAS declined from66.00±21.71to38.00±20.98, OHIP-14score declined from17.20±8.79to12.80±6.46, P<0.01. No significant differences were found between two treatment groups regarding the improvement of mouth opening degree,VAS,OHIP-14score, P>0.05.(2) In the OSF group,the concentration of wntl in saliva was significantly higher than normal group (61.45±4.13ng/L vs40.21±3.05ng/L), P<0.01, the concentration of wntl in GCF was higher than normal group (56.52±3.58ng/L vs53.52±1.97ng/L), P<0.05.A positive correlation was found between the concentration of wntl in saliva and GCF, P<0.01; there were significant correlations between wntl in saliva and mouth opening degree,VAS,wntl in GCF and mouth opening degree, P<0.05; there was no significant correlation between wntl in GCF and VAS,P>0.05.(3) In the first group, the concentration of wnt1in saliva decreased from61.38±5.27ng/L at baseline to43.59±3.75ng/L at5weeks, P<0.01, the concentration of wnt1in GCF decreased from55.21±3.37ng/L at baseline to44.55±5.56ng/L at5weeks, P<0.05.In the second group, the concentration of wnt1in saliva decreased from61.53±2.87ng/L at baseline to46.75±10.02ng/L at5weeks, P<0.01, the concentration of wntl in GCF decreased from57.84±3.45ng/L to51.41±4.08ng/L, P<0.01. There was no significant differences between two treatment groups regarding the decreases of wntl in saliva and GCF, P>0.05.(4) The expression of wntl mRNA level in the OSF group (37.22±12.34) x10-5was significantly higher than normal control group (4.48±1.55)x10-5,P<0.01.Conclusions(1) By using OHIP-14to evaluate the efficacy of either triamcinolone acetonide combined with salvia miltiorrhiza or triamcinolone acetonide alone in the treatment of OSF patients,the clinical manifestation and quality of life improved after treatment,suggesting that OHIP scale might be helpful to standardize the clinical management of OSF.(2) The expression of wntl in saliva and GCF decreased obviously in OSF groups after receiving either triamcinolone acetonide combined with salvia miltiorrhiza or triamcinolone acetonide alone treatment.(3) The expression of wntl mRNA level in OSF buccal tissues was significantly higher than normal, demonstrating the wnt/β-catenin signaling pathway was abnormal activation in OSF.(4) The expression of wntl in saliva and GCF of OSF patients were higher than normal, and were positive correlated with the severity of clinical symptoms and signs of OSF,indicating the detection of protein in saliva and GCF might become a noninvasive method for the evaluation of OSF. |
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