口腔癌輔助性治療及功能改善之研究

Abstract

口腔癌及牙科修復材料相關研究在近年均有顯著進展，探討新型治療與材料技術在口腔醫學的整合臨床與基礎研究。首先，使用含抗菌胜肽的噴劑，能有效緩解口乾症狀與口腔疼痛，提升患者的生活品質，尤其在疼痛管理方面效果顯著。雖然短期內未見對口腔黏膜炎有明顯改善，但該噴劑有助於減少因口腔衛生不佳導致的黏膜潰瘍及感染，改善口腔環境，顯示有助減輕口腔黏膜炎與口乾症狀，並改善營養攝取與生活品質。其次，木蘭醇作為免疫調節及抗腫瘤輔助用藥，能降低口腔癌復發率，減少術後再手術機會，並提升患者存活率與口腔健康狀況。在動物實驗中，利用小鼠原位口腔鱗狀細胞癌模型，評估木蘭醇之抗腫瘤與免疫調節作用，高劑量組顯著抑制腫瘤生長，促進細胞凋亡，並增加NK細胞、細胞毒性T細胞與樹突細胞比例，同時抑制免疫抑制細胞，且安全性良好。材料研究部分，比較傳統包埋、銑削與立體列印義齒基底樹脂（DBR）的物化與生物性能，結果顯示立體列印DBR具最低表面粗糙度、無細胞毒性，且對生物膜形成具最高抑制效果，顯示其有潛力提升口腔衛生與長期穩定性。此外，針對聚芳醚酮（PAEK）牙科植體進行手持式非熱等離子體（HNP）處理，可顯著增加表面親水性與表面自由能，促進成骨細胞黏附、增殖與礦化標的物表達，且無明顯炎症反應。重建方面，採用非熱等離子體技術處理植體表面，加速骨結合，有助於改善缺骨及缺牙問題，為傳統鈦金屬植牙提供替代或輔助方案。咀嚼功能復形則引入DLP立體列印義齒技術，提高假牙製作的精確度，降低感染風險，提升義齒貼合度和患者咀嚼功能，改善因張口受限及黏膜變薄所造成的口腔微環境改變。綜合多胜肽藥劑與木蘭醇的應用，不僅提升口腔癌的口腔衛生和免疫功能，減少治療相關的疼痛感，促進營養攝取，有助於改善患者的心理狀態和生活品質，能有效降低併發症和腫瘤復發率，分別在臨床症狀控制、腫瘤免疫調節、義齒材料性能優化與植體表面功能化等面向展現應用潛力，對提升口腔醫療品質與病人生活品質具有重要意義，為口腔癌患者提供更全面的輔助治療選擇。

Advances in oral cancer therapy and dental restorative materials increasingly emphasize integrating novel therapeutics with material innovations to optimize clinical outcomes.An antimicrobial peptide spray effectively alleviated xerostomia and oral pain, with marked benefit in pain management. While short-term impact on mucositis was limited, it reduced ulceration and infection, improving oral environment, nutrition, and quality of life. Magnolol, an immunomodulatory and antitumor agent, decreased recurrence rates, reduced reoperation needs, and enhanced survival. In a murine oral squamous cell carcinoma model, high-dose magnolol suppressed tumor growth, promoted apoptosis, increased NK cells, cytotoxic T cells, and dendritic cells, while reducing immunosuppressive populations, with favorable safety. Material innovations included stereolithography-printed denture base resins exhibiting lowest surface roughness, no cytotoxicity, and greatest biofilm inhibition, supporting superior oral hygiene and long-term stability. Polyaryletherketone (PAEK) implants treated with handheld non-thermal plasma (HNP) showed enhanced hydrophilicity, osteoblast adhesion, proliferation, and mineralization without inflammation, accelerating osseointegration and offering an alternative to titanium in compromised bone. Digital light processing (DLP) denture fabrication improved fit, accuracy, and masticatory function, while lowering infection risk. Combining antimicrobial peptides, magnolol, advanced denture materials, and plasma-functionalized implants addresses oral cancer care at multiple levels—pain relief, immune modulation, oral hygiene, and prosthetic performance—potentially reducing recurrence and improving quality of life. These strategies represent promising adjunctive options to elevate oral oncology treatment standards.