Oral findings and dental behaviour before and after liver transplantation – a single-centre cross-sectional study

Authors

Anne Kauffels,

Gerhard Schmalz,

Otto Kollmar,

Jan E. Slotta,

Michael Weig,

Uwe Groß,

Oliver Bader,

Dirk Ziebolz

Abstract

Objective

The aim of this single-centre, cross-sectional study was to evaluate dental, periodontal and mycological findings, as well as oral behaviour, in patients before (pre-LTx) and after (post-LTx) liver transplantation.

Methods

A total of 47 patients pre-LTx and 119 patients post-LTx were asked to participate. Oral health behaviour was assessed using a standardised questionnaire. Oral examinations included dental [decayed, missing and filled teeth (DMFT) index] and periodontal [papillary bleeding index (PBI), periodontal probing depth (PPD) and clinical attachment loss (CAL)] findings. For Candidascreening, swabs from the oral mucosa were cultured. Statistical analysis was performed using the Student's t-test or the Mann–Whitney U-test, depending on whether or not the data followed a normal distribution; Fisher's exact test was also performed. The significance level was α = 5%.

Results

A total of 110 patients were included (pre-LTx, n = 35; post-LTx, n = 75). Different patients were investigated in the post-LTx and pre-LTx groups. Lack of use of supplemental oral-hygiene aids was noted. Between-group comparisons failed to find significant overall differences in DMFT and periodontal status. The post-LTx group showed fewer decayed teeth (P = 0.03). A total of 86% of patients pre-LTx and 84% of patients post-LTx were found to need dental treatment, and 60% of patients pre-LTx and 55% of patients post-LTx showed a need for periodontal treatment. The prevalence of Candida albicans was high; however, there were no statistically significant differences between the groups in regard to fungal infection.

Conclusion

Improved dental care pre- and post-transplant, including screening for fungal infections, is recommended to avoid systemic infections in LTx patients. Increased attention to oral health care, and interdisciplinary collaboration to provide guidance, is needed to improve the oral health of patients before and after LTx.

http://onlinelibrary.wiley.com/doi/10.1111/idj.12290/full

Manejo odontológico em paciente com Linfoma não Hodgkin submetido a transplante autólogo de células tronco hematopoiéticas - Dental care in patient with nonHodgkin lymphoma and autologous stem cell transplantation

Manejo odontológico em paciente com Linfoma não Hodgkin submetido a transplante autólogo de células tronco hematopoiéticas - Dental care in patient with nonHodgkin lymphoma and autologous stem cell transplantation

Sumário
O linfoma não Hodgkin (LNH) é o nome que se dá a um grupo heterogêneo de doenças, sendo uma neoplasia maligna de células B, T ou Natural Killer que se infiltram nessas células linfoides ou hematopoiéticas normais. Sua etiologia ainda permanece desconhecida, no entanto inúmeros fatores imunológicos e imunodeficiências parecem estar envolvidos em seu desenvolvimento. O tratamento varia de acordo com o subtipo do LNH, podendo dessa forma levar a cura dos pacientes em 50% dos casos. O Objetivo desse trabalho é relatar detalhadamente o manejo odontológico em uma paciente diagnosticada com LNH, submetida a tratamento quimioterápico concomitante ao radioterápico e posterior transplante autólogo de células tronco hematopoiéticas. A paciente foi submetida a diversos procedimentos odontológicos dentre eles endodôntico, restaurador dentário, reabilitador protético e cirurgia oral, posterior a anamnese e confirmação de condições clínicas e laboratoriais favoráveis que não contra indicavam o manejo odontológico. A atuação do cirurgião dentista sobre os pacientes oncológicos tem se mostrado ao longo dos anos primordial, sobretudo no que diz respeito as manifestações bucais que o tratamento pode gerar. No entanto, o cuidado com o paciente deve
ocorrer antes, durante e após o tratamento, com adequação do meio bucal, acompanhamento a intercorrências durante o tratamento e restabelecimento no pós tratamento.

Summary
The nonHodgkin's lymphoma (NHL) is the name given to a heterogeneous group of disorders, a malignancy of T, B, or natural killer cells. They are infiltrating these normal lymphoid or hematopoietic cells. Its etiology remains unknown. However, numerous immune factors and immune deficiencies appear to be involved in their development. The treatment varies depending on the subtype of NHL and it may thus lead to the cure of patients in 50% of cases. The aim of this work is to report in detail the dental management in a patient diagnosed with NHL, underwent chemotherapy as well as radiotherapy and subsequently autologous transplantation of hematopoietic stem cells. The patient was submitted to various dental procedures among them endodontics, dental restorative, rehabilitative prosthetics and oral surgery treatments. The subsequent history and confirmation of favorable clinical and laboratory conditions was not contraindicated for the dental management. The role of the dentist on cancer patients has been important over the primary years, especially regarding the oral manifestations that treatment can generate. However, patient care should take place before, during and after cancer treatment. It is possible with the adequacy of the oral environment,
monitoring the events during the treatment and the recovery in the post treatment.

artigo na íntegra: http://www.moreirajr.com.br/revistas.asp?fase=r003&id_materia=6330

PROGRAMAÇÃO - XV CONGRESSO BRASILEIRO DE TRANSPLANTES 2017

Confira a programação do 

XV CONGRESSO BRASILEIRO DE TRANSPLANTES 2017

LOCAL: Bourbon Cataratas - Foz do Iguaçu/PR - FOZ DO IGUAÇU/PR | 18 a 21 de Outubro de 2017

https://sistemaparaevento.com.br/evento/abto2017/programacao/gradeatividades/38