Association between the time after transplantation and different immunosuppressive medications with dental and periodontal treatment need in patients after solid organ transplantation

Abstract

Objective

Aim of this study was to investigate the association of time after transplantation and different immunosuppressive medications with dental and periodontal treatment needs in patients after solid organ transplantation (SOT).

Methods

After lung, liver or kidney transplantation, patients were included and divided into subgroups based on the time after SOT (0-1, 1-3, 3-6, 6-10 and >10 years) and immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs. combination). Dental treatment need was determined by the presence of carious lesions, while periodontal treatment need was diagnosed based on a Periodontal Screening index score of 3-4. The overall treatment need included both the dental and/or periodontal treatment needs. Statistical analysis was performed using the Kruskal-Wallis test and Chi²-test (p<0 .05="" p="">

Results

A total of 169 patients were included after SOT. A dental treatment need of 44%, a periodontal treatment need of 71% and an overall treatment need of 84% were detected in the total cohort. Only patients with >10 years after SOT had a lower dental treatment need compared to the other groups (p=0.02). All other comparisons of dental, periodontal and overall treatment needs were comparable between subgroups depending on time since SOT. Furthermore, no statistically significant differences were found in terms of the dental, periodontal or overall treatment needs following the administration of different immunosuppressive medications.

Conclusion

The high treatment need of patients after SOT, irrespective of the time since transplantation, suggests insufficient dental and periodontal treatment before and maintenance after organ transplantation. Furthermore, immunosuppressive medication was not associated with the treatment need.

Transplant Infectious Disease

Acesso em: http://onlinelibrary.wiley.com/doi/10.1111/tid.12832/full

What is the role of the dentistry in organ transplants?

What is the role of the dentistry in organ transplants?

Infections of oral origin are a potential threat for transplant candidates
because oral diseases tend to be more severe and untreated in people
who have received transplants. Although not yet scientifically proven,
evaluation and dental treatment during the pre-transplantation period is
recommended in order to prevent infections and resulting odontogenicorigin
sepsis during the post-transplant period, when patients receive
immunosuppressive therapy.1
Careful oral examination and evaluation of the patient, including
laboratory tests, is recommended in order to ensure correct oral preparation
and control of oral disease prior to organ transplantation (OT). Patients
with chronic diseases that lead to OT may present at any dental office for
treatment and therefore general dentists should be aware of the unique
concerns involving their assessment, education, treatment and maintenance
of oral health.2
The equilibrium between viral persistence and immune regulation of the
host is modified in many immunological conditions related to OT. Among
the opportunistic oral infections that can cause some impairment in these
patients, the most common are fungal infections, and viral infections
by CMV and HSV, and must be diagnosed early by a dentist.3 The use
of systemic medications can affect the periodontal tissues, modifying
their inflammatory and immune response, especially the gingiva. Some
immunosuppressive drugs used in OT may trigger gingival hyperplasia.4
Because of the conditions above described it is considered that the
communication between the organ transplant team and dentist is
important in formulating individualized care plans and transplant
patients need comprehensive and regular dental care during the pre
and post-transplant period and a doctor of oral medicine should be part
of a multidisciplinary team of medical specialists.5 Appropriate dental
care increases the survival of the transplanted organ.

http://www.joralres.com/index.php/JOR/article/view/388/373

Manual de Orientação ao Paciente em Transplante - Odontologia

Resultados das Eleições ABTO – Gestão 2018/2019

A Comissão de Odontologia da ABTO cumprimenta a Diretoria da ABTO  para a gestão 2018/2019 representados aqui pelos Presidente: Paulo Manuel Pêgo Fernandes e Vice-Presidente: Tainá Veras de Sandes Freitas e cumprimentar, dentre os demais, o colega Cirurgião Dentista Renato Costa Franco Baldan por ter sido eleito para o DEPARTAMENTO DE TRANSPLANTE DE TECIDOS.

Toda a nova diretoria pode ser vista em:

http://www.abto.org.br/abtov03/default.aspx?c=1109&mn=476