Periodontal status and post‐transplantation complications following intensive periodontal treatment in patients underwent allogenic hematopoietic stem cell transplantation conditioned with myeloablative regimen

Abstract

: Objectives: Evaluation of the periodontal status is necessary prior to management with high‐dose chemotherapy before hematopoietic stem cell therapy (HSCT). During medical therapy, pre‐existing periodontal conditions may exacerbate and cause local and systemic complications. When possible, maximal oral health should be achieved prior to engraftment. In this study, we aimed to determine the alterations occurred in the periodontal status of the patients after periodontal treatment and allogenic HSCT and evaluate the effect of intensive periodontal approach on the short‐term complications of HSCT. Methods: The alterations occurred in the periodontal tissues 3–4 weeks after periodontal treatment and after HSCT periods of 3 months for 29 patients treated with full‐mouth periodontal treatment completed in 24 h in addition to eradication of dental foci, and oral hygiene status were evaluated using pocket depth measurements, presence of bleeding on probing and plaque and gingival indices. The incidence and severity of acute graft‐versus‐host disease (GVHD) and oral mucositis (OM) were recorded. Duration of engraftment period and the episode of febrile neutropenia were also evaluated. Results: There were significant improvements in periodontal status after periodontal treatment (P < 0.001). There were 14 (48.3%) patients without acute GVHD and 17 (58.6%) patients with no sign of OM. The majority of OM was at grade II level. There was a negative relation that exists between the percentage of BOP (+) sites and presence of OM (r = −0.518, P < 0.05). Conclusions: Together with a significant reduction in gingival inflammation and maintenance of the improvement in periodontal health, remarkable decrease in the incidence and severity of OM were observed.

Oral chronic graft-versus-host disease: A short review

“…Radiotherapy and chemotherapeutic agents used for the conditioning regimens of transplantation have directly damaged the mucosal progenitor cells, leading to loss of mucosal integrity, thus evaluation of the periodontal status is needed prior to management with high-dose chemotherapy and/or HSCT and when the treatment will result in myelossupression [17]. Table 2.…”

Fungal and viral oral infections in individuals with onco-hematologic neoplasms in a University Hospital

“…Topical antifungal agents, such as Nystatin, are the first line of treatment for candidiasis 7,8 , however, systemic antifungal medications are more effective in immunosuppressed individuals 8 . In relation to viral infections, immunosuppression may reactivate latent viral infections, generally with more serious atypical signs than those manifesting in immunocompetent patients 9,10 . In the oral mucosa, herpes simplex is the most common viral infection, characterized by the formation of vesicles that rupture and form painful ulcers in the oral cavity and oropharynx 11 .…”

Existe associação entre doença periodontal e câncer? Análise investigativa clínica

“…Assim, um parâmetro que pode influenciar a severidade da mucosite é a presença de DP, graças a sua natureza infecto-inflamatória (EPSTEIN et al, 2012). Variados estudos indicam que a severidade, frequência e duração da mucosite podem ser reduzidas ao se promover uma adequação bucal prévia ao regime de mielossupressão (SONIS; KUNZ, 1988;BOROWSKI et al, 1994;SANTOS et al, 2011;CORACIN et al, 2013;GURGAN et al, 2013;FERNANDES, L. L. et al, 2014 Gy normalmente não tem seu fluxo salivar normalizado COKE, 2007;SPEKSNIJDER et al, 2010). Este quadro de salivação reduzida associado ao aumento do acúmulo de placa e alterações na microbiota bucal beneficia a progressão da DP (LEUNG et al, 1998).…”