Severe Gingival Bleeding in a Myelodysplastic Patient: Management and Outcome

Pereira, Cláudio Maranhão; Gasparetto, Patrícia Freire; Coracin, Fabio Luiz; Marques, José Francisco Comenalli; Lima, Carmen S. P.; Corrêa, Maria Elvira P.

doi:10.1902/jop.2004.75.3.483

Cited by 8 publications

(14 citation statements)

References 16 publications

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“…Son un grupo heterogéneo y se cree que algunas de ellas son parte del mismo espectro de alteraciones hematopoyéticas las cuales, pueden transformarse en leucemia mieloide aguda (LMA) hasta en un 20 -25 % de los casos 21 . Cursan con anemia en el 90% de los casos y la mayoría presenta también neutropenia y trombocitopenia 22 . La edad de aparición más frecuente es a partir de los 60 años con una marcada predilección por el sexo masculino 21 .…”

Section: Síndromes Mielodisplási-cosunclassified

“…La edad de aparición más frecuente es a partir de los 60 años con una marcada predilección por el sexo masculino 21 . La clasificación FAB (French-American-British classification) divide estas alteraciones en: anemia refractaria sin exceso de blastos (AR), anemia refractaria con exceso de blastos (AREB), anemia refractaria sideroblástica (ARS) y leucemia mielomonocítica crónica (LMMC) 22 . Las complicaciones orales son frecuentes debido a las alteraciones cuantitativas y cualitativas de la sangre y a los agentes quimioterápicos utilizados para el tratamiento de la MDS, pudiendo estar presentes entre el 15 y el 85% de los pacientes.…”

Section: Síndromes Mielodisplási-cosunclassified

“…Además pueden aparecer otros signos y síntomas orales como parestesias, petequias y herpes labial e intraoral persistente debido a la neutropenia 22 .…”

Section: Síndromes Mielodisplási-cosunclassified

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Alteraciones gingivales no relacionadas con placa

Palacios-Sánchez¹,

Cerero-Lapiedra

Campo‐Trapero

et al. 2006

RCOE

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Resumen: El depósito de placa bacteriana constituye el principal factor etioló-gico de las alteraciones gingivales; sin embargo se debe tener en cuenta que las lesiones gingivales pueden ser la manifestación de múltiples procesos en los cuales la placa no constituye el factor principal. Debido a la importancia que pueden tener algunos de estos procesos y a que las lesiones gingivales pueden ser un signo temprano que pueden ayudar a establecer un diagnóstico precoz, se ha propuesto hacer una revisión de los mismos destacando las alteraciones gingivales que aparecen relacionadas con enfermedades mucocutáneas, con niveles hormonales, con los tratamientos farmacológicos, con las infecciones víricas, con las discrasias sanguíneas y, por último, las alteraciones gingivales de origen genético o fibromatosis gingival hereditaria. Palabras clave: Encía, Gingivitis descamativa crónica, Hiperplasia gingival.Abstract: Dental plaque remains the main aetiological factor of gingival diseases; nevertheless, a number of gingival lesions could be the expression of other, non-plaque related entities. The aim of this paper is to perform a review and underscore the importance of some of these diseases, since they can be an early and useful sign in order to establish an accurate diagnosis. The main entities are: gingival lesions related to mucocutaneous diseases, gingival lesions related to hormonal levels, gingival alterations produced by pharmacological treatments, gingival lesions produced by viral infections, gingival alterations related to haematological disorders and, finally, gingival alterations of genetic origin such as gingival fibromatosis.

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Section: Síndromes Mielodisplási-cosunclassified

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Alteraciones gingivales no relacionadas con placa

Palacios-Sánchez¹,

Cerero-Lapiedra

Campo‐Trapero

et al. 2006

RCOE

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“…These studies were published and reported from 1979 to 2012. Nine studies were case reports, 7,13,16,23,29,[44][45][46]48 two were cross-sectional studies, 9,10 three were prospective randomized clinical trials, 8,12,39 three were retrospective studies, 18,40,47 and one study was a case report and review article. 35 The general objective of the studies was to evaluate the periodontal status of the patients with MDS and/or AML and to investigate the dental treatments they have received.…”

Section: Resultsmentioning

confidence: 99%

“…During the pancytopenic phases of therapy, patients should be advised about careful tooth brushing to prevent gingival bleeding . Some clinicians advise their patients to discontinue tooth brushing with severe pancytopenia or when the platelet count is below 20 × 10 9 /L . This leads to retention of plaque and calculus; hence, more spontaneous gingival bleeding .…”

Section: Discussionmentioning

confidence: 99%

Oral and dental management of people with myelodysplastic syndromes and acute myeloid leukemia: A systematic search and evidence‐based clinical guidance

Abed

Alhabshi

Alkhayal

et al. 2019

Special Care in Dentistry

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Aims To systematically search all studies that discussed dental procedures in patients diagnosed with myelodysplastic syndromes (MDS) and/or acute myeloid leukemia (AML) and to provide an evidence‐based clinical guidance on oral and dental management of people with MDS and/or AML. Methods The systematic search followed the Preferred Reporting Item for Systematic Review and Meta‐analyses Protocols (PRISMA‐P) guideline. Two databases systems were used (MEDLINE and EMBASE). PROSPERO was searched for ongoing or recently completed systematic reviews. The International Clinical Trials Registry Platform Search was searched for ongoing or recently completed trials. Level of evidence was evaluated based on the Oxford Level of Evidence. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to summarize the evidence. Results Only 18 articles were selected and included in data synthesis and analysis. The level of evidence and recommendation ranged from 1 to 5 and A to D, respectively. Conclusions All the included studies in the data synthesis (n = 18) showed no specific guidelines were followed; however, all reflected the importance of liaison with the patient's hematoncologist at all stages of MDS and/or AML therapy. Recommendations Oral and dental assessment is crucial prior to MDS therapy to help reduce anticipated complications. Dental treatment prior to hematopoietic stem cell transplantation and/or active stage of MDS therapy is tricky and always required liaison with the hematoncologist. MDS can progress to AML; hence, dental care providers are in a good position to spot any changes and refer early to the hematoncologist for further assessment.

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Hematologic Diseases Non-Neoplastic

Laskaris

2023

Periodontal Manifestations of Local and Systemic Diseases

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Severe Gingival Bleeding in a Myelodysplastic Patient: Management and Outcome

Abstract: The results of this study suggest that periodontal therapy should be performed in MDS patients presenting thrombocytopenia, gingival hyperplasia, and gingival bleeding, with the intent of preventing further hemorrhagic episodes and possible systemic infection.

Cited by 8 publications

References 16 publications

Alteraciones gingivales no relacionadas con placa

Alteraciones gingivales no relacionadas con placa

Oral and dental management of people with myelodysplastic syndromes and acute myeloid leukemia: A systematic search and evidence‐based clinical guidance

Hematologic Diseases Non-Neoplastic

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