Cancer patients can suffer oral toxic effects secondary to antineoplastic therapy in the form of radiotherapy and/ or chemotherapy. This risk is conditioned by a range of factors, including the high cell turnover rate of the oral mucosa, the diversity and complexity of the oral microflora, and soft tissue trauma during normal oral function. The present study offers a literature review of the main oral complications secondary to chemotherapy, and describes the different options for dental treatment before, during and after oncological treatment, published in the scientific literature. To this effect a PubMed-Medline® search was made using the following keywords: chemotherapy, cancer therapy, dental management, oral mucositis, neurotoxicity, intravenous bisphosphonates and jaw osteonecrosis. The search was limited to human studies published in the last 10 years in English or Spanish. A total of 50 articles were identified: 17 research papers, 25 reviews, 6 letters to the Editor, and two clinical guides developed by expert committees. The data obtained showed the main oral complications of chemotherapy to be mucositis, neurotoxicity, susceptibility to infections, dental, salivary and taste alterations, and the development of osteonecrosis. Based on the reviewed literature, elective dental treatment can be provided before chemotherapy, with emphasis on the elimination of infectious foci. During chemotherapy, dental treatment should be limited to emergency procedures, while dental treatment of any kind can be prescribed after chemotherapy -with special considerations in the case of patients who have received treatment with intravenous bisphosphonates.
Leukocytes are the main cellular elements of inflammatory and immune reactions of the organism. Leukocyte alterations are the consequence of an imbalance between the formation of leukocytes in the bone marrow and its elimination by the mononuclear phagocytic system. Factors that can modify leukopoyesis are varied and can lead to an alteration in the number of leukocytes or tumoral alterations of white cells (leukemias, lymphomas and plasma cell tumors). There is also a wide range of clinical manifestations that can derive from them: from very slight symptoms to life-threatening conditions. In some cases oral manifestations will be the first signs and it will be the dentist's responsibility to identify the underlying disorder and guide the diagnosis of the patient. It is important to be familiar with the special management required for these patients, in which the dental treatment can affect the course of the underlying disease. The objective of this article is to review the literature concerning the oral manifestations and the considerations that must factor in the dental treatment of patients with leukocyte alterations.
Introduction: Transplant is the replacement with therapeutic purposes, of organs, tissues or cellular material for others, from a donor who is usually a human, alive or dead. In recent years, transplant organs have been developed by the advances that have occurred with immunosuppressive drugs and medical-surgical technology. Due to the frequency of transplants that are performed today, it is common to find these patients in dental clinics. Objectives: To review the literature on oral manifestations in transplant patients and general dental management and according to transplant organs (heart, lung, liver, kidney, pancreas and bone marrow). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary "Medical Subject Headings" (MeSH). We obtained a total of 30 articles (eight literature reviews, three randomized clinical trials, one cohort study, three case-control studies, eight clinical case series and seven cross-sectional studies). Results and discussion: We describe the most common oral manifestations in transplant patients (viral, bacterial and fungal infections, gingival enlargement secondary to drug therapy and higher risk in the development of oral malignancy) and the special dental management that should be carried out on these patients, generally and specifically according to the type of transplant.
Many respiratory disorders can compromise routine dental care and require special treatment for the affected patients. Patients often visit the dental clinic with respiratory problems already diagnosed by other specialists. The dental professional therefore must provide correct dental care in the context of such a diagnosis. The present study offers a literature review of those respiratory disorders which can have implications for dental care. Chronic obstructive pulmonary disease (COPD) and asthma require special measures, such as working with the patient in the vertical position, since some of these subjects do not tolerate decubitus. On the other hand, patients with COPD can suffer infectious lung diseases secondary to the aspiration of microorganisms in the presence of deficient periodontal conditions. The treatments received by patients with respiratory diseases can also influence their oral health. In this sense, it has been shown that inhalatory medication used for asthma can cause oral disorders such as xerostomia, oropharyngeal candidiasis and an increased presence of caries (due to the action of β-agonists), as well as gingivitis. In contrast, oral manifestations of tuberculosis are infrequent. The clinical appearance of the lesions is very similar to that of squamous cell carcinoma; it is therefore important to establish a correct differential diagnosis in such cases. Mention also will be made of patients with obstructive sleep apnea syndrome (OSAS), characterized by critical narrowing and occlusion of the upper airways during sleep. In this context, the dental professional is often directly implicated in the management of such patients by preparing and fitting oral devices designed to advance the mandible. Lastly, mention will be made of dental management in the event of foreign body aspiration, where rapid intervention by the dental professional is critical. The basic approach in such cases is adequate prevention.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.