Necessidade de tratamento odontológico em pacientes candidatos a transplante simultâneo de pâncreas-rim e fígado num centro único.

Ramaglia, Andrea Helena Francisca; Netto, Alcides Augusto Salzedas; Monteiro, Mirella M. B.; Pimentel, Carolina Frade Magalhães Girardin; Abranches, Denise Calutá; Rangel, Érika Bevilaqua; Gonzalez, Adriano Miziara

doi:10.1590/0100-6991e-20192224

Rev. Col. Bras. Cir.

2019

DOI: 10.1590/0100-6991e-20192224

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Necessidade de tratamento odontológico em pacientes candidatos a transplante simultâneo de pâncreas-rim e fígado num centro único.

Andrea Helena Francisca Ramaglia

Alcides Augusto Salzedas Netto

Mirella M. B. Monteiro

et al.

Abstract: RESUMO Objetivo: avaliar as condições bucais e os principais fatores predisponentes para tratamento odontológico de pacientes em lista de espera para transplante simultâneo de pâncreas-rim e para transplante hepático, em um centro único. Métodos: foram avaliados 100 pacientes na fila de espera, 50 candidatos a transplante hepático e 50 a transplante simultâneo de pâncreas-rim, no período de agosto de 2015 a fevereiro de 2018. Exames extra e intrabucais foram correlacionados com variáveis demográficas pré-tra… Show more

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The association between oral health status and the clinical outcome of cirrhotic patients on the waiting list for liver transplantation

Lee

Chang

et al. 2021

The Kaohsiung J of Med Scie

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Liver transplantation (LT) candidates often present with poor oral hygiene, which could potentially lead to systemic infections and sepsis owing to their cirrhotic state.In this study, we investigated the oral health status of LT candidates and propose guidance for the detection and treatment of encountered oral lesions among these patients. The decayed, missing, and filled teeth (DMFT) index was determined through oral examination. The presence of dental calculus was detected using panoramic radiography and defined by the radiopaque dental calculus (RDC). From January 2011 to August 2018, 56 LT candidates were enrolled with a median followup of 39 months. The overall mean numbers of decayed, missing, and filled teeth among these patients were 2.7 ± 2.8, 10.9 ± 8.3, and 5.4 ± 4.5, respectively. Eighteen patients (32.1%) had RDC. The 5-year survival rates of all 56 patients was 57.7%, while that of those who either received LT (23 patients) or not were 82.1% and 39.8%, respectively. A Cox regression model revealed better overall survival of patients after LT (adjusted hazard ratio [aHR] = 0.067, p = 0.001), worse survival among patients with RDC (aHR = 3.468, p = 0.010), at Child-Pugh stages B and C (aHR for stage B = 11.889, p = 0.028; aHR for stage C = 19.257, p = 0.013) compared to patients at Child-Pugh stage A, and those with a model for end-stage liver disease (MELD) score ≥25 (aHR = 13.721, p = 0.018). This study demonstrates that RDC was associated with worse prognosis in LT candidates. We therefore recommend that interprofessional collaboration should be a routine preoperative procedure for the evaluation of oral hygiene among LT candidates.

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The association between oral health status and the clinical outcome of cirrhotic patients on the waiting list for liver transplantation

Lee

Chang

et al. 2021

The Kaohsiung J of Med Scie

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Is dental caries associated with liver transplantation? A systematic review and meta‐analysis

et al. 2020

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Objective The aim of this systematic review and meta‐analysis was to evaluate the experience of dental caries in individuals pre‐ or postliver transplant. Materials and Methods Searches in PubMed, Scopus, Web of Science, Ovid, and Lilacs from databases’ inception date up to April 2020 were undertaken. Gray literature and manual searches were also conducted. Observational studies were eligible. The retrieved references were evaluated by two independent reviewers. Meta‐analysis and risk of bias assessment using the University of Adelaide tool were conducted. The strength of the evidence was assessed with GRADE. Results The search retrieved 1990 references. Twenty‐four cross‐sectional studies were included. One subgroup analysis demonstrated no significant difference in the number of teeth with dental caries between pre‐liver transplant and healthy individuals (mean difference = 1.65, confidence interval = −0.87 to 4.17). The prevalence of dental caries among pre‐liver transplant individuals was 73.82% and in the post‐transplant individuals was 72.83%. In the included studies, the main concern regarding risk of bias was the absence of control for confounding variables. The strength of the evidence was very low. Conclusions Dental caries may be a relevant issue in pre‐ and postliver transplant individuals. Oral health counseling should be included in the care of pre‐ and/or postliver transplant individuals.

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Necessidade de tratamento odontológico em pacientes candidatos a transplante simultâneo de pâncreas-rim e fígado num centro único.

Cited by 2 publications

References 12 publications

The association between oral health status and the clinical outcome of cirrhotic patients on the waiting list for liver transplantation

The association between oral health status and the clinical outcome of cirrhotic patients on the waiting list for liver transplantation

Is dental caries associated with liver transplantation? A systematic review and meta‐analysis

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