Gingival inflammation and platelet count in patients with leukemia: preliminary results

Abstract

Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = −0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.

Periodontal status of candidates for allogeneic hematopoietic stem cell transplantation

“…Moreover, the percentage of sites with bleeding had no association with platelets, but was associated with the percentage of visible plaque, contributing to the hypothesis that the gingival bleeding observed during dental examination was probably due to gingival inflammation induced by biofilm and not the systemic condition involved. These results are in agreement with other authors who did not find correlation between platelet count and gingival bleeding in leukemic patients with thrombocytopenia …”

Evaluation of Periodontal Parameters in Patients with Early Stage Chronic Lymphocytic Leukemia

“…Ipak, kod bolesnika s leukemijom utvrđene su statistički značaj-no veće vrijednosti parodontoloških indeksa nevezano za dob bolesnika, što se podudara s rezultatima našeg istraživanja. Druga presječna studija, koju su proveli Angst i suradnici, obuhvaćala je 37 ispitanika s različitim vrstama leukemije, a proučavala je utjecaj trombocitopenije na gingivalno krvarenje (33). Rezultati su pokazali da je utjecaj niske razine trombocita na gingivalno krvarenje bio vrlo slab, te da statistički nije bio značajan.…”

“…However, in agreement with the results of our research, statistically significant higher levels of periodontal indices were found in leukemic patients compared to controls, irrespective of the patient's age. Another cross-sectional study, conducted by Angst et al, included 37 patients with different types of leukemia in which authors studied the effect of thrombocytopenia on gingival bleeding (33). The results showed that the impact of low levels of platelets on gingival bleeding was very low and was not statistically significant.…”

Avaliação retrospectiva das alterações orais em crianças com leucemia linfoblástica aguda

“…5 -11 Esses pacientes também podem apresentar infiltração leucêmica gengival, processos inflamatórios gengivais acentuados, sangramentos gengivais espontâneos e sangramento submucoso bucal, devido à trombocitopenia. 5,7 Durante o tratamento antineoplásico, as lesões orais (mucosite, xerostomia e infecções virais ou fúngicas) podem surgir como reações adversas, sendo as manifestações orais são mais comuns na fase de indução. 8 -12 A quimioterapia deveria destruir as células malignas, mas devido ao seu mecanismo de ação inespecífico, acaba agindo também nos tecidos normais, principalmente naqueles que possuem rápida divisão celular (mucosa bucal).…”