Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients

Abstract

Solid organ transplant/HSCT recipients are at risk of orofacial diseases. Adequate management of these patients alleviates local symptoms responsible for impaired eating, helps prevent systemic and lethal complications, and helps where dental healthcare has been neglected.

Oral Pyogenic Granuloma After Bone Marrow Transplant in the Pediatric/Adolescent Population: Report of 5 Cases

“…6 However, the majority of previous cases of PG after HCT occur on the tongue rather than the gingivae. 1 Similarly, in this case series, 4 of the 5 patients presented with PG on the tongue, whereas none of them developed gingival PG.…”

“…1 Oral complications occur in up to 70% of patients after HCT and include mucositis, xerostomia, dental caries, opportunistic infections, gingival overgrowth, lip/oral cancers, and graft versus host disease (GVHD). 1,2 In patients who develop chronic GVHD (cGVHD) after HCT, oral involvement occurs in 45% to 83% and often presents as hyperkeratotic plaques, lichenoid lesions, sclerosis resulting in restricted opening of the mouth, mucosal ulcers, xerostomia, dysphagia, and taste disturbances. 3 Rarely, patients may develop oral pyogenic granulomas (PGs) in the oral cavity with or without associated cGVHD.…”

The Oral Cavity State in Renal Transplant Recipients

“…As a result of the interaction of cyclosporine A and calcium channel blockers, almost regularly in all patients receiving this combination of drugs, gingival hyperplasia appears (9). In patients with a renal transplant, lip and oral cancer are also described (10) and less frequently post-transplant lymphoproliferative disorders, oral ulceration and oral lichenoid reactions (11). In addition to the documented oral lesions, the emergence of new entities with characteristics of orofacial granulomatosis is described, especially in children with solid organ transplantation (12).…”

“…Kao posljedica interakcije ciklosporina A i blokatora kalcijevih kanala, gotovo redovito se svim bolesnicima koji primaju ovu kombinaciju lijekova pojavljuje hiperplazija gingive (9). Kod osoba s transplantiranim bubregom opisana je pojava raka usnice i usne šupljine (10), a rjeđe poslijetransplantacijski limfoproliferativni poremećaj, oralne ulceracije i lihenoidne reakcije (11). Uz već dokumentirane oralne lezije, opisana je pojava novih entiteta s obilježjima orofacijalne granulomatoze, osobito kod djece s transplantiranim solidnim organom (12).…”

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

“…Possibly, oncocytic ductal metaplasia can be observed in children. When dense fibrosis and acinar destruction is noted, mostly it reflect past disease, on the other hand, the presence of fibroplasia, acinar and periductal inflammation and ductal damage reflect current disease activity [3,20].…”