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Albagieh H, Alosimi A, Aldhuhayan A, AlAbdulkarim A, Fatani B, Alabood A. Dental management of patients with renal diseases or undergoing renal transplant. Saudi Dent J 2024; 36:270-276. [PMID: 38420005 PMCID: PMC10897630 DOI: 10.1016/j.sdentj.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The kidneys carry out many essential processes. A reduced glomerular filtration rate is the primary cause of renal failure. Patients with chronic kidney disease are significantly increasing all around the world. Patients with varying degrees of renal disease will be seen on the dental chair, and the dentist must be aware of dental considerations when treating such patient. Dental clinicians should carefully evaluate the oral findings and general condition of the renal disease patient. OBJECTIVE To increase the awareness of dentists in the dental management of patients with renal diseases or undergoing renal transplant. METHODS This study reviews 56 articles searched on two databases PubMed and Google Scholar with English language. CONCLUSION Every dentist should be well-informed regarding dental considerations and oral manifestations when treating a patient with any renal disease. Simple treatment plan modification can prevent the evolution of mild to critical medical or dental complications in renal disease patients.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Asim Alosimi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Bader Fatani
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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2
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Grabowska M, Kędzierska-Kapuza K, Kram A, Gill K, Teresiński L, Sipak O, Piasecka M. The long-term effects of multidrug immunosuppressive protocols based on calcineurin inhibitors and conversion to rapamycin on the morphology, apoptosis, and proliferation of rat salivary glands. Pharmacol Rep 2023; 75:1240-1253. [PMID: 37658979 PMCID: PMC10539461 DOI: 10.1007/s43440-023-00521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The effect of multidrug immunosuppressive protocols on the salivary glands is still unknown. This study aimed to determine the influence of immunosuppressive regimens based on calcineurin inhibitors (CNIs) and conversion to rapamycin on the morphology, apoptosis, and proliferation of rat salivary glands. METHODS Male rats received cyclosporin A (CsA), tacrolimus (FK-506), mycophenolate mofetil (MMF), rapamycin (Rapa), and prednisone (Pre) according to three-drug protocols: CMP (CsA, MMF, and Pre), CMP/R (CsA, MMF, and Pre with conversion to Rapa), TMP (FK-506, MMF, and Pre), and TMP/R (FK-506, MMF, and Pre with conversion to Rapa). Morphological and immunohistochemical and quantitative analyses of the salivary glands were performed. RESULTS Structural changes in salivary glands were observed in all experimental groups, especially in the submandibular gland. In the salivary glands, the percentages of collagen fibers and TUNEL-, Ki67- and PCNA-positive cells were higher in the experimental groups vs. the control but were lower in the CMP/R and TMP/R groups vs. the CMP and TMP groups, with the exception of collagen fibers in the parotid gland in the TMP/R group vs. the TMP group. CONCLUSIONS Long-term administration of CNIs in triple regimens and after conversion to rapamycin monotherapy, causes morphological changes in the salivary glands of rats. Immunosuppressive treatment based on CNIs is associated with an increase in collagen accumulation. The effects of the conversion of treatment with CNIs to rapamycin in immunosuppressive protocols in rat salivary glands lead to decreased fibrosis, apoptosis, and proliferation. These changes may possibly prevent abnormalities resulting from the application of CNIs.
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Affiliation(s)
- Marta Grabowska
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Karolina Kędzierska-Kapuza
- Department of Gastroenterological Surgery and Transplantation, Central Hospital of Ministry of Internal Affairs and Administration, Wołoska 137, 02-507, Warsaw, Poland
- Medical Center for Postgraduate Education, Warsaw, Poland
| | - Andrzej Kram
- Department of Pathology, West Pomeranian Oncology Center, Strzałowska 22, 71-730, Szczecin, Poland
| | - Kamil Gill
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Leszek Teresiński
- Department of Pathology, West Pomeranian Oncology Center, Strzałowska 22, 71-730, Szczecin, Poland
| | - Olimpia Sipak
- Department of Obstetrics and Pregnancy Pathology, Faculty of Health Sciences, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland
| | - Małgorzata Piasecka
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, Żołnierska 48, 71-210, Szczecin, Poland.
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3
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Bharati J, Anandh U, Kotton CN, Mueller T, Shingada AK, Ramachandran R. Diagnosis, Prevention, and Treatment of Infections in Kidney Transplantation. Semin Nephrol 2023; 43:151486. [PMID: 38378396 DOI: 10.1016/j.semnephrol.2023.151486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Kidney transplant often is complicated by infections in the recipient from therapy-related and patient-related risk factors. Infections in kidney transplant recipients are associated with increased morbidity, mortality, and allograft dysfunction. There is a predictable timeline after kidney transplant regarding the types of pathogens causing infections, reflecting the net state of immunosuppression. In the early post-transplant period, bacterial infections comprise two thirds of all infections, followed by viral and fungal infections. Infections occurring early after kidney transplantation are generally the result of postoperative complications. In most cases, opportunistic infections occur within 6 months after kidney transplantation. They may be caused by a new infection, a donor-derived infection, or reactivation of a latent infection. Community-acquired pneumonia, upper respiratory tract infections, urinary tract infections, and gastrointestinal infections are the most common infections in the late period after transplantation when the net immunosuppression is minimal. It is crucial to seek information on the time after transplant, reflecting the net state of immunosuppression, previous history of exposure/infections, geography, and seasonal outbreaks. It is imperative that we develop regionally specific guidelines on screening, prevention, and management of infections after kidney transplantation.
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Affiliation(s)
- Joyita Bharati
- Section of Nephrology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
| | - Urmila Anandh
- Department of Nephrology, Amrita Hospitals, Faridabad, Delhi National Capital Region, India
| | - Camille N Kotton
- Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Thomas Mueller
- Renal Transplant Program, University Hospital of Zurich, Zurich, Switzerland
| | | | - Raja Ramachandran
- Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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4
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Burtscher D, Dalla Torre D. Dental implant procedures in immunosuppressed organ transplant patients: a systematic review. Int J Oral Maxillofac Surg 2021; 51:380-387. [PMID: 34274207 DOI: 10.1016/j.ijom.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022]
Abstract
During the last decades, the number of immunosuppressed organ transplant patients has increased consistently. Nevertheless, immunosuppression has been discussed as a contraindication for dental implant procedures for many years. Hence, the purpose of this systematic review was to assess the survival rate and outcomes of dental implants after solid organ transplantation. An electronic and manual literature search was conducted up to March 2021. Publications describing dental implants placed in patients after organ transplantation were included without any limitations regarding study design or date of publication. Ten articles met the inclusion criteria, leading to a sample of 93 patients with 249 implants. Implant survival rates were 100% over a mean follow-up of 60 months. In every case, implant surgery was performed under antibiotic coverage. No major medication-related complications were reported. Despite the limited amount of evidence in the literature, implant procedures seem to be a safe treatment option in immunosuppressed organ transplant patients. The observance of appropriate treatment protocols including a strict maintenance programme seems to be crucial for the long-term success of such treatments. However, stringent data regarding various influencing factors such as the prevalence of peri-implantitis are still missing.
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Affiliation(s)
- D Burtscher
- University Clinic of Prosthodontics, Medical University Innsbruck, Innsbruck, Austria.
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5
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GÜMRÜ B, TARÇIN B. Solid Organ Transplant Candidates and Recipients: Dentists’ Perspective. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.915422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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6
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Sarmento DJDS, Aires Antunes RSCC, Cristelli M, Braz-Silva PH, Maciel R, Pestana JOMDA, Gallottini M. Oral manifestations of allograft recipients immediately before and after kidney transplantation. Acta Odontol Scand 2020; 78:217-222. [PMID: 31718409 DOI: 10.1080/00016357.2019.1685680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To identify the oral lesions of individuals with kidney disease immediately before and shortly after kidney transplantation, taking into account the immunosuppressive regimen, antiviral prophylaxis and type of transplantation.Methods: A prospective observational cohort study was carried from January 2017 to January 2018. Eighty individuals aged 18 years or older who were admitted for kidney transplantation were eligible to participate. Clinical data regarding medical history, immunosuppressive therapy, antiviral prophylaxis, laboratorial data and oral examination were performed by the same trained researcher, in three different moments: 24 hours before transplantation (1st time point), 15-20 days (2nd time point) and 45-60 days (3rd time point) after transplantation.Results: In the first, second and third time points, it was found that 3.7% (3/80), 23.7% (18/76) and 25.7% (19/74) of the participants showed oral soft tissue lesions. Ulcers and candidiasis were the most frequent oral lesions, and they were associated with the use of everolimus (p = .005) and azathioprine (p = .034), respectively. Less patients reported xerostomia after transplantation than before (p < .001).Conclusions: Oral lesions are common in the short term after renal transplantation and are particularly related to both toxicities of immunosuppressive drugs and immunosuppression.
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Affiliation(s)
| | | | - Marina Cristelli
- Division of Renal Transplant, Kidney and Hypertension Hospital, Federal University of São Paulo, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Division of Virology, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Rafael Maciel
- Division of Renal Transplant, Social Institute of Health Care, Campina Grande, Brazil
| | | | - Marina Gallottini
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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7
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Osiak M, Wychowanski P, Grzeszczyk M, Durlik M, Fiedor P. Differences in the Incidence of Pathologic Lesions on the Oral Mucosa in Patients Undergoing Hemodialysis vs Renal Organ Transplant Recipients Subjected to Long-term Pharmacologic Immunosuppressive Therapy. Transplant Proc 2020; 52:2409-2411. [PMID: 32222390 DOI: 10.1016/j.transproceed.2020.02.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 11/15/2022]
Abstract
Disorders of homeostasis and an increased incidence of infection in patients undergoing hemodialysis causes frequent appearance of pathologic changes in the oral mucosa. The organ transplant and subsequent pharmacologic immunosuppression may result in systemic disorders manifesting by pathologic oral lesions. METHODS The study was conducted on 18 patients undergoing hemodialysis and 18 patients after renal transplant. The study comprised case taking and physical examination, including detailed intraoral and extraoral examination. RESULTS The intraoral examination revealed gingivitis in 61.1% of patients in both groups. In the renal transplant group compared with the hemodialysis group 55.6% vs 38.9% of patients had gingival recession, 55.6% vs 44.4% had periodontitis, 27.8% vs 22.2% had macroglossia, and 11.1% vs 5.6% had geographic tongue, respectively. In the patients on hemodialysis leukoplakia and pallor or pathologic pigmentation of oral mucosa were more frequently observed lesions. Other significant findings in the renal transplant group were lingual papillary atrophy, aphthae, and erythroplakia. Patients of both group reported xerostomia, halitosis, gum bleeding, dysgeusia in their history. DISCUSSION Both groups of patients after renal transplant and patients undergoing hemodialysis presented pathologic lesions in the oral cavity. The study revealed the differences between type and frequency of these pathologic changes, which shows different effect of the above methods of treatment of end-stage renal failure on the oral cavity.
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Affiliation(s)
- Martyna Osiak
- Department of Oral Surgery, Medical University of Warsaw, Warsaw, Poland.
| | - Piotr Wychowanski
- Department of Oral Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Grzeszczyk
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Durlik
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Fiedor
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
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8
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Serrano J, López-Pintor RM, Fernández-Castro M, Ramírez L, Sanz M, Casañas E, García JA, Recuero S, Bohorquez C, Hernández G. Oral lesions in patients with primary Sjögren's syndrome. A case-control cross-sectional study. Med Oral Patol Oral Cir Bucal 2020; 25:e137-e143. [PMID: 31880282 PMCID: PMC6982992 DOI: 10.4317/medoral.23254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/07/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To evaluate the presence of oral lesions in a group of patients with primary Sjögren's syndrome (pSS) and compare these results with a matched control group (CG). MATERIAL AND METHODS An observational cross-sectional study was conducted. 61 pSS patients (60 women, 1 man, mean age 57.64±13.52) diagnosed according to the American European Criteria (2002), and 122 matched control patients (120 women, 2 men, mean age 60.02±13.13) were included. Demographic and medical data, oral lesions and salivary flow rate were collected. RESULTS Compared with the controls, pSS patients were 3.95 more likely to have oral lesions (OR 3.95; 95% CI 2.06-7.58; p=0.0001). 57.4% pSS patients presented oral lesions compared to 25.4% in CG. The most common were candidiasis (13.1% vs 2.5%), traumatic lesions (13.1% vs 4.1%), apthae (8.2% vs 0), and fissuration of the tongue (8.2% vs 0.8%). pSS patients with oral lesions had lower salivary flow levels (stimulated and unstimulated), although these differences were not significant. Significant associations were found between the presence of oral lesions and systemic manifestations and history of parotid gland enlargement in pSS patients. CONCLUSION pSS patients suffer more oral lesions than general population and these lesions may aggravate the pSS disease.
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Affiliation(s)
- J Serrano
- Departamento de Especialidades Clínicas Odontológicas Facultad de Odontología Universidad Complutense de Madrid Plaza Ramón y Cajal s/n, 28040 Madrid. Spain
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9
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Hernández G, Paredes V, López-Pintor RM, de Andrés A, de Vicente JC, Sanz M. Implant treatment in immunosuppressed renal transplant patients: A prospective case-controlled study. Clin Oral Implants Res 2019; 30:524-530. [PMID: 30980770 DOI: 10.1111/clr.13437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this clinical study was to evaluate long-term outcomes of implant therapy in a cohort of immunosuppressed renal transplant patients compared with a matched control group. MATERIAL AND METHODS Pharmacologically immunosuppressed renal transplant patients received dental implant treatment between 2001 and 2011. Periodontal, clinical and radiographic parameters were prospectively measured with a mean follow-up of 116.8 months (range from 84 to 192 months). A matched controlled non-transplant sample receiving similar implant treatment in the same time was included as a control group. RESULTS Implant survival rate was over 98% in both test and control groups (100% and 98.84%, respectively). Peri-implant mucositis was diagnosed in 46.80% of the implants in the study group and in 48.80% in the control group. Peri-implantitis occurred in 5.10% of the implants in the study group and in 8.10% of the controls. Wound healing and post-operative pain were similar in both groups. CONCLUSIONS Despite the limitations of this study, pharmacological immunosuppression in renal transplant patients did not affect implant outcomes. Renal transplant patients should be carefully controlled periodically after implant treatment. CLINICAL IMPLICATIONS The results from this investigation justify the use of dental implants for the dentalrehabilitation of immunosuppressed patients after renal transplantation provided they follow the necessarylong-term monitoring and regular maintenance of their oral and systemic health.
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Affiliation(s)
- Gonzalo Hernández
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Víctor Paredes
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Amado de Andrés
- Department of Nephrology, Hospital 12 de octubre, Madrid, Spain
| | - Juan Carlos de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital of Asturias, School of Medicine and Dentistry, Oviedo University, Oviedo, Spain
| | - Mariano Sanz
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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10
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Ito K, Okuno T, Sawada A, Sakai K, Kato Y, Muro K, Yanagita M, Teramoto Y, Yamasaki T, Inoue T, Ogawa O, Kobayashi T. Recurrent Aphthous Stomatitis Caused by Cytomegalovirus, Herpes Simplex Virus, and Candida Species in a Kidney Transplant Recipient: A Case Report. Transplant Proc 2019; 51:993-997. [PMID: 30979493 DOI: 10.1016/j.transproceed.2019.01.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/20/2018] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Recipients of organ transplants are immunosuppressed and at high risk of oral infection. Oral diseases are often neglected compared with infections of other organs that typically confer higher morbidity. However, severe local symptoms hinder oral intake, decrease quality of life, and are sometimes lethal. Here we describe a case of a 57-year-old woman who developed recurrent aphthous stomatitis after kidney transplantation; the cause of the infection was complex and included cytomegalovirus, herpes simplex virus, and Candida species. Since misdiagnosis of oral diseases impairs patient quality of life and increases morbidity, clinicians should be aware of possible etiologies of oral infections in renal transplant recipients.
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Affiliation(s)
- K Ito
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - T Okuno
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - A Sawada
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - K Sakai
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - Y Kato
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - K Muro
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - M Yanagita
- Department of Nephrology, Kyoto University Hospital, Kyoto, Japan
| | - Y Teramoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - T Yamasaki
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - T Inoue
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
| | - O Ogawa
- Department of Urology, Kyoto University Hospital, Kyoto, Japan.
| | - T Kobayashi
- Department of Urology, Kyoto University Hospital, Kyoto, Japan
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Frequency of Pathologic Changes in the Oral Cavity in Patients Subjected to Long-term Pharmacologic Immunosuppressive Therapy After Kidney, Liver, and Hematopoietic Cell Transplantation. Transplant Proc 2018; 50:2176-2178. [DOI: 10.1016/j.transproceed.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/16/2018] [Accepted: 04/06/2018] [Indexed: 12/18/2022]
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12
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Kwak EJ, Choi YH, Park W, Cho ES. Oral Papillomatosis in Immunocompromised Patients: A Case Series of Kidney Transplant Recipients and Myelodysplastic Syndrome. J Oral Maxillofac Surg 2018; 76:128-133. [DOI: 10.1016/j.joms.2017.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 06/16/2017] [Accepted: 06/16/2017] [Indexed: 12/23/2022]
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13
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Paredes V, López-Pintor RM, Torres J, de Vicente JC, Sanz M, Hernández G. Implant treatment in pharmacologically immunosuppressed liver transplant patients: A prospective-controlled study. Clin Oral Implants Res 2017; 29:28-35. [DOI: 10.1111/clr.13035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Víctor Paredes
- Department of Oral Medicine and Surgery; School of Dentistry; Complutense University; Madrid Spain
| | - Rosa María López-Pintor
- Department of Oral Medicine and Surgery; School of Dentistry; Complutense University; Madrid Spain
| | - Jesús Torres
- Department of Oral Medicine and Surgery; School of Dentistry; Complutense University; Madrid Spain
| | - Juan Carlos de Vicente
- Department of Oral and Maxillofacial Surgery; University Hospital of Asturias; School of Medicine and Dentistry; Oviedo Spain
| | - Mariano Sanz
- Department of Oral Medicine and Surgery; School of Dentistry; Complutense University; Madrid Spain
| | - Gonzalo Hernández
- Department of Oral Medicine and Surgery; School of Dentistry; Complutense University; Madrid Spain
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14
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González-Serrano J, Serrano J, López-Pintor RM, Paredes VM, Casañas E, Hernández G. Prevalence of Oral Mucosal Disorders in Diabetes Mellitus Patients Compared with a Control Group. J Diabetes Res 2016; 2016:5048967. [PMID: 27847829 PMCID: PMC5099460 DOI: 10.1155/2016/5048967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/10/2016] [Accepted: 08/17/2016] [Indexed: 11/28/2022] Open
Abstract
Chronic hyperglycemia is associated with impaired wound healing and higher susceptibility to infections. It is unclear whether patients with diabetes mellitus (DM) present more oral mucosal disorders compared to control groups. The objectives were to compare (a) the prevalence rates of oral mucosal disorders in the DM and non-DM population and (b) the prevalence rates of specific disorders in the DM and non-DM population. Full-text articles were included if they met the following inclusion criteria: (a) they must be original articles from scientific journals, (b) they must be only cross-sectional studies in English, (c) the prevalence of oral mucosal disorders in DM patients must be evaluated, (d) results must be compared with a healthy control group, and (e) oral mucosal disorders must be specified in DM and non-DM group. All studies showed higher prevalence of oral mucosal disorders in DM patients in relation to non-DM population: 45-88% in type 2 DM patients compared to 38.3-45% in non-DM groups and 44.7% in type 1 DM patients compared to 25% in non-DM population. Tongue alterations and denture stomatitis were the most frequent significant disorders observed. The quality assessment following the Joanna Briggs Institute (JBI) Prevalence Critical Appraisal Tool showed the low quality of the existing studies.
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Affiliation(s)
- José González-Serrano
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Julia Serrano
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Víctor Manuel Paredes
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Elisabeth Casañas
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
| | - Gonzalo Hernández
- Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, Madrid, Spain
- *Gonzalo Hernández:
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Palla B, Burian E, Klecker JR, Fliefel R, Otto S. Systematic review of oral ulceration with bone sequestration. J Craniomaxillofac Surg 2015; 44:257-64. [PMID: 26782844 DOI: 10.1016/j.jcms.2015.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/27/2015] [Accepted: 11/25/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This article represents the first systematic review entirely dedicated toward a disease called oral ulceration with bone sequestration (OUBS). We performed this review in order to further define and outline this disease. A secondary interest was to recognize the prevalence and importance of OUBS in relation to other oral disorders accompanied by ulceration and bone exposure. MATERIAL AND METHODS The systematic review was registered with PROSPERO (registration number CRD42015024294) and performed in cooperation with Harvard's Countway Library. Searches were built using MeSH terms and proximity operators previously mentioned in OUBS descriptions. Database searches were performed through EMBASE, Medline, and PubMed, followed by a handsearch of bibliographies for relevant articles. Articles were assessed against eligibility and inclusion criteria centering on bone exposure without known etiologic cause. We sought to gather information on patient age, sex, anatomical location, clinical presentation, and comorbidities. PRISMA guidelines were followed. RESULTS The searches identified 766 records total. Despite considerable inspection, we found only 8 articles qualifying for our review. In the 8 articles, there were a total of 24 patients fulfilling the criteria of OUBS. Although some abstracts mentioned idiopathic nature, most authors presented clinical cases with probable causes to ulceration and sequestration. The mean age of these patients was 43.21 ± 11.94 years. The male to female ratio was 3:1. The predominant area of occurrence was the mandible (n = 23, 95.8%). CONCLUSION The representation of OUBS in the literature remains scarce. More data must be generated and gathered on the concept of OUBS so as to determine the true incidence and importance of this disease. Despite rare occurrences of conditions characterizing OUBS, the recent discussion of this topic in the scientific community calls for more knowledge to be brought forth, with great benefit to patients suffering from ulcerative diseases and osteonecrosis.
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Affiliation(s)
| | - Egon Burian
- Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Riham Fliefel
- Department of Oral and Maxillofacial Surgery (Chair: Prof. Dr. Dr. Michael Ehrenfeld), Ludwig-Maximilians-Universität, Munich, Germany; Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-Universität, Munich, Germany; Department of Oral & Maxillofacial Surgery, Alexandria University, Alexandria, Egypt
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery (Chair: Prof. Dr. Dr. Michael Ehrenfeld), Ludwig-Maximilians-Universität, Munich, Germany.
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Gašpar M, Glavina A, Grubišić K, Sabol I, Bušić M, Mravak M. The Oral Cavity State in Renal Transplant Recipients. Acta Stomatol Croat 2015; 49:204-13. [PMID: 27688404 PMCID: PMC4993595 DOI: 10.15644/asc49/3/2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/25/2015] [Indexed: 12/16/2022] Open
Abstract
AIM Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient's visits to the dentist in the post-transplant period. MATERIAL AND METHODS The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. RESULTS Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. CONCLUSION Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists.
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Affiliation(s)
- Marija Gašpar
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Glavina
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Ivan Sabol
- National Transplant Coordinator, Ministry of Health, Republic of Croatia
| | - Mirela Bušić
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marinka Mravak
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Rudjer Bošković Institute, Zagreb, Croatia
- National Transplant Coordinator, Ministry of Health, Republic of Croatia
| | - Stipetić
- Department of Oral medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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The long-term administration of calcineurin inhibitors decreases antioxidant enzyme activity in the rat parotid and submandibular salivary glands. Life Sci 2015; 134:1-8. [DOI: 10.1016/j.lfs.2015.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/29/2015] [Accepted: 04/23/2015] [Indexed: 11/21/2022]
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López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Oral candidiasis in patients with renal transplants. Med Oral Patol Oral Cir Bucal 2013; 18:e381-7. [PMID: 23385511 PMCID: PMC3668861 DOI: 10.4317/medoral.18658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/16/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Oral candidiasis (OC) is a frequent oral lesion in renal transplant patients (RTPs). Despite the increased prevalence of OC in RTPs, no study has examined related risk factors. The aims of this study were to analyze the prevalence of and risk factors for OC in RTPs compared with age- and gender-matched healthy control group (HC) as well as determine the incidence of OC after transplantation. STUDY DESIGN [corrected] We analyzed the prevalence and risk factors of OC in a group of 500 RTPs (307 men, 193 women, mean age 53.63 years) and 501 HC subjects (314 men, 187 women, mean age 52.25 years). Demographic and pharmacological data were recorded for all subjects. Incident cases of OC were ascertained retrospectively from outpatient clinical records only in the RTP group. RESULTS The prevalence of OC was 7.4% in RTPs compared with 4.19% in HC (P<0.03). The most frequent type of OC in the two groups was denture stomatitis. Statistical association was found between OC and age, mycophenolate mofetil dose and blood levels, dentures and tobacco. The multiple logistic regression model only chose for denture variable. According to the outpatient clinical records, 24 RTPs suffered OC during the first moth post-transplant. Severe lesions affecting the oral cavity and pharynx appeared in 79% of the OC cases. CONCLUSIONS This study shows a lower prevalence of OC in RTPs than previous reports. Denture stomatitis was the most frequent OC prevalence form described in RTPs. Severe candidiasis is more frequent in the immediate posttransplant period. The presence of denture is an important risk factor of OC. These results emphasise the importance of adequate pre- and post-transplant oral health and denture cleaning and adjustment is recommended for these subjects to prevent this infection.
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Affiliation(s)
- Rosa-María López-Pintor
- Department of Oral Medicine and Orofacial Surgery, Faculty of Odontology, Complutense University, Madrid, Spain.
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Musiał K, Zwolińska D. HSP27 as a potential preneoplastic marker in patients with chronic kidney disease. Oral Dis 2013; 19:631. [PMID: 23530879 DOI: 10.1111/odi.12102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Petti S, Polimeni A, Berloco PB, Scully C. Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients. Oral Dis 2012; 19:18-36. [PMID: 22458357 DOI: 10.1111/j.1601-0825.2012.01925.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients are at risk of several diseases, principally attributable to immunosuppression. This global overview of SOT/HSCT-associated orofacial diseases is aimed at providing a practical instrument for the oral healthcare management of SOT/HSCT recipients. METHODS Literature search was made through MEDLINE. The associations between orofacial diseases and SOT/HSCT were assessed using observational studies and case series and were classified into 'association', 'no association', and 'unclear association'. RESULTS Lip/oral cancers, drug-induced gingival overgrowth (DIGO), infections, including hairy leukoplakia and, less frequently, post-transplantation lymphoproliferative disorders (PTLDs) and oral lichenoid lesions of graft-versus-host disease (GVHD), were associated with SOT. Lip/oral cancers, GVHD, mucositis, DIGO, infections and, less frequently, PTLDs were associated with HSCT. Associations of orofacial granulomatosis-like lesions and oral mucosa-associated lymphoid tissue-type lymphoma with SOT, and of pyogenic granuloma and hairy leukoplakia with HSCT were unclear. Periodontal disease and dental caries were not associated with SOT/HSCT. For none of the local treatments was there a strong evidence of effectiveness. CONCLUSIONS 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.
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
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Integrity of the oral tissues in patients with solid-organ transplants. J Transplant 2012; 2012:603769. [PMID: 22363835 PMCID: PMC3272846 DOI: 10.1155/2012/603769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/16/2011] [Accepted: 10/20/2011] [Indexed: 12/19/2022] Open
Abstract
The relationship between the use of immunosuppressants in solid-organ transplant patients and oral tissue abnormalities has been recognized. The objective of this study was to determine the state of oral tissue integrity in renal, heart, and liver transplant patients who are on continuous medical and dental control. Forty patients of both sexes were clinically evaluated at the Clinical Hospital of the University of Chile to identify pathologies of oral mucosa, gingival enlargement (GE), decayed, missing, filled teeth (DMFT) index, and salivary flow. The average age of the transplant subjects was 49.4 years, and the age range was 19 to 69 years. Most subjects maintained a good level of oral hygiene, and the rate mean of DMFT was 14.7. The degree of involvement of the oral mucosa and GE was low (10%). Unlike other studies, the frequency of oral mucosal diseases and GE was low despite the fact that these patients were immunosuppressed. Care and continuous monitoring seem to be of vital importance in maintaining the oral health of transplant patients.
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