0000000000602370
AUTHOR
Carmen Gavaldá Esteve
Dental management in transplant patients
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…
Dental considerations in patients with respiratory problems.
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 infec…
Lichen sclerosus of the oral mucosa : a case report
Lichen sclerosus or lichen sclerosus et atrophicus is a chronic inflammatory disease predominantly affecting the genital mucosa and skin. Clinically, it is characterized by white atrophic plaques in the anogenital region. The lesions are generally asymptomatic, but may cause discomfort with itching and pain. Extragenital mucosal involvement is very unusual, and lesions limited to the oral mucosa are even less frequent. Knowledge of such lesions is important in order to establish a differential diagnosis with other white oral lesions, and histological confirmation is required. We present the case of a 31-year-old woman with a well delimited, pearly white lesion located in the upper gingival …
Bacteremia originating in the oral cavity. A review
In patients at risk because of heart disease, bacteremias induced by invasive dental treatments have been reported as a cause of bacterial endocarditis (BE) - a serious disorder that continues to involve a high mortality. As a result, different scientific societies have supported recommendations for the administration of antibiotics prior to invasive dental treatments, in order to neutralize bacteremia. In this context, the recommendations of the American Heart Association (AHA) are the most widely used in our setting. Advances in our knowledge of the etiopathogenesis of bacterial endocarditis have placed increasingly less importance on invasive dental treatments as a causal factor (the AHA…
Concept, diagnosis and classification of bisphosphonate-associated osteonecrosis of the jaws: a review of the literature
Background: Bisphosphonates (BPs) and other antiresorptive agents such as denosumab are widely prescribed for the treatment of osteoporosis and are also used in patients with multiple myeloma and metastatic breast or prostate cancer for avoiding bone reabsorption and fractures that result in increased morbidity-mortality among such individuals. Material and Methods: We made a bibliographic search to analyze the concept, diagnosis and the different classifications for bisphosphonate-associated osteonecrosis of the jaws. Results: Osteonecrosis of the jaws (ONJ) is an important complication of exposure to BPs or other antiresorptive agents, and although its prevalence is low, it can pose manag…
Oral manifestations and dental management of patient with leukocyte alterations
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 …
Dental management in patients with hemostasis alteration
Haemostasis is a mechanism that, through different interdependent biologic processes, has the purpose of ensuring the integrity and permeability of the circulatory system. Hemostasis term means prevention the loss of blood. Interventions or treatments in the oral cavity, in particular those with a possibility of bleeding, represent a risk for patients with disorders of hemostasis. Prevention is the key to avoid bleeding complications after oral surgical procedures and therefore it is essential a detailed medical history of the patient. The appropriate diagnosis and treatment in patients with disorders of hemostasis, depends directly in the understanding of hemostasis standard mechanisms. Em…
Dental treatment considerations in the chemotherapy patient
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,…
Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain)
A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). Study design: The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Results: Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total o…
An update on the management of anticoagulated patients programmed for dental extractions and surgery
Oral anticoagulants (OACs) antagonizing vitamin K - fundamentally sodium warfarin and acenocoumarol - are widely used for preventing arterial thromboembolism in patients with atrial fibrillation and/or heart valve prostheses, and for the treatment and prevention of deep venous thrombosis and pulmonary embolism. The handling of these drugs requires correct monitorization and dose adjustment to obtain the desired therapeutic effect while minimizing the adverse effects associated both with excessive anticoagulation (which leads to bleeding) and with insufficient antithrombotic action (which can produce thrombosis). This is particularly important when patients must be subjected to surgical proc…