Doss Laura M, Dandoy Christopher E, Kramer Kathi, Pate Abigail, Flesch Laura, El-Bietar Javier, Lane Adam, Davies Stella M, Thikkurissy Sarat
Department of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Blood Cancer. 2018 Jan;65(1). doi: 10.1002/pbc.26773. Epub 2017 Aug 26.
Mucositis is well described after pediatric hematopoietic stem cell transplant (HSCT) but other aspects of oral health such as dental plaque and gingivitis are poorly understood. The aim of this study was to describe dental plaque, gingivitis, and mucositis early after HSCT.
We conducted a prospective longitudinal observational study to describe dental plaque, gingivitis, and mucositis in the peritransplant period. We conducted comprehensive oral evaluations that included the Miyazaki tongue coating, modified simplified oral hygiene, modified gingivitis of Suomi and Barbano, and mucosal ulceration indices at baseline on days 0, +7, +14, and +28.
Data were collected from 19 patients with a median age of 8.0 years (5.1-12.8) at time of HSCT. Sixteen patients (85%) had plaque accumulation that progressively worsened, 16 (85%) developed severe gingival inflammation, 13 (68%) developed mucositis, and 11 (58%) had oral ulcerations. All oral indices worsened from baseline during the study period. Gingivitis and oral plaque persisted in most patients at day +28 while mucositis and oral ulcerations slightly improved.
Gingivitis, dental plaque, mucositis, and oral ulcerations are common after HSCT. Additional studies are needed to ascertain methods that decrease plaque and gingivitis development and severity.
小儿造血干细胞移植（HSCT）后口腔黏膜炎已有充分描述，但口腔健康的其他方面，如牙菌斑和牙龈炎，人们了解甚少。本研究的目的是描述HSCT后早期的牙菌斑、牙龈炎和口腔黏膜炎情况。
我们开展了一项前瞻性纵向观察研究，以描述移植前后时期的牙菌斑、牙龈炎和口腔黏膜炎情况。我们进行了全面的口腔评估，包括在第0天、+7天、+14天和+28天基线时的宫崎舌苔、改良简化口腔卫生、改良的Suomi和Barbano牙龈炎以及黏膜溃疡指数。
收集了19例HSCT时中位年龄为8.0岁（5.1 - 12.8岁）患者的数据。16例患者（85%）有牙菌斑积聚且逐渐加重，16例（85%）出现严重牙龈炎症，13例（68%）出现口腔黏膜炎，11例（58%）有口腔溃疡。在研究期间，所有口腔指标均较基线恶化。在+28天时，大多数患者的牙龈炎和牙菌斑持续存在，而口腔黏膜炎和口腔溃疡略有改善。
HSCT后牙龈炎、牙菌斑、口腔黏膜炎和口腔溃疡很常见。需要进一步研究以确定减少牙菌斑和牙龈炎发生及严重程度的方法。
