Frequency of Pathologic Changes in the Oral Cavity in Patients Subjected to Long-term Pharmacologic Immunosuppressive Therapy After Kidney, Liver, and Hematopoietic Cell Transplantation.

作者信息

Osiak M, Szubińska-Lelonkiewicz D, Wychowański P, Karakulska-Prystupiuk E, Jędrzejczak W, Wojtowicz A, Fiedor P

机构信息

Department of Dental Surgery, Medical University of Warsaw, Warsaw, Poland.

出版信息

Transplant Proc. 2018 Sep;50(7):2176-2178. doi: 10.1016/j.transproceed.2018.04.003. Epub 2018 Apr 11.

INTRODUCTION

Patients subjected to long-term immunosuppressive therapy after organ and cells transplantation are more susceptible than healthy people to the development of the pathologic changes in the oral cavity, including precancerous lesions, oral cancers, lesions following viral infections (herpes simplex virus, Epstein-Barr virus, and cytomegalovirus), fungal infections mainly caused by Candida albicans, drug-induced gingival overgrowth, stomatitis, and tongue disorders.

MATERIAL AND METHODS

Clinical case material included 38 patients after kidney, liver, or blood-forming cells transplantation subjected to various immunosuppressive therapy schemes. The study comprised standard case taking and physical examination of the patient, including detailed intraoral and extraoral stomatological examinations.

RESULTS

Extraoral examination confirmed 1 case of multifocal basal cell carcinoma in the auricular region and one case of systemic lupus erythematosus. Intraoral examination revealed gingivitis (60.5%), gingival recession (58%), periodontitis (55.26%), macroglossia (15.8%), lingual papillary atrophy (13.16%), leukoplakia aphthae/ulcerations (10.5%), lichen planus, pallor of mucous membranes (7.9%), pathologic pigmentation of oral mucosa, geographic tongue (5.26%) and erythroplakia (2.6%). When their histories were taken, patients reported xerostomia (68.42%), halitosis (23.68%), gum bleeding while brushing teeth (18.42%), and dysgeusia (15.78%).

DISCUSSION

Both the patients after organ and hematopoietic stem cells transplantations and those qualified for a transplant should undergo multispecialty treatment, particularly dental treatment, to enable the detection of pathologies at an early stage and commencement of effective therapy. Cooperation between the main doctor and the dentist is crucial in the process of treatment of this group of patients.