Search

Background The authors undertook a prospective study to determine whether kidney transplant recipients had an increased risk of developing complications, such as local acute infection, alveolitis, increased bleeding, pain, and delayed healing, after tooth extraction. Methods The authors selected patients who underwent kidney transplants more than 6 months ago (study group) and patients who had not (control group) older than 18 years who needed to undergo extraction of erupted teeth. The same oral surgeon performed all tooth extractions while the patients were under local anesthesia. Another blind researcher examined the patients 3, 7, and 21 days after tooth extraction. The first end point was occurrence of complications (local acute infection, alveolitis, increased bleeding), and the second end point was socket reepithelialization on day 21. Results Forty-five tooth extractions were performed on 38 study group participants and 61 on 57 control group participants. There was no statistical difference between the groups regarding the incidence of any complication or delayed socket epithelialization. Conclusions The results of this pilot study suggest that there is no difference in postoperative healing after tooth extractions between stable kidney transplant patients and control patients. Practical Implications This is the first prospective study assessing the frequency of postoperative complications after tooth extraction in kidney transplant recipients. This clinical trial was registered at ClinicalTrials.gov . The registration number is NCT02547753.

Objective To clinically assess the socket healing after tooth extraction and the occurrence of intra- and postoperative complications in chronic kidney failure (CKF) patients on hemodialysis (HD) by comparing them to a control group. Study desing This is a prospective study involving 48 patients with CKF on HD (study group – SG) and 29 participants without CKF (control group – CG) undergoing tooth extractions. No prophylactic antibiotic was given to the participants. One calibrated dentist evaluated all individuals at 3, 7, 21, and 60 days after the tooth extractions and assessed hemostasis time, occurrence of local or distant infection, epithelization, and deposition of alveolar bone. Results In the SG, 87 teeth were extracted through 65 interventions, and in the CG, 76 teeth were extracted through 36 interventions. Bleeding beyond 30 minutes was observed in 12 interventions (18.5%) on SG participants and was controlled with local hemostatic agents. None of the groups had individuals presenting postoperative infectious complications at the surgical site or a distance. After 21 days, we observed delayed epithelialization in 29.9% (26/87) of the individuals of SG compared to 3.9% (3/37) of those of CG (P Conclusions Individuals with CKF on hemodialysis tend to heal up well following dental extractions. They did not have an increased risk of infectious complications after simple tooth extractions, but they showed prolonged bleeding events more often than controls. Additional research studies using larger sample sizes of patients with CKF on hemodialysis are needed to confirm our findings. Clinical relevance This pilot study contributes to dentists ability to provide better dental management for people with chronic kidney failure undergoing hemodialysis through understanding the course of healing following dental extractions.

Purpose The aim of this study was to describe the relation between occlusal features and enzyme replacement therapy in patients with mucopolysaccharidoses. Materials and Methods A cross-sectional study was conducted. The sample consisted of 20 patients with mucopolysaccharidoses, 10 of whom were undergoing treatment at a hospital in northeast Brazil. Occlusal features were evaluated by clinical examination and panoramic radiography. A structured questionnaire was administered to evaluate the dental care of each patient. Pearson χ2, Fisher exact, and Mann-Whitney tests were used for data analysis, with a level of significance of 5%. Results Marked overjet (75%) and anterior open bite (70%) were the most frequent occlusal alterations, and 15% had Class III disorders. Radiography visualized the presence of impacted teeth (75%) and prolonged retention of deciduous teeth (65%). Patients with enzyme replacement therapy had a lower average maximum protrusion (P = .033). A total of 75% of mothers said they had not been advised to take their children to the dentist and 10% of children had never been to the dentist. Conclusion Patients with mucopolysaccharidoses exhibited notable occlusal alterations, especially marked overjet and anterior open bite. Enzyme replacement therapy seems to influence the maximum protrusion of patients.

Objective: To evaluate clinically the postextraction socket healing in patients with chronic kidney failure (CKF) undergoing hemodialysis (HD) and in a control group of individuals. Study Design: This was a prospective observational study that included 48 individuals with CKF in HD to compose the study group (SG) and 29 patients in the control group (CG) without CKF. A questionnaire on medical history, clinical examination, and laboratory tests were applied. All participants were subjected to extractions of erupted teeth, without antibiotic prophylaxis. Postoperative evaluations were performed 3, 7, 21, and 60 days after the extractions. Results: In the SG, we performed 87 extractions in 65 surgeries, and, in the CG, 76 extractions were performed in 36 surgeries. In the SG, there was a significant delay in surgical wound epithelization (29.9% vs 3.9%, P

Objective: The objective of this study is to assess the prevalence of oral lesions in a cohort of renal transplant recipients before and just after transplantation. Study design: This is a cohort study involving 80 renal transplant recipients. The same researcher/dentist evaluated orofacial characteristics at the 3 different time points: immediately before transplantation, 15 to 20 days after transplantation, and 45 to 60 days after renal transplantation. Oral lesions were photographed and a presumptive diagnosis was established. Results: Immediately before transplantation, 3 of the 80 participants (3.7%) showed some oral soft tissue lesions. In the second and third time periods, 23.7% (18 out of 76) and 25.7% (19 out of 74) of the participants showed oral soft tissue lesions, respectively. Ulcers and candidiasis were the most frequent lesions associated with the use of everolimus (P = .023) and azathioprine (P = .034), respectively. Fewer patients reported xerostomia after transplantation than before (P

Objectives To investigate the radiographic findings of mucopolysaccharidoses (MPS) on panoramic radiographs in a series of 16 patients. Study Design This retrospective cross-sectional study included panoramic radiographs of 16 patients with cytogenetically diagnosed MPS. Two blinded, previously calibrated observers evaluate the presence or absence of the following features: type of dentition; stage of dental age in comparison with chronologic age; delayed exfoliation of deciduous teeth; supernumerary teeth; teeth impaction; enlarged, cyst-like dental crypt; hypercementosis; taurodontism; generalized enamel hypoplasia; enlargement of the bone marrow spaces; thinning of cortical bone; unusual morphology of condyles; and flattening of the condylar head. Results The final sample was composed of 8 MPS IV, 7 MPS VI, and 1 MPS I cases. All patients presented unusual morphology of condyles. Cyst-like dental crypt (75%), taurodontism, and teeth impaction (68.75% each) were also overall common findings. Generalized enamel hypoplasia was exclusively identified in patients with MPS IV (75% of those patients). Conclusions Radiographic features of oral and maxillofacial manifestations in patients with MPS frequently encountered by dentists may help recognize the disorder. However, because of sample size limitations, it was not possible to infer any statistical relationship between the radiographic features and the types of MPS.

Objective The aim of this study was to perform a survey of diagnosed lesions at a Stomatology Clinic at a University for 1 year. Study Design Retrospective study with analysis of 58 patients’ records. Poorly completed records or uncertain diagnoses were excluded. Results Through the analysis of the records, a male prevalence (51.7%) aged above 41 years (58.6%) was observed, with lower levels of education (elementary school) and lower salary. The majority of the diagnosed lesions were single, localized in the lip, especially the lower lip. Actinic cheilitis was the most prevalent diagnosis, followed by vascular injuries, and lower prevalence of leukoplakia and carcinoma. Biopsy was the complementary exam most performed, followed by imaging examinations. Laser therapy was the most used treatment not only to surgery, but also for biomodulation. Conclusions Actinic cheilitis had a great prevalence in the patients. Male patients older than 41 years and considered at risk for oral cancer were the most seen by the Health Service. Ease of access for people, particularly those with low salaries, to a referral service of Oral Diagnosis located in the interior, can help to overcome the deficiencies or shortcomings of the Public Service. Support: PIBIC.

Objective The aim of this study was to verify the prevalence of oral cancer in patients admitted to a referral oncology hospital. Study Design Cross-sectional and descriptive study, in which 166 patients diagnosed with cancer were examined. Results Of the admitted patients, there was a prevalence of males (64.5%) with an average age of 51.7 years and nonwhite color (59%). Among the various types of cancer, acute leukemia (34.9%) was the most prevalent, followed by lymphomas (16.9%), pharynx and larynx (7.8%), mouth (6%), lung (6%), and head and neck cancer (6%). Chemotherapy was the most prescribed (58.4%) therapeutic approach, followed by its association with radiotherapy (18.7%), and only radiotherapy (9.6%). Radiotherapy was the most used treatment for oral cancer. Conclusions In the evaluated sample, oral cancer was the fourth most prevalent type, predominating for the sixth decade of life, in a ratio of 4 males to 1 female. Radiotherapy was the most-used treatment. Financial support: PIBIC.

Objective The aim of this study was to determine the prevalence of oral acute complications related to antineoplastic treatment. Study Design The sample consisted of 166 patients in a reference hospital in which clinical examination was carried out. Results There was male prevalence (64.5%) aged between 31 and 60 years (51.2%) and nonwhite skin color (59%). Acute leukemia (34.9%) and lymphomas (16.9%) were the most frequent neoplasms found. Chemotherapy was the widely prescribed antineoplastic treatment (87.3%), usually associated to other therapeutic approach (33.1%). The most prevalent complaint was burning mouth (25%), followed by toothache (21.4%), dysphagia (16.6%), xerostomia (15.5%), and oral ulceration (14.3%). Oral mucositis was the most prevalent toxicity (18.7%), followed by xerostomia (15.7%) and candidosis (8.4%). Conclusions The dentist must be aware of the oral acute complications in patients under chemotherapy antineoplastic treatment because they have high morbidity, mainly mucositis stage I, present in this study in all ages and sexes. Support: PIBIC

A 70-year-old female patient was referred to the stomatology clinic for evaluation of an injury on her tongue. On medical history, it was found she was a patient with type 2 diabetes mellitus and hypertension, using antihypertensive, hypoglycemic, and antihistamine agents along with insulin, eye drops, and sedatives. She was also being seen by an endocrinologist. She is allergic to many medications (acetylsalicylic acid and its derivatives, dipyrone, and nonsteroidal anti-inflammatory drugs). On oral examination, the patient had a dry oral mucosa with little lubrication and mild candidosis of the tongue, treated by ketoconazole. The clinical diagnosis was Sjogren syndrome. Anti-SSA and anti-SSB were found to be positive. A rheumatoid factor (RF) test was within the normal limits, as was the hemogram. The patient has not yet consented to lip biopsy due to decompensated diabetes (glycated hemoglobin 7.6% and fasting glycemia 115 mg/dL). The patient was referred to the doctor for diabetes control and is under proper follow-up care.

A 41-year-old male patient, a white farmer, was referred to the stomatology clinic diagnosed as having actinic cheilitis. Clinically, atrophic and leukoplastic areas were observed throughout the lower lip, and loss of the border between the red lip skin and the cutaneous portion. An incisional biopsy was performed in the leukoplastic area, and histopathologic examination showed atrophic and atypical stratified orthokeratinized pavement epithelium with severe oral epithelial dysplasia. The therapeutic approach was the removal of all leukoplastic areas using the high-intensity diode laser for re-epithelialization of the affected mucosa. Proper follow-up is being performed every 3 months, and after 9 months, no signs of relapse were observed. Because of the potential for malignancy of actinic cheilitis and the presence of dysplastic epithelial alterations, an early approach is justified. The vaporization of the labial tissues with high-intensity diode laser was effective in superficial removal of affected tissues.