RESUMO
The protocols for oral evaluation and treatment of patients with renal failure and renal transplants are presented. Guidelines for dental treatment planning are outlined, and extraction versus conservation of teeth is discussed. Information on special considerations involving dialysis, antibiotic prophylaxis, drug therapy, and immunosuppression is provided. The goal of treatment is to restore maximum function while minimizing the risk of oral infection after transplantation.
Assuntos
Assistência Odontológica para a Pessoa com Deficiência/métodos , Falência Renal Crônica , Transplante de Rim , Antibacterianos/uso terapêutico , Infecções Bacterianas/prevenção & controle , Hemorragia/etiologia , Hepatite Viral Humana/etiologia , Humanos , Falência Renal Crônica/fisiopatologia , Doenças da Boca/complicações , Doenças da Boca/terapia , Saúde Bucal , Planejamento de Assistência ao Paciente , Pré-Medicação , Diálise Renal/efeitos adversos , Doenças Dentárias/complicações , Doenças Dentárias/terapiaRESUMO
A case of rapidly progressive periodontal disease associated with human immunodeficiency virus (HIV) infection is presented. Rapid horizontal bone loss, with only moderate inflammation, occurred during a 13-month period. Pocket depth was significantly less than anticipated, given the degree of bone loss. The patient had no signs or symptoms of acquired immune deficiency syndrome (AIDS). The cause, features, diagnosis, and management are discussed.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças Periodontais/complicações , Adulto , Reabsorção Óssea/complicações , Doença Crônica , Hemorragia Gengival/complicações , Retração Gengival/complicações , Humanos , Masculino , Bolsa Periodontal/complicaçõesRESUMO
The incidence of oral cancer has increased in the past ten years. Early diagnosis and treatment are essential to long-term survival; however, patients at highest risk visit the dentist infrequently. The reddish, velvety or erythroplakial lesion at the base of the tongue or floor of the mouth is highly suspicious in any patient and requires further evaluation. High-risk patients with less suspicious appearing lesions must be reevaluated on close recall. Prognosis improves vastly when the lesion is detected and treated early. One study demonstrated a 64% five-year survival rate for patients with oral cancer that was diagnosed before regional lymph node involvement versus a 15% five-year survival for patients whose lesions were diagnosed after regional lymph node involvement. By including an oral cancer examination in routine physical examination of patients, the physician and public health nurse can increase the likelihood of early detection of oral cancer.
Assuntos
Neoplasias Bucais/diagnóstico , Idoso , Bochecha , Feminino , Humanos , Leucoplasia/diagnóstico , Leucoplasia/mortalidade , Neoplasias Labiais/diagnóstico , Neoplasias Labiais/mortalidade , Masculino , Pessoa de Meia-Idade , Soalho Bucal/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/mortalidade , Neoplasias Palatinas/diagnóstico , Neoplasias Palatinas/mortalidade , Exame Físico , Prognóstico , Fatores de Tempo , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/mortalidadeRESUMO
This article reviews the therapeutic problems that arise in the dental management of hemophilia patients with inhibitor and suggests an anesthesia technique that may eliminate the need for factor replacement during restorative procedures. Intraligamentary anesthesia was used during restorative procedures that were performed throughout an 8-year period on a patient with factor VIII inhibitor. Multiple restorative procedures were accomplished without the use of replacement factor and with no postoperative bleeding. This technique, in consultation with the patient's physician, may be performed by most general practitioners in their private offices.