RESUMEN
Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.
Asunto(s)
Bloqueadores de los Canales de Calcio/efectos adversos , Anemia de Fanconi/terapia , Granuloma Piogénico/inducido químicamente , Trasplante de Células Madre Hematopoyéticas , Inmunosupresores/efectos adversos , Enfermedades de la Boca/inducido químicamente , Amlodipino/efectos adversos , Niño , Ciclosporina/efectos adversos , Femenino , Humanos , Hiperplasia/inducido químicamente , Masculino , Fenobarbital/efectos adversosRESUMEN
OBJECTIVE: To evaluate the occurrence and severity of oral complications, number of radiotherapy (RT) interruptions and quality of life (QoL) in a population of head and neck cancer patients receiving a preventive oral care program (POCP) and photobiomodulation therapy (PBMT). METHODS: Prospective cohort of 61 head and neck cancer patients undergoing radiochemotherapy were monitored and submitted to a POCP that included oral hygiene and plaque control, removal of infection foci, dental restorations, periodontal therapy, fluorotherapy, oral hydration, and denture removal at night, combined with daily PBMT. Outcomes included occurrence of adverse effects such as severity of oral mucositis (OM) and oral symptoms (pain, solid and fluid dysphagia, odynophagia, dysgeusia), quality of life impacts, and interruptions of radiotherapy (RT) due to symptoms. Disease-free and overall survival rates were evaluated. RESULTS: There was a significant improvement in oral health conditions between initial assessment and the two longitudinal assessments (p < 0.05), which indicates that the POCP was effective for plaque control and reduction of gingival inflammation. All participants were free of OM at the beginning of the RT regimen and only 45.9% after the 7th session, and few patients ranked the highest score of OM. For all symptoms related to OM, there was a progressive increase of severity until the 14th RT session, which remained stable until the completion of the RT regimen. The same effect was observed for the quality of life measures. Discontinued RT due to OM occurred in only three patients (5%), and the maximum duration was 10 days. The overall survival rate was 77% and disease-free survival was 73.8%. Lower survival time was observed for patients with no response to RT (p < 0.01). CONCLUSIONS: The findings of this study suggest a positive effect of an oral preventive care program for head and neck cancer patients submitted to RT. The PBMT associated with a rigorous POCP resulted in satisfactory control of oral adverse effects, reduction of quality of life impacts, and interruption of RT regimen due to severe OM.
Asunto(s)
Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/radioterapia , Terapia por Luz de Baja Intensidad/métodos , Enfermedades de la Boca/etiología , Enfermedades de la Boca/prevención & control , Adulto , Anciano , Quimioradioterapia/efectos adversos , Quimioradioterapia/métodos , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/inducido químicamente , Salud Bucal , Higiene Bucal/métodos , Estudios Prospectivos , Calidad de Vida , Traumatismos por Radiación/etiología , Traumatismos por Radiación/prevención & controlRESUMEN
OBJECTIVE: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. METHODOLOGY: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. RESULTS: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. CONCLUSION: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.
Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades de la Boca/inducido químicamente , Neoplasias/tratamiento farmacológico , Adolescente , Antineoplásicos/uso terapéutico , Niño , Preescolar , Trastornos de Deglución/inducido químicamente , Femenino , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/tratamiento farmacológico , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Enfermedades de la Boca/clasificación , Mucosa Bucal/patología , Estudios ProspectivosRESUMEN
Abstract Objective: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. Methodology: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. Results: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. Conclusion: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Enfermedades de la Boca/inducido químicamente , Neoplasias/tratamiento farmacológico , Antineoplásicos/efectos adversos , Trastornos de Deglución/inducido químicamente , Estudios Prospectivos , Estudios Longitudinales , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/tratamiento farmacológico , Enfermedades de la Boca/clasificación , Mucosa Bucal/patología , Antineoplásicos/uso terapéuticoRESUMEN
The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.
Asunto(s)
Trastornos Relacionados con Cocaína/complicaciones , Abuso de Marihuana/complicaciones , Enfermedades de la Boca/inducido químicamente , Mucosa Bucal/efectos de los fármacos , Salud Bucal/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Alcoholismo/complicaciones , Alcoholismo/epidemiología , Estudios de Casos y Controles , Trastornos Relacionados con Cocaína/epidemiología , Estudios Transversales , Índice CPO , Femenino , Humanos , Masculino , Abuso de Marihuana/epidemiología , Persona de Mediana Edad , Enfermedades de la Boca/epidemiología , Factores de Riesgo , Salivación/efectos de los fármacos , Tasa de Secreción/efectos de los fármacos , Distribución por Sexo , Fumar/efectos adversos , Fumar/epidemiología , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Oral complications may be observed during chemotherapy and are important side effects that may directly affect the anticancer treatment, even causing septicaemia in some cases. This research was done in order to evaluate changes in oral lesions during follow-up of children and adolescents in chemotherapy at Hospital Estadual Infantil Nossa Senhora da Glória (HEINSG). METHODS: The study design was longitudinal, 45 patients were evaluated and monitored for 1 month after the initiation of chemotherapy. Twenty-eight patients were male and 17 female, ranging from 3 months to 18 years old. RESULTS: The results show an increase in the number of mucositis cases and a decrease in xerostomia cases after the initiation of treatment, and other oral lesions were also found in low numbers. CONCLUSIONS: It is possible to avoid oral complications by maintaining a good oral health, and reducing infectious outbreaks. It is also feasible to obtain an early diagnosis of, and treat these oral complications, preventing them from following a more severe clinical course that may negatively affect the individual's treatment. This outcome requires the presence of a dental surgeon on the multidisciplinary cancer treatment team.
Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades de la Boca/inducido químicamente , Neoplasias/complicaciones , Adolescente , Niño , Preescolar , Disgeusia/inducido químicamente , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Neoplasias/tratamiento farmacológico , Salud Bucal , Prevalencia , Estomatitis/inducido químicamente , Xerostomía/inducido químicamenteRESUMEN
Abstract: The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Anciano de 80 o más Años , Adulto Joven , Abuso de Marihuana/complicaciones , Salud Bucal/estadística & datos numéricos , Trastornos Relacionados con Cocaína/complicaciones , Enfermedades de la Boca/inducido químicamente , Salivación/efectos de los fármacos , Tasa de Secreción/efectos de los fármacos , Factores Socioeconómicos , Fumar/epidemiología , Estudios de Casos y Controles , Índice CPO , Abuso de Marihuana/epidemiología , Estudios Transversales , Encuestas y Cuestionarios , Factores de Riesgo , Distribución por Sexo , Trastornos Relacionados con Cocaína/epidemiología , Alcoholismo/complicaciones , Alcoholismo/epidemiología , Dependencia de Heroína/tratamiento farmacológico , Persona de Mediana Edad , Enfermedades de la Boca/epidemiología , Mucosa Bucal/efectos de los fármacosRESUMEN
Introdução: as reações adversas a medicamentos constituem um problema importante na prática do profissional da área da saúde, já que essas reações são causas de hospitalização, aumento no tempo de permanência hospitalar e da morbimortalidade. Muitas das reações adversas aos fármacos apresentam-se na cavidade oral. Objetivo: descrever os principais medicamentos com potencial de efeitos colaterais na cavidade oral, agrupando os que causam efeitos adversos semelhantes. Método: trata-se de estudo bibliográfico e descritivo por meio de utilização de estudos originais e atualizados a partir dos bancos de dados oficiais SciELO, PUBMED e LILACS. Priorizaram-se artigos em língua portuguesa, inglesa e espanhola, que incluíam revisões bibliográficas, meta-análises e relatos de casos publicados entre 2000 e 2015. Foram utilizados como descritores os termos: manifestações orais e medicamentos, lesões orais e medicamentos, mucosa oral e medicamentos e reação medicamentosa na cavidade oral. Resultados e Discussão: dezenove artigos foram analisados detalhadamente e mostram predominância de relatos de caso. Vários medicamentos foram associados com alterações patológicas nos tecidos orais, sobretudo os medicamentos utilizados em oncologia e medicamentos com ação no sistema nervoso central. As reações adversas às drogas dependem do fármaco e são bastante variáveis, e dentre as encontradas destacam-se ulceração de mucosa, hiperplasia gengival, xerostomia e diminuição do fluxo salivar. Conclusão: algumas lesões são comuns a diferentes medicamentos e, dessa forma, é fundamental a observação correta da possibilidade de sequela associada à terapia medicamentosa. Uma anamnese adequada com um levantamento do histórico médico completo do paciente é essencial para o profissional de saúde estar apto a fazer o diagnóstico das alterações e concluir o tratamento adequado para a solução do problema. (AU)
Introduction: adverse drug reactions are an important problem in the practice of health professionals, since these reactions may cause hospitalization, increase in length of hospital stay and morbidity and mortality. Many adverse drug reactions occur in the oral cavity. Objective: to describe the main drugs with potential side effects in the oral cavity, grouping those that cause similar adverse effects. Methods: bibliographic and descriptive study through use of original studies from three databases: SciELO, PubMed and LILACS. Selected papers were in Portuguese, English and Spanish, which included literature reviews, meta-analysis and case reports published between 2000 and 2015. The terms used were: oral medications and manifestations, oral lesions and medicines, oral mucosa and drugs and adverse drug reaction in the oral cavity. Results and Discussion: nineteen articles were analyzed in detail and case reports were predominant. Several drugs have been associated with pathological changes in oral tissue, in particular drugs used in oncology and those acting on the central nervous system. Adverse drug reactions depend on the medication and are quite variable. Among the found reaction are: ulcerative mucosa, gingival hyperplasia, xerostomia and decreased salivary flow. Conclusion: some lesions are common to different drugs, making critical the proper observation of possible sequelae associated with drug therapy. Detailed anamnesis with a complete medical history of the patient is essential for the proper diagnosis and a better therapeutic decision. (AU)
Asunto(s)
Preparaciones Farmacéuticas/análisis , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Enfermedades de la Boca/inducido químicamente , Manifestaciones Bucales , Literatura de Revisión como Asunto , Fenómenos Farmacológicos y ToxicológicosRESUMEN
The development of Angular Cheilitis and the reactivation of Herpes Simplex Virus, could be related to a decrease in the resistance of the immune system in the infected host, being common in cancer patients receiving antineoplastic chemotherapy. The objective of the present manuscript is to report Antimicrobial Photodynamic Therapy as a treatment of infected oral lesions of patients submitted to chemotherapy.
Asunto(s)
Antineoplásicos/efectos adversos , Herpes Simple/inducido químicamente , Herpes Simple/tratamiento farmacológico , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/tratamiento farmacológico , Fotoquimioterapia/métodos , Adolescente , Adulto , Queilitis/inducido químicamente , Queilitis/tratamiento farmacológico , Femenino , Herpes Simple/patología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Fármacos Fotosensibilizantes/administración & dosificación , Resultado del TratamientoRESUMEN
We describe a 39-year-old woman with an apparent captopril-induced, contact mucosal-dominant pemphigus vulgaris and angioedema, who took captopril during a bout of arterial hypertension. This exposure suggests that captopril and pathophysiology of angioedema stimulated the development of pemphigus vulgaris, which was diagnosed using the novel, indirect immunofluorescence BIOCHIP mosaic, with the modification to detect serum IgG4 autoantibodies. We discuss the patient, who experienced a chain of events leading to the active stage of pemphigus vulgaris, and review concepts of pemphigus vulgaris inducible by drugs and pathological immunity.
Asunto(s)
Angioedema/inducido químicamente , Antihipertensivos/efectos adversos , Captopril/efectos adversos , Enfermedades de la Boca/inducido químicamente , Pénfigo/inducido químicamente , Adulto , Angioedema/patología , Femenino , Técnica del Anticuerpo Fluorescente Directa , Humanos , Inmunoglobulina G/sangre , Enfermedades de la Boca/patología , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Pénfigo/patologíaRESUMEN
AbstractWe describe a 39-year-old woman with an apparent captopril-induced, contact mucosal-dominant pemphigus vulgaris and angioedema, who took captopril during a bout of arterial hypertension. This exposure suggests that captopril and pathophysiology of angioedema stimulated the development of pemphigus vulgaris, which was diagnosed using the novel, indirect immunofluorescence BIOCHIP mosaic, with the modification to detect serum IgG4 autoantibodies. We discuss the patient, who experienced a chain of events leading to the active stage of pemphigus vulgaris, and review concepts of pemphigus vulgaris inducible by drugs and pathological immunity.
Asunto(s)
Adulto , Femenino , Humanos , Angioedema/inducido químicamente , Antihipertensivos/efectos adversos , Captopril/efectos adversos , Enfermedades de la Boca/inducido químicamente , Pénfigo/inducido químicamente , Angioedema/patología , Técnica del Anticuerpo Fluorescente Directa , Inmunoglobulina G/sangre , Enfermedades de la Boca/patología , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Pénfigo/patologíaAsunto(s)
Microesferas , Enfermedades de la Boca/inducido químicamente , Polimetil Metacrilato/efectos adversos , Anciano , Biopsia , Cementos para Huesos/efectos adversos , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades de la Boca/diagnóstico , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Polimetil Metacrilato/administración & dosificaciónRESUMEN
INTRODUCTION: Acute lymphocytic leukemia is a type of cancer most common in children and it is characterized by excessive and disordered immature leukocytes in the bone marrow. AIM: Identify most frequent oral manifestations in children with acute lymphocytic leukemia under chemotherapy treatment. METHODOLOGY: The research was conducted on the electronic database PubMed/Medline, Science Direct, Scielo and Scopus. It has been sought papers with full presentation, wrote in Portuguese, English and Spanish, published between January 1992 and April 2013. RESULTS: From studies primarily selected, only eight met the criteria of inclusion. All studies performed intraoral examinations to diagnose oral lesions. According to results, the most frequent lesions were mucositis, candidiasis, periodontitis and gingivitis. The oral health condition from acute lymphocytic leukemia carriers varied according oral hygiene of the patient. CONCLUSION: The results of studies identified such a great part of patients with ALL presented some lesion in oral cavity during or after chemotherapy treatment. The dentist surgeon needs to recognize oral manifestations and intervene in the oral health of patients with ALL, contributing and helping with treatment.
Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades de la Boca/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Niño , HumanosRESUMEN
Introdução: A leucemia linfocítica aguda é um dos tipos de câncer mais comuns em crianças e é caracterizada pela produção excessiva e desordenada de leucócitos imaturos na medula óssea. Objetivo: Identificar as manifestações orais mais frequentes em crianças portadoras de leucemia linfocítica aguda sob o tratamento quimioterápico. Metodologia: A pesquisa foi realizada nas bases de dados eletrônicas PubMed/Medline, Science Direct, Scielo e Scopus. Procurou-se por artigos apresentados na íntegra, escritos em português, inglês e espanhol, publicados entre janeiro de 1992 e abril de 2013. Resultados: Dos estudos selecionados primariamente, apenas oito atenderam aos critérios de inclusão. A população avaliada foi um grupo de crianças portadoras de leucemia linfócitica aguda. Todos os estudos realizaram exames intraorais para o diagnóstico das lesões bucais. De acordo com os resultados, as lesões mais frequentes foram mucosite, candidíase, periodontite e gengivite. A condição de saúde bucal dos portadores de leucemia linfócitica aguda variou de acordo com a higiene bucal do paciente. Conclusão: Pacientes com LLA podem apresentar alguma lesão na cavidade oral durante ou após o início da quimioterapia. O cirurgião dentista necessita reconhecer as manifestações orais e intervir na saúde bucal do paciente com LLA, contribuindo e auxiliando no seu tratamento. .
Introduction: Acute lymphocytic leukemia is a type of cancer most common in children and it is characterized by excessive and disordered immature leukocytes in the bone marrow. Aim: Identify most frequent oral manifestations in children with acute lymphocytic leukemia under chemotherapy treatment. Methodology: The research was conducted on the eletronic database PubMed/Medline, Science Direct, Scielo and Scopus. It has been sought papers with full presentation, wrote in Portuguese, English and Spanish, published between January 1992 and April 2013. Results: From studies primarily selected, only eight met the criteria of inclusion. All studies performed intraoral examinations to diagnose oral lesions. According to results, the most frequent lesions were mucositis, candidiasis, periodontitis and gingivitis. The oral health condition from acute lymphocytic leukemia carriers varied according oral hygiene of the patient. Conclusion: The results of studies identified such a great part of patients with ALL presented some lesion in oral cavity during or after chemotherapy treatment. The dentist surgeon needs to recognize oral manifestations and intervene in the oral health of patients with ALL, contributing and helping with treatment. .
Asunto(s)
Niño , Humanos , Antineoplásicos/efectos adversos , Enfermedades de la Boca/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológicoRESUMEN
Introduction: Radiotherapy (RT) and chemotherapy (CT) are therapeutic methods widely used in patients with malignancies in the head and neck regions. However, these therapies are able to induce significant acute and late toxicities to oral structures and surrounding tissues. Objective: To describe the acute and chronic oral complications of RT and CT in head and neck, showing the way the dentist can handle them. Materials and methods: Virtual Health Library (VHL) Bireme: LILACS, IBECS, MEDLINE and BBO, PubMed, SciELO, Brazilian Digital Library of Theses and Dissertations (BDTD), Capes database journals and renowned oral medicine books. The search strategies used included the following words: radiotherapy, chemotherapy, adverse effects and treatment. Thirty-two references were selected between 1990 and 2012 for the development of this study. Results: Both therapies are associated with adverse effects that significantly affect the patients quality of life. Their adverse effects are dose-dependent and may occur from the first week of treatment. Among the most important complications are included the oral mucositis, radiodermatitis, hypossialia, hypogeusia, radiation caries, opportunistic infections, developmental abnormalities, osteoradionecrosis and trismus. A preliminary evaluation of the oral health status and the accompanying by the dentist during treatment may act to prevent and reduce the damage to oral tissues. Conclusion: The multidisciplinary treatment, including medical team, dental surgeon, speech therapist, psychologist and nutritionist is the best alternative to minimize or even prevent many complications resulting from physical and psychological anticancer treatment.
Introdução: A radioterapia (RT) e a quimioterapia (QT) são terapias amplamente empregadas em pacientes portadores de neoplasias malignas em região de cabeça e pescoço. No entanto, são métodos capazes de provocar toxicidades significativas às estruturas orais e tecidos adjacentes. Objetivo: Descrever as complicações bucais agudas e crônicas da RT e QT em cabeça e pescoço, evidenciando a maneira com que o cirurgião-dentista (CD) pode abordá-los. Materiais e métodos: Biblioteca Virtual em Saúde (BVS) Bireme: LILACS, IBECS, MEDLINE e BBO - PubMed, SciELO, Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), Base Periódicos Capes e livros renomados da área estomatológica. A estratégia de busca utilizada incluiu as seguintes palavras: radioterapia, quimioterapia, efeitos adversos e tratamento. Foram selecionadas 32 referências entre 1990 e 2012 para o desenvolvimento deste estudo. Resultados: Ambas as terapias estão associadas a reações adversas que afetam de forma significativa a qualidade de vida dos pacientes. Seus efeitos adversos são dose-dependentes e podem manifestar-se a partir da primeira semana de tratamento. Entre as complicações orais mais importantes estão a mucosite, radiodermite, hipossialia, hipogeusia, cárie de radiação, infecções oportunistas, anormalidades do desenvolvimento, osteorradionecrose e trismo. A avaliação prévia da condição bucal e o acompanhamento pelo CD durante o tratamento podem atuar na prevenção e redução dos danos causados aos tecidos bucais. Conclusão: O tratamento multidisciplinar, incluindo equipe médica, cirurgiãodentista, fonoaudiólogo, nutricionista e psicólogo é a melhor alternativa para minimizar ou mesmo prevenir diversas complicações físicas e psicológicas advindas do tratamento antineoplásico.
Asunto(s)
Humanos , Quimioterapia , Enfermedades de la Boca/inducido químicamente , Enfermedades de la Boca/prevención & control , Neoplasias de Cabeza y Cuello/terapia , Radioterapia/efectos adversos , Boca , Boca/efectos de la radiación , Resultado del TratamientoRESUMEN
Hydroxyurea (HU) is an antimetabolic agent commonly used in myeloproliferative disorders and hematological diseases as well as in severe psoriasis. Despite of usually be well tolerated, sometimes it can induce immunosuppression and mucocutaneous adverse effects associated with discomfort or pain. Nevertheless, oral mucosal adverse reactions are extremely uncommon and present as ulcers, tongue depapilation and dyschromia. Complete remission of adverse effects is usually observed after withdrawal of the medication. The aim of this paper is to report two patients with oral lesions related to HU treatment. T0 he patients were adequately managed by changing hydroxyurea with imatinib mesilate. Oral lesions are rare complications of long-term hydroxyurea treatment and may be an indication of stopping therapy and substitution with imatinib mesilate.
Asunto(s)
Antineoplásicos/efectos adversos , Hidroxiurea/efectos adversos , Enfermedades de la Boca/inducido químicamente , Adolescente , Adulto , Benzamidas , Enfermedades de las Encías/inducido químicamente , Humanos , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Enfermedades de los Labios/inducido químicamente , Masculino , Suelo de la Boca/efectos de los fármacos , Mucosa Bucal/efectos de los fármacos , Úlceras Bucales/inducido químicamente , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Enfermedades de la Lengua/inducido químicamenteRESUMEN
Low-dose methotrexate (MTX) is frequently used for patients with rheumatoid arthritis (RA). High doses of MTX frequently produce side effects. The aim of this study was to explore oral complications of low-dose MTX therapy in a population of RA patients. This is a cross-sectional study in which oral examination was performed on a population of RA patients. Patients undergoing MTX therapy (5-20 mg weekly) for at least six months were included in the study group, and RA patients being treated under another regimen were used as controls. The frequency of oral lesions was compared between groups. The chi-square test was used to compare frequencies. Relative risk (RR) and its confidence interval (CI) were established. Significance level was set at 0.05. Twenty-eight RA patients on a low-dose MTX regimen and 21 controls were enrolled in the study. Oral lesions were found in 22 patients (78.6%) undergoing MTX therapy, and in 5 patients (23.8%) undergoing other therapies (p < 0.001). There were no significant differences regarding age, gender or dosage. The most common oral events observed in patients in the MTX group were ulcerative/erosive lesions (60.7%) and candidiasis (10.7%). Patients in the control group presented lower prevalence of the same lesions (p < 0.001). The RR for developing oral lesions was 11.73 (CI 2.57 - 58.98), with low-dose MTX therapy. In conclusion, the prevalence of oral mucosa lesions in RA patients receiving low doses of MTX therapy is higher than in RA patients not receiving the drug.
Asunto(s)
Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Metotrexato/efectos adversos , Enfermedades de la Boca/inducido químicamente , Adulto , Factores de Edad , Anciano , Antirreumáticos/administración & dosificación , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Mucosa Bucal/efectos de los fármacos , Factores de Riesgo , Factores SexualesRESUMEN
Low-dose methotrexate (MTX) is frequently used for patients with rheumatoid arthritis (RA). High doses of MTX frequently produce side effects. The aim of this study was to explore oral complications of low-dose MTX therapy in a population of RA patients. This is a cross-sectional study in which oral examination was performed on a population of RA patients. Patients undergoing MTX therapy (5-20 mg weekly) for at least six months were included in the study group, and RA patients being treated under another regimen were used as controls. The frequency of oral lesions was compared between groups. The chi-square test was used to compare frequencies. Relative risk (RR) and its confidence interval (CI) were established. Significance level was set at 0.05. Twenty-eight RA patients on a low-dose MTX regimen and 21 controls were enrolled in the study. Oral lesions were found in 22 patients (78.6 percent) undergoing MTX therapy, and in 5 patients (23.8 percent) undergoing other therapies (p < 0.001). There were no significant differences regarding age, gender or dosage. The most common oral events observed in patients in the MTX group were ulcerative/erosive lesions (60.7 percent) and candidiasis (10.7 percent). Patients in the control group presented lower prevalence of the same lesions (p < 0.001). The RR for developing oral lesions was 11.73 (CI 2.57 - 58.98), with low-dose MTX therapy. In conclusion, the prevalence of oral mucosa lesions in RA patients receiving low doses of MTX therapy is higher than in RA patients not receiving the drug.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Metotrexato/efectos adversos , Enfermedades de la Boca/inducido químicamente , Factores de Edad , Antirreumáticos/administración & dosificación , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Estudios Transversales , Metotrexato/administración & dosificación , Mucosa Bucal/efectos de los fármacos , Factores de Riesgo , Factores SexualesRESUMEN
Los pacientes pediátricos oncológicos con frecuencia presentan lesiones orales debido a su neoplasia o como efecto colateral del tratamiento. El objetivo de este estudio fue comparar la prevalencia de patologías de la mucosa oral en niños con cáncer que fueron hospitalizados y tratados con quimioterapia en el Hospital Regional de Concepción, en los años 1997 y 2007. Se realizó un estudio descriptivo retrospectivo longitudinal en datas de 148 pacientes (74 cada año) con patologías neoplásicas en tratamiento con quimioterapia (Leucemias, linfomas, tumores del Sistema Nervioso Central y otros), registrando sus datos generales y la patología bucal (mucositis (M), candidiasis (C), lesiones por Virus Herpes tipo 1 (VHS) y síndromes hemorragíparos (H) . Los datos se resumieron en tablas anuales y fueron sometidos a análisis estadísticos. Se encontró una disminución significativa del número de pacientes con patologías bucales en el año 2007 en relación al año 1997 (P<0.05, Tet de Fisher). Además se encontró una tendencia a la baja en los pacientes con candidiasis y con mucositis en el año 2007 en comparación con 1997. Es necesario seguir estudiando medidas para prevenir, diagnosticar y/o tratar tempranamente las patologías orales de los pacientes en tratamiento antineoplásico.
Pediatric oncology patients frequently have oral lesions due to malignancy or as a side effect of treatment. The aim of this study was to compare the prevalence of oral pathologies in oncology patients hospitalized and treated at the Regional Hospital of Concepción, Chile, in the years 1997 and 2007. A retrospective study was carried out in 74 patients each year. Patients suffered from acute lymphoblastic leukemia, acute myeloblastic leukemia, central nervous system tumors, lymphomas and other neoplasms. General data (age, gender, oncologic disease) and presence of oral pathologies (candidiasis, mucositis post-chemotherapy, herpetic lesions and hemorrhage) were obtained from their clinical records. Data was analyzed for statistical differences. A significant reduction in the number of patients with oral pathologies was found in 2007 in comparison to 1997 (P<0.05, Fisher´s test). In addition, candidiasis and oral mucositis showed less prevalence in 2007 as compared to 1997, although no significant differences were found. For the relevance of oral pathologies in the chemotherapy it´s important to continue studies about prevention, early detection and treatment of oral pathologies.