Restorative Dental Treatment in a Patient with Mild to Moderate Chronic Kidney Disease (Stages 1-3).

Patients with chronic kidney disease (CKD) stage 2 have mildly damaged kidneys but they still work well. The dentist can proceed with the required restorative dental treatment, which is considered a low-risk non-surgical dental procedure, with no major complications expected. Patients with CKD stage 3 have moderate impairment of renal function with altered drug metabolism, bioavailability, and rate of excretion. Diabetes is a common comorbidity in patients with CKD.

Patient with Severe End-Stage Renal Disease Stages (4-5) Presenting for Surgical Periodontal Therapy.

Patients with ESRD have an increased risk of bleeding owing to platelet dysfunction associated with uremia. It is important to obtain coagulation tests and complete blood count before the surgical procedure, and abnormal values should be discussed with the patient's physician. A conservative surgical technique must be followed to decrease the risk of bleeding and infection. The dentist should ensure the availability of local hemostatic agents at the dental office to be used as needed to obtain hemostasis. Following the medical complexity status (MCS) system, the patient can be designated as MCS 2B category.

Patient on Hemodialysis Develops Painful Periodontal Abscess and Presents for Treatment.

Dialysis patients have an increased risk of acquiring hepatitis B, hepatitis C, and HIV because the dialysis machine is disinfected, not sterilized. Therefore, the dentist must follow standard precautions for infection control when treating dialysis patients. Following the medical complexity status (MCS) system, the patient can be designated as MCS 2B category.

Oral lichen planus preceding concomitant lichen planopilaris.

Lichen planus (LP) is an immune-mediated mucocutaneous disorder with a wide array of clinical presentations. Oral lichen planus (OLP) is characterized clinically by striae, desquamation, and/or ulceration. Lichen planopilaris (LPP), a variant of LP, affects the scalp, resulting in perifollicular erythema and scarring of cutaneous surfaces accompanied by hair loss. The association between OLP and LPP has been reported previously with scant information on concomitant or sequential disease presentation. We describe a patient with concomitant OLP and LPP, and to the best of our knowledge, this is the first report on OLP preceding the onset of LPP.