Dental management in transplant patients

Introduction: Transplant is the replacement with therapeutic purposes, of organs, tissues or cellular material for others, from a donor who is usually a human, alive or dead. In recent years, transplant organs have been developed by the advances that have occurred with immunosuppressive drugs and medical-surgical technology. Due to the frequency of transplants that are performed today, it is common to find these patients in dental clinics. Objectives: To review the literature on oral manifestations in transplant patients and general dental management and according to transplant organs (heart, lung, liver, kidney, pancreas and bone marrow). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 30 articles (eight literature reviews, three randomized clinical trials, one cohort study, three case-control studies, eight clinical case series and seven cross-sectional studies). Results and discussion: We describe the most common oral manifestations in transplant patients (viral, bacterial and fungal infections, gingival enlargement secondary to drug therapy and higher risk in the development of oral malignancy) and the special dental management that should be carried out on these patients, generally and specifically according to the type of transplant.Introduction: Transplant is the replacement with therapeutic purposes, of organs, tissues or cellular material for others, from a donor who is usually a human, alive or dead. In recent years, transplant organs have been developed by the advances that have occurred with immunosuppressive drugs and medical-surgical technology. Due to the frequency of transplants that are performed today, it is common to find these patients in dental clinics. Objectives: To review the literature on oral manifestations in transplant patients and general dental management and according to transplant organs (heart, lung, liver, kidney, pancreas and bone marrow). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 30 articles (eight literature reviews, three randomized clinical trials, one cohort study, three case-control studies, eight clinical case series and seven cross-sectional studies). Results and discussion: We describe the most common oral manifestations in transplant patients (viral, bacterial and fungal infections, gingival enlargement secondary to drug therapy and higher risk in the development of oral malignancy) and the special dental management that should be carried out on these patients, generally and specifically according to the type of transplant

Dental management of patients with endocrine disorders

Introduction: The endocrine system is responsible for hormonal secretion and is closely related to the central nervous system, as it diversifies its functions through the hypothalamus and pituitary glands. It controls physiological processes and maintains homeostasis. The neuroendocrine system is responsible for adaptation to environmental changes. Therefore, in dentistry, it is important to be aware of the risks and difficulties that may arise during the dental management of patients with endocrine disorders, and that visits to the dental clinics often represent a stressful situation. Objectives: To review the literature on oral manifestations and dental management in patients with endocrine disorders (disorders of the thyroid, parathyroid and adrenal glands). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 19 articles (ten literature reviews, one case-control study, and eight clinical case series). Results and discussion: We describe the most common oral manifestations in patients with endocrine disorders and the special dental management that should be carried out on these patient

Foreign body granulomatous reactions to cosmetic fillers

Introduction: The use of different facial cosmetic fillers has increased in recent years. The introduction of apparently inert substances in the epidermis can give rise to foreign body granulomatous reactions. Objetives: A literature review is made of the foreign body granulomatous reactions to cosmetic fillers. Material and methods: A PubMed-Medline search was made using the following keywords: 'granulomatous reactions', 'foreign body reactions', 'esthetic fillers', 'cosmetic fillers'. The search was limited to articles published in English and Spanish during the last 10 years. A total of 22 articles were reviewed. Results: A great variety of substances have been found to give rise to foreign body granulomatous reactions. The most common locations are the upper and lower lip and the nasogenian sulcus. The clinical presentation is variable and can range from single or multiple nodules to diffuse facial swelling of hard-elastic consistency, accompanied by reddening. Most lesions are asymptomatic or cause only mild discomfort. The literature describes different treatments, including systemic corticosteroids, local tacrolimus infiltrations, minocycline, retinoids, allopurinol, 5% imiquimod, and surgical removal. Conclusions: In view of the current demand for esthetic treatments, the use of cosmetic fillers can be expected to increase in future, together with the incidence of complications