cGVHD-Related Caries and Its Shared Features with Other 'Dry-Mouth'-Related Caries

Author(s)

Alan Roger Santos-Silva ^[1] ; Patricia do Socorro Queiroz Feio ^[2] ; Pablo Agustin Vargas ^[3] ; Maria Elvira Pizzigatti Correa ^[4] ; Marcio Ajudarte Lopes ^[5]

Affiliation

^[1] Universidade Estadual de Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Semiology Area - Brasil

^[2] Universidade Estadual de Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Semiology Area - Brasil

^[3] Universidade Estadual de Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Semiology Area - Brasil

^[4] Universidade Estadual de Campinas. BMT Unit, Hematology and Blood Transfusion Center (Hemocentro) - Brasil

^[5] Universidade Estadual de Campinas. Piracicaba Dental School. Department of Oral Diagnosis, Semiology Area - Brasil

• Document type: Journal article
• Source: Brazilian Dental Journal; v. 26, n. 4, p. 435-440, 2015-08-00.

Abstract

<p>Several systemic diseases and their medical treatment may predispose the development of aggressive dental caries. Head and neck radiotherapy, chemotherapy, Sjögren's syndrome and long-standing treatment with drugs that induce hyposalivation are some of these conditions. The aim of this article is to describe the clinical features of five patients who developed chronic graft-versus-host-disease (cGVHD) as a complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and, in spite of close dental follow-up, subsequently developed rampant caries. In these cases, the restorations showed early failure and the caries still progressed until generalized teeth destruction. The majority of the teeth therefore had to be extracted due to advanced dental caries and rapid clinical progression. Herein the term "cGVHD-related caries" is proposed to describe this under-recognized complication of cancer treatment that may evolve in allo-HSCT recipients that develop cGVHD. This condition is poorly recognized in the literature and may represent the final result of the clustering of oral complications in cGVHD patients, including mucositis, oral pain, hyposalivation, taste loss and oral infections, leading to rampant caries due to impaired oral hygiene and increased intake of highly cariogenic food. Consequently, the knowledge of this oral complication should improve the medical and dental management of cGVHD oral manifestations and improve the quality of life of patients with this post allo-HSCT complication.</p> (AU)

• FAPESP's process: 13/18402-8 - Evaluation of the direct effects of radiation on the enamel, dentin and dental pulp of head and neck cancer patients
• Grantee: Alan Roger dos Santos Silva
• Support Opportunities: Regular Research Grants