RESUMEN
INTRODUCTION: Graft-versus-host disease (GVHD) is a systemic complication that can affect patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and the mouth is one of the places affected by the disease (oGVHD). Topical corticosteroids are used to control the painful symptoms, causing a local immunosuppression and increasing the risk for opportunistic infections. OBJECTIVE: This study aims to report a case of a 42-year-old woman, diagnosed with Chronic Myeloid Leukemia, who developed oGVHD and herpes simplex virus (HSV) infection after HSCT. CASE REPORT: oGVHD was confirmed by incisional biopsy and viral infection by HSV types 1 and 2 was confirmed by PCR. Topical and systemic corticotherapy and antiviral therapies were instituted. The immunosuppression intensified viral infection and antimicrobial photodynamic therapy (aPDT) was instituted as an adjuvant treatment. aPDT application, along with the patient's immune recovery, antivirals and corticosteroids resulted in clinical improvement of oral lesions. FINAL CONSIDERATIONS: This study highlights aPDT as an effective adjunct therapy in the local treatment of opportunistic infections in onco-hematological patients.
Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Herpes Simple , Adulto , Antivirales/uso terapéutico , Femenino , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Herpes Simple/tratamiento farmacológico , Humanos , SimplexvirusRESUMEN
PURPOSE: The objective of this study was to evaluate the effect of primer-cement systems with different functional phosphate monomers on the adhesion of zirconia to dentin with and without aging protocols. MATERIALS AND METHODS: Bovine teeth (Nâ¯=â¯180) were embedded in acrylic resin after sectioning their roots with with their coronal parts exposed. The buccal surface of each tooth was polished with silicon carbide papers (#200, 400, 600) until dentin exposure. Sintered zirconia cylinders (Nâ¯=â¯180) (Ø: 3.4â¯mm; height: 4â¯mm) (Vita In-Ceram 2000) were prepared and distributed into 18 groups (nâ¯=â¯10 per group) considering the following factors: "Cementation System" (Panavia F - PAN; RelyX Ultimate - ULT, Multilink N - MULT) and "aging" (water storage in distilled water at 37⯰C for 24â¯h (control, C); 30 days (30D); 6 months (6â¯M) and thermocycling for 5000 (5TC), 10,000 (10TC) and 20,000 (20TC) thermal cycles (5-55⯰C; dwell time: 30â¯s)". Zirconia and dentin cementation surfaces were conditioned according to the recommendations of the manufacturers of each resin cement. The cylinders were adhesively cemented to the dentin surfaces and the specimens were submitted to the aging protocols. After aging, the specimens were subjected to shear bond strength test (SBS) (1â¯mm/min) in a Universal Testing Machine and failure types were analyzed. The data (MPa) were statistically using Kruskal-Wallis followed by the Dunn test (αâ¯=â¯5%). The degree of conversion (DC) rates of the cementing systems were also measured. RESULTS: While without aging (24â¯h) no significant difference was found between the cement systems (pâ¯>â¯0.05), after 30D (4.3-5.4), the highest decrease in all groups were observed after 5TC (1.5-2.3) (pâ¯<â¯0.05). Overall, MULT and ULT presented significantly higher results than that of PAN (pâ¯<â¯0.05). Pre-test failures during TC were more frequent in the PAN group. Complete adhesive failures at the cement/dentin interface were more frequent for MULT (30-80%) and PAN (10-70%) and for ULT (20-90%) at the cement/ceramic interface. DC of the tested cements did not show significant difference. CONCLUSION: Adhesion performance of the primer-cement systems with different functional phosphate monomers on zirconia-dentin complex varied as a function of aging strategies with MULT and ULT delivering higher bond strength values. When failure types considered, none of the cement systems performed well on both ceramic and dentin.