RESUMEN
AIM: The aim of the present study was to describe the salivary shedding of human herpesviruses (HHV) in renal transplant recipients and to observe the oral manifestations in this group. METHODS: A prospective case-control study was conducted with a study group of 20 renal transplant recipients and a control group of 20 non-transplanted, immunocompetent individuals. Clinical examination evaluated the presence of drug-induced gingival overgrowth (DIGO), salivary flow, and caries. Stimulated saliva was collected from both groups, with HHV being detected by using real-time polymerase chain reaction. RESULTS: The mean age of the study group was 45.90 ± 9.89 years, with 55% (11/20) being female, 60% (12/20) being Caucasian, 65% (13/20) having a deceased donor, and 70% (14/20) having used tacrolimus as the main immunosuppressive drug. Renal transplant recipients had shedding of more herpesviruses compared to the control group, with the exception of HHV-7. Statistical significance was found for herpes simplex virus-1 (HSV-1) (P = 0.017) and cytomegalovirus (P = 0.035). DIGO was observed in seven patients (35%), with 35% (7/20) presenting with decreased salivary flow and four (20%) reporting xerostomia. CONCLUSION: Renal transplant recipients excreted herpesviruses more often than control individuals, especially HSV-1. Decreased salivary flow and xerostomia were more frequent in patients who used tacrolimus, whereas those who used cyclosporine had more cases of DIGO.
Asunto(s)
Infecciones por Herpesviridae/epidemiología , Herpesviridae , Trasplante de Riñón/efectos adversos , Saliva/virología , Brasil/epidemiología , Estudios de Casos y Controles , Ciclosporina/uso terapéutico , Citomegalovirus , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/virología , Infecciones por Virus de Epstein-Barr/epidemiología , Infecciones por Virus de Epstein-Barr/virología , Femenino , Herpes Simple/epidemiología , Herpes Simple/virología , Infecciones por Herpesviridae/virología , Herpesvirus Humano 1 , Herpesvirus Humano 4 , Herpesvirus Humano 6 , Herpesvirus Humano 7 , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Infecciones por Roseolovirus/epidemiología , Infecciones por Roseolovirus/virología , Tacrolimus/uso terapéutico , Esparcimiento de Virus/efectos de los fármacosRESUMEN
BACKGROUND: Drug-induced gingival overgrowth (DIGO) is attributed mainly to the prolonged use of calcium channel blocking agents, anticonvulsants, and anti-calcineurin inhibitors . The management of DIGO depends on the severity of the disease and includes surgical intervention and plaque control. Compared to conventional surgical treatment, the recent literature data have shown that gingivectomy using a high-power laser (HPL) is a short and easy procedure, which results in minimal postoperative discomfort and greater patient accep- tance. OBJECTIVE AND METHODS: The purpose of this study was to report two cases of recurrent DIGO treated surgically using HPL (λ 808nm, 1.5W). RESULTS: Minimal bleeding and discomfort were observed during surgery, and patients reported no pain or bleeding after the procedure. After 1 year of follow-up, patients presented a minimal increase of gingival volume, indicating that laser technology can improve the efficiency and prognosis of DIGO. CONCLUSIONS: The HPL was able to preventing hemorrhage and improving the patient's collaboration with the treatment and quality of life.
Asunto(s)
Sobrecrecimiento Gingival/cirugía , Gingivectomía/métodos , Láseres de Semiconductores/uso terapéutico , Adolescente , Amlodipino/efectos adversos , Bloqueadores de los Canales de Calcio/efectos adversos , Niño , Femenino , Estudios de Seguimiento , Sobrecrecimiento Gingival/inducido químicamente , Gingivoplastia , Humanos , Masculino , Factores de TiempoRESUMEN
INTRODUÇÃO: A hiperplasia gengival pode ser causada por alguns medicamentos, entre os quais a fenitoína. Torna-se importante a prevenção, o diagnóstico precoce e o seguimento de pessoas com epilepsia por profissional da área odontológica. OBJETIVO: O presente artigo tem o propósito de discutir os aspectos etiológicos, clínicos e terapêuticos da hiperplasia gengival medicamentosa. METODOLOGIA: Revisão da literatura. RESULTADOS: A necessidade de aliar o tratamento odontológico ao tratamento medicamentoso é enfatizada como forma de prevenir e/ou minimizar a hiperplasia gengival medicamentosa conseqüente à ação farmacológica de algumas drogas e fatores irritantes localizados nos tecidos dentais e periodontais.
INTRODUCTION: Gingival hyperplasia may be caused by some drugs including phenytoin. There are very important factors in this area, including prevention, early diagnosis, and follow-up of people with epilepsy by an specialist in odontological area. OBJECTIVE: The aim of this paper is to discuss the etiology, clinical and therapeutic aspects of drug induced gingival hyperplasia. METHODOLOGY: Literature review. RESULTS: The need to combine dental and drug treatment is emphasized as a way to prevent and/or minimize drug induced gingival hyperplasia due to pharmacological action of some drugs, as well as, local dental and periodontal irritants.