Periodontal considerations in chemotherapy of patients with head and neck cancers

Dental clinics may encounter patients who are involved with head and neck cancer and are under chemotherapy. This review discuss about oral and periodontal complications due to chemotherapy and current ways to decrease this complications. 20 articles about chemotherapy and related complications were used for this review. Periodontist has to participate before and during the treatment of patients with head and neck cancers who receive chemotherapic agents and his / her cooperation with oncologist is necessary to achieve the best results. Participation of periodontist in all treatment stages of patients with head and neck cancers is critical. Participation of periodontist is necessary before beginning of treatment of patients with head and neck cancers and this cooperation must continue during and after treatment to achieve the best results

[Evaluation of the effect of adjunctive use of calcium hydroxide combined with periodontal dressing on dentin hypersensitivity after periodontal surgery]

Dentinal hypersensitivity is one of the most common complications which many patients complain in different ways. Dentinal hypersensitivity is caused by the opening of dentinal tubules to an oral cavity due to fractures, attritions, etc. It is a common complications after periodontal surgery. Many treatments have been suggested for this problem, till now. Calcium hydroxide is one of the materials used for treatment of root hypersensitivity after periodontal surgery. The aim of this study was to evaluate the effect of calcium hydroxide combined with periodontal dressing on root hypersensitivity after periodontal surgery. This study was done on 30 patients with severe periodontitis who needed periodontal surgery for both quadrants in each jaw. In each patient one quadrant was treated as a test and the other side was used as a control. In the test group 90mg of Calcium Hydroxide powder mixed with 1cm of Co-pack covered the site surgical. Twenty-one patients completed the procedure After surgery, a periodontal dressing combined with calcium hydroxide covered the area on the test side. The other side was used as a control and covered with a pure dressing. After one week the dressing was removed and the amount of hypersensitivity was measured with air flow and an explorer using the visual analog scale. Data were analyzed using the Wilcoxon sign rank test. The results showed that there were not any significant differences between the two sides in root sensitivity, but Plaque index in the test sides was lower than the control side. The periodontal dressing can not be used as a carrier for calcium hydroxide to reduce root hypersensitivity after periodontal surgery. Decrease in plaque accumulation after using the combination of calcium hydroxide and periodontal dressing may accelerate surgical wound healing but further investigations are necessary

[Evaluation of height of facial alveolar crest and pocket depth following periodontal flap surgery with and without crestal bone exposure]

Surgery is one treatment modality for periodontal diseases that can stimulates osteoclastic activity and results in resorption of alveolar crestal bone. The aim of this study was to compare the effect of two procedures of periodontol surgery on resorption of alveolar crestal bone. Twenty patients were selected from patients referred to our dental school. After initial therapy, the surgical treatments were performed by a surgeon and the study was performed with split mouth design. One side was treated with an apically positioned flap [APF] with bone exposure [20 quadrants] and on the opposite side APF without bone exposure [20 quadrants]. At the time of surgery the distance between CEJ to bone crest was recorded. After two months, the patients were examined for the same parameters using the bone sounding technique. According to the results, in sites with apically positioned flap with bone exposure, crestal resorption was 0.77 +/- 0.63 and on the opposite side it was 1.05 +/- 0.79 mm. The difference between the two sides was not significant. Pocket changes were significant in both techniques but there was not any significant differences between the two procedures. According to the results of this study, similar alveolar crestal bone resorption occurred during the healing process in the two procedures and this resorption may have an important role in reconstruction of biologic width

[-vitro evaluation of periodontal dressing plus calcium hydroxide on L929 fibroblast cells]

In most cases, after the surgical procedures were completed, the area was covered with a surgical pack. Dentin hypersensitivity is one of the common problems after periodontal surgeries. Calcium Hydroxide is an inexpensive and available material used for desensitizing. The purpose of this study was to evaluate the cytotoxicity of mixture of calcium hydroxide and periodontal dressing on L929 fibroblasts. In this study Rat fibroblasts were used. For preparing extracts, we added 0, 1, 5 and 10 mg of calcium hydroxide to 1 gr of periodontal dressing. Then, they were placed in autoclave followed by 5[cc] of basal media [DMEM].A control group consisting of L929 fibroblasts plus basal media was also considered. After 24, 48 and 72 hours incubation, we examined the numbers [quantity] as well as the morphology of the cells [quality]. For quantitative evaluation [MTT assay] after adding Tetrazolium salt to cells, we read the optical density of each plate using ELISA reader. The data were analyzed statistically using chi-square and Kruskal wallis test. All of the plates had the same quality but the cells in the control group showed more proliferation. All of the plates had plenty of vital and normal fibroblasts but in comparison with the control group the cells had developed less proliferation. Statistical test analysis of the data showed a significant difference between the optical density of the experimental plates and the control group indicating that the number of vital cells in control group was significantly greater than the test groups. Because the number of active vital cells in the plates with periodontal dressing was equal to other plates but less than control group, it can be concluded that the cytotoxic effects in the different plates were related to periodontal dressing, not Calcium hydroxide