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

[ evaluation of calulus rate in patients with nephrolithiasis]

Some reports show that oral manifestations such as uremia osteomatiis, self bleeding, periodontal diseases, xerostomia and calculus formation are increased in patients with renal disease. Based on similar structural composition and similar process of production of kidney stones and dental calculus, we performed this study to evaluate the prevalence of dental calculus in patients with kidney diseases. In this case-control study, 30 patients with idiopathic nephrofithiasis were selected as case group and 30 sex and age matched healthy persons were selected as control. They had no systemic and periodontal diseases. Silness-Loe plaque index and Green-Vermillion calculus index were recorded for both groups. Data were analyzed by Chi-square, Fisher's Exact test, T-student and Two-way ANOVA. Results of this study showed that there were not any significant differences between case and control groups in amount of plaque and dental calculus P=0.79. Patients with nephrolithiasis are not more susceptible to calculus formation

[ evaluation of periodontium in patient's with spastic parapareseis related to HTLVI virus]

HTLVI virus is one of human's retroviruses which is the cause of T Lymphocytes Leukemia and spastic parpareseis or HTLVI associated myelopathy and some other inflammatory diseases, in some patients. Regarding that HTLVI is an endemic virus in Khorasan and the lack of studies and researches about its intraoral clinical signs, we decided to study periodontal status in patients with HTLVI associated Spastic Paraparesis. This was a case- control study with easy sampling that performed on about 30 patients [10 men and 20 women] with the mean age of 42 years in Mashhad dental school in 2004. Patients, whose HTLV1 involvement had been proved, took part in this study. Patients were chosen among people refered to neurology Department of Mashhad Ghaem hospital. Periodontal state, gingival disease, pocket depth, presence of leukoplakia, gingival linear erythema, candida infection, ANUG, NUP, were studied and three indices including Debris, Calculus Index [Green and Vermelion] and Gingival Index [Loe and silness] were recorded. In the view of Debris, Calculus and gingival indices, there were significant differences between control and case groups but there were no significant differences between two groups in pocket depth, leukoplakia, candida infection, ANUG and NUP. The patients with HAM/TSP have higher plaque, calculus and inflammation, compered to the healthy individuals. To eliminate Plaque and prevent of gingival disease, good oral hygiene is recommended