ABSTRACT
Immunotherapies, particularly therapeutic antibodies, are increasingly used in the treatment of many autoimmune or oncological diseases. Patients treated with therapeutic antibodies may present with an increased risk of infection or of osteonecrosis of the jaws (ONJ). There is currently no consensus on the management of patients treated with therapeutic antibodies. These treatments are mainly used in hospitals, but they have been increasingly prescribed in ambulatory treatment for patients undergoing oral care. It is therefore important to establish therapeutic precautions for these patients. We had for aim to describe these antibody therapies, their indications, their potentially adverse effects in the oral cavity and to review the latest recommendations.
Subject(s)
Antibodies/adverse effects , Immunotherapy/adverse effects , Oral Medicine/methods , Stomatognathic Diseases/etiology , Stomatognathic Diseases/therapy , Autoimmune Diseases/complications , Autoimmune Diseases/therapy , Humans , Immunotherapy/methods , Neoplasms/complications , Neoplasms/therapy , Practice Guidelines as Topic , Stomatognathic Diseases/diagnosisABSTRACT
For 15 years, the investigation of a relationship between periodontal diseases and complications of pregnancy is explored, and allowed the publication of conflicting results. This work is a literature review of articles of high level of evidence, which aims to clarify the impact of treatment of periodontal disease on pregnancy. Among the 15 selected randomized controlled trials (RCT), nine concluded a significant reduction in pregnancy complications between the "experimental" group treated and "control" group. However, six other RCT concluded that the lack of a significant difference between the two groups has higher levels and a more robust methodology. In 2006, a RCT, published in an influent medical journal, announced that there would be no significant benefit to treat pregnant women to reduce the complications of pregnancy. The contradictions found in the different studies have led some authors of meta-analysis to allocate the RCT per groups of power, based on their methodology. Meta-analysis using this methodology concluded that there is no benefit for periodontal treatment to reduce complications of pregnancy. In conclusion, the next RCT conducted should standardize their methodological criteria, and preferably multicenter, including a large number of participants. In addition, a more precise definition of periodontal diseases for the purpose of research is necessary. Finally, the notion of success or failure of periodontal treatment must be considered.
