Granulomatosis with Poliangeitis (Wegener's Granulomatosis): Orofacial Manifestations. Systematic Review and Case Report.

PURPOSE: To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity. MATERIALS AND METHODS: A bibliographic search was performed on Pubmed with the keywords 'Wegener's granulomatosis', 'etiology', 'oral manifestations', 'oral cavity', 'gingiva'. The inclusion criteria were papers published in English in the last 10 years that made reference to clinical cases with in which the oral cavity was affected. The quality of the results was assessed with 'The 2013 Care Checklist'. RESULTS: Nineteen clinical cases were analysed. The average quality was 7.68/13 (range 5-10/13). 73.7% of patients were women, the most frequent area for the lesions was the gingiva and the most prevalent lesion was gingival hyperplasia. 68.4% of the patients had this lesion as a first sign, 21.1% as a progression and 10.5% as a recurrence. 68.4% of the lesions resolved once medical treatment was established. CONCLUSION: GPA is a multisystem disorder associated with considerable morbidity and mortality if not treated. Early diagnosis improves the prognosis. The first manifestation of the disease can be seen in the oral cavity. It is important that dentists recognise the oral manifestation in order to improve the prognosis. Key words: granulomatosis, polyangiiitis, Wegener's granulomatosis.

Manejo odontológico del paciente con EPOC / Dental management of the patient with COPD

El objetivo de este trabajo es revisar la literatura científica disponible sobre las consideraciones odotológicas y las manifestaciones orales que pueden presentar los pacientes con EPOC. Para ello se revisaron los artículos disponibles en Pubmed. De los resultados destacamos que los principales factores de riesgo de la EPOC son el tabaco y la edad. En España se prevé un aumento de pacientes con EPOC debido al envejecimiento paulatino de la población. En la práctica odontológica hay un promedio de 130 pacientes con EPOC de cada 2.000 pacientes que acuden a la consulta. El dentista debe llevar a cabo el tratamiento odontológico siguiendo las consideraciones pre, intra y postoperatorias propuestas para los pacientes con EPOC, e identificar aquellos que son inestables para posponer la cita o considerar su hospitalización. Las lesiones orales más frecuentes son la enfermedad periodontal, xerostomía, caries, y erosiones del esmalte. Conclusiones: Dada la alta prevalencia de la EPOC es necesario tener en cuenta ciertas precauciones a la hora de realizar el tratamiento dental y las contraindicaciones farmacológicas en estos pacientes. El dentista debe estar familiarizado con esta enfermedad y promover la salud oral en estos pacientes

The aim purpose of this work was to review the available scientific literature on the odontologic considerations and oral lesions that can present a patient with COPD. In order to do so, the available articles were checked in Pubmed. The principal risk factors for COPD include smoking and age. In Spain, an increase in the number of patients with COPD is expected due to the gradual aging of the population. In dental practice there is an average of 130 patients with COPD out of every 2000 patients who come to the dental clinic. The dentist must carry out the dental treatment following the considerations proposed for patients with COPD and identify the unstable patients to postpone the dental appointment or consider their hospitalization. The most frequent oral lesions are periodontal disease, xerostomia, caries and enamel erosions. Conclusions: Given the high prevalence of COPD, it is necessary to take into account certain precautions when performing dental treatment and pharmacological contraindications in these patients. The dentist should be familiar with this illness and promote the oral health in these patients

Manejo y consideraciones clínicas de los pacientes asmáticos en la consulta dental / Management and clinical considerations of the asthmatic patients in the dental practice

El objetivo de este trabajo es revisar la literatura científica disponible sobre las consideraciones odontológicas y las manifestaciones orales que pueden presentar los pacientes asmáticos. Se han revisado 34 artículos publicados entre los años 2001 y 2018. En función de su fisiopatología hay 5 tipos de asma, y clínicamente se clasifica en leve, moderada y grave. Entre los factores de riesgo destacan el tabaco, obesidad, genética, factores socioeconómicos y exposición a ciertas sustancias. El tratamiento de elección se basa en los broncodilatadores y glucocorticoides inhalados. Esta medicación disminuye la cantidad de flujo y el pH salival. Por este motivo la cavidad oral es más susceptible de desarrollar patologías como caries, enfermedad periodontal y candidiasis oral. Concluimos que, dada la alta prevalencia del asma, es necesario que el odontólogo tenga en cuenta las consideraciones pre, intra y postoperatorias propuestas para los pacientes asmáticos, y evite los fármacos que puedan precipitar un ataque. El dentista debe estar familiarizado con esta enfermedad, y promover la salud oral en estos pacientes

The purpose of this work is to review the available scientific literature on the dental considerations and the oral manifestations that may present asthmatic patients. 34 articles published between 2001 and 2018 were reviewed. According to its pathophysiology, there are 5 types of asthma, and clinically, the asthma severity classification is divided into mild, moderate and severe. The principal risk factors for asthma include tobacco, obesity, genetics, socioeconomic factors and exposure to substances. The treatment of choice is based on inhaled bronchodilators and glucocorticoids. This medication decreases the amount of flow and salivary pH. For this reason, the oral cavity is more susceptible to developing pathologies such as caries, periodontal disease and oral candidiasis. Conclusions. Given the high prevalence of asthma, the dentist must carry out the dental treatment following the considerations proposed for patients with asthma and should know the pharmacological contraindications in these patients. The dentist should be familiar with this illness and promote the oral health in these patients