Faculty Bibliography

This case report describes the periodontal management of a patient with end-stage liver disease undergoing liver transplantation. In the first part of this article, all medical and dental findings are reported to elaborate adequate diagnoses. A patient-specific treatment plan was structured given the challenging periodontal and systemic scenarios. The second part describes the periodontal therapy delivered in close interaction with the referring physicians. Last, the article reviews current principles and protocols in managing these patients.

The authors present a case study of a 13-year-old female with a past medical history of tuberous sclerosis complex (TSC), an autosomal dominant disorder. It usually presents with a triad of epilepsy, mental deficiency and facial angiofibromas that are often distributed around the nose, cheek and chin, and are frequently shaped like butterfly wings. In addition, oral manifestations include gingival enlargement and developmental enamel pitting on the facial aspect of the anterior permanent dentition in 50% to 100% of patients. The patient's chief complaint was gingival enlargement and gingival bleeding. The histology of the excised gingival tissue revealed epithelial and fibrous hyperplasia, consistent with TSC.

Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.

Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.

Communication between the organ transplant team and dentist is important in formulating individualized care plans to reduce the incidence of pre- and post-transplant complications. Periodontal diseases and other oral infections may present serious risks that could compromise the success of a solid organ transplant. This article reviews why dentistry is an important component of total transplant care while the patient is on the waiting list for a transplant and after the transplantation. Recommendations regarding the care of the organ transplant patient are given.

Oral sores can occur anywhere in the oral cavity and oropharyngeal region. Since not all oral sores are benign, a careful differential diagnosis is important. The two most common types are canker sores (recurrent aphthous stomatitis) and cold sores (herpetic lesions). Early intervention is important with both. The pharmacist will most likely be the primary source for recommending medications (e.g., topical corticosteroids, oral and topical antivirals) for the treatment of these conditions

The choice of treatment for head and neck cancer usually depends on the origin and stage. The majority of patients undergo radiation therapy or surgery, or a combination of both, and caring for individuals undergoing radiotherapy involves multifaceted management. Counseling patients before, during, and after head and neck radiotherapy is important to help them become aware of several oral complications that may be severe and may interfere with everyday living. The pharmacist's role is to help lessen oral discomfort and morbidity in this population. The three major types of treatment for managing head and neck cancer are radiation therapy, surgery, and chemotherapy.1 The majority of patients undergo radiation therapy or surgery, or a combination of both. Chemotherapy is usually used as a supplement to the above treatments. Combining chemotherapy and radiotherapy does not improve long-term survival rates over those achieved by radiotherapy and surgery. The choice of treatment usually depends on the origin and stage of the head and neck cancer. Approximately 50,000 new head and neck cancers are diagnosed annually in the United States, and there are about 350,000 deaths yearly worldwide. Most head and neck cancer starts in the squamous cells of the mucosal tissue that lines the head and neck region, such as the tonsils and tongue. Squamous cell carcinoma represents more than 90% of all head and neck cancers. Head and neck cancer can occur anywhere in the head and neck region, and radiation therapy to this area usually results in numerous oral adverse effects that require additional palliative treatment to alleviate these troublesome symptoms