title: Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients.
abstract: OBJECTIVE
  Solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients are at risk of several diseases, principally attributable to immunosuppression. This global overview of SOT/HSCT-associated orofacial diseases is aimed at providing a practical instrument for the oral healthcare management of SOT/HSCT recipients.
  
  
  METHODS
  Literature search was made through MEDLINE. The associations between orofacial diseases and SOT/HSCT were assessed using observational studies and case series and were classified into 'association', 'no association', and 'unclear association'.
  
  
  RESULTS
  Lip/oral cancers, drug-induced gingival overgrowth (DIGO), infections, including hairy leukoplakia and, less frequently, post-transplantation lymphoproliferative disorders (PTLDs) and oral lichenoid lesions of graft-versus-host disease (GVHD), were associated with SOT. Lip/oral cancers, GVHD, mucositis, DIGO, infections and, less frequently, PTLDs were associated with HSCT. Associations of orofacial granulomatosis-like lesions and oral mucosa-associated lymphoid tissue-type lymphoma with SOT, and of pyogenic granuloma and hairy leukoplakia with HSCT were unclear. Periodontal disease and dental caries were not associated with SOT/HSCT. For none of the local treatments was there a strong evidence of effectiveness.
  
  
  CONCLUSIONS
  Solid organ transplant/HSCT recipients are at risk of orofacial diseases. Adequate management of these patients alleviates local symptoms responsible for impaired eating, helps prevent systemic and lethal complications, and helps where dental healthcare has been neglected.
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy. stefano.petti@uniroma1.it
authors.forename: S
authors.initials: S
authors.lastname: Petti
authors.forename: A
authors.initials: A
authors.lastname: Polimeni
authors.forename: P B
authors.initials: PB
authors.lastname: Berloco
authors.forename: C
authors.initials: C
authors.lastname: Scully
mesh_terms: D019214:Gingival Overgrowth / Q000209:etiology; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D017733:Leukoplakia, Hairy / Q000209:etiology; D009059:Mouth Diseases / Q000209:etiology*; D009062:Mouth Neoplasms / Q000209:etiology; D016377:Organ Transplantation; D011183:Postoperative Complications; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents