title: cGVHD-Related Caries and Its Shared Features with Other 'Dry-Mouth'-Related Caries.
abstract: Several systemic diseases and their medical treatment may predispose the development of aggressive dental caries. Head and neck radiotherapy, chemotherapy, Sjögren's syndrome and long-standing treatment with drugs that induce hyposalivation are some of these conditions. The aim of this article is to describe the clinical features of five patients who developed chronic graft-versus-host-disease (cGVHD) as a complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and, in spite of close dental follow-up, subsequently developed rampant caries. In these cases, the restorations showed early failure and the caries still progressed until generalized teeth destruction. The majority of the teeth therefore had to be extracted due to advanced dental caries and rapid clinical progression. Herein the term "cGVHD-related caries" is proposed to describe this under-recognized complication of cancer treatment that may evolve in allo-HSCT recipients that develop cGVHD. This condition is poorly recognized in the literature and may represent the final result of the clustering of oral complications in cGVHD patients, including mucositis, oral pain, hyposalivation, taste loss and oral infections, leading to rampant caries due to impaired oral hygiene and increased intake of highly cariogenic food. Consequently, the knowledge of this oral complication should improve the medical and dental management of cGVHD oral manifestations and improve the quality of life of patients with this post allo-HSCT complication.
authors: Department of Oral Diagnosis, Semiology Area, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, BR.
authors: Alan Roger
authors: AR
authors: Santos-Silva
authors: Department of Oral Diagnosis, Semiology Area, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, BR.
authors: Patricia do Socorro Queiroz
authors: Pdo S
authors: Feio
authors: Department of Oral Diagnosis, Semiology Area, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, BR.
authors: Pablo Agustin
authors: PA
authors: Vargas
authors: BMT Unit, Hematology and Blood Transfusion Center (Hemocentro), Universidade Estadual de Campinas, Piracicaba, SP, BR.
authors: Maria Elvira Pizzigatti
authors: ME
authors: Correa
authors: Department of Oral Diagnosis, Semiology Area, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, BR.
authors: Marcio Ajudarte
authors: MA
authors: Lopes
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003731:Dental Caries / Q000150:complications*; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014987:Xerostomia / Q000150:complications*; D055815:Young Adult