title: Pulp Obliteration in a Patient with Sclerodermatous Chronic Graft-versus-Host Disease.
abstract: Dental pulp calcification is a common finding associated with localized dental trauma, genetic disorders, and systemic inflammatory diseases. Chronic graft-versus-host disease (cGVHD) is a frequent complication after allogeneic hematopoietic cell transplantation (allo-HCT) characterized by immune-mediated injury to the skin, mouth, eyes, liver, and other tissues, resulting in significant disability and reduced quality of life. We report a patient with sclerodermatous cGVHD who presented with general pulp calcification in all teeth 5 years after allo-HCT. A review of full mouth dental radiographs obtained just before allo-HCT revealed normal-appearing pulp chambers. Based on prior reports of generalized pulp calcification associated with progressive systemic sclerosis, we hypothesized that the etiology was likely related to the presence of cGVHD with associated vascular and fibrotic tissue changes within the pulp vasculature. Clinicians should consider cGVHD in the differential diagnosis of generalized pulp calcification.
authors.affiliation: Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil; Division of Oral Medicine and Dentistry, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts. Electronic address: camillabfgomes@hotmail.com.
authors.forename: Camilla Borges Ferreira
authors.initials: CB
authors.lastname: Gomes
authors.affiliation: Division of Oral Medicine and Dentistry, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Nathaniel Simon
authors.initials: NS
authors.lastname: Treister
authors.affiliation: Miller Lung Dental Group, South Attleboro, Massachusetts.
authors.forename: Brian
authors.initials: B
authors.lastname: Miller
authors.affiliation: Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Philippe
authors.initials: P
authors.lastname: Armand
authors.affiliation: Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts.
authors.forename: Bernard
authors.initials: B
authors.lastname: Friedland
mesh_terms: D002908:Chronic Disease; D003782:Dental Pulp / Q000473:pathology*; D004730:Endothelium, Vascular / Q000002:abnormalities; D006086:Graft vs Host Disease / Q000097:blood / Q000276:immunology / Q000473:pathology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000097:blood / Q000276:immunology / Q000473:pathology; D014074:Tooth Calcification
keywords: Allogeneic hematopoietic cell transplantation; dental pulp obliteration; oral chronic graft-versus-host disease; pulp calcification