Principles governing the prosthodontic treatment of patients with cardiac transplants

Article Abstract:

Prosthodontic dentistry, that area of dentistry that has to do with dentures and crown and bridge work, must be practiced particularly carefully on people who have received heart transplants. Since 80 percent of transplant recipients now survive at least one year, with a survival rate of six years for patients who received transplants after 1978, there is a clear need for prosthodonture for these people. Routine dental treatment should be postponed until patients have achieved stable levels of immunosuppressants. Most organisms that cause terminal infections in transplant patients occur in the mouth, and the dentist should understand where specific organisms are likely to be found. Immunosuppressive drugs themselves cause changes in the mouth, such as gingival hyperplasia (enlargement of the gums) or perioral hyperesthesia (heightened sensitivity around the mouth). These are side effects of cyclosporin A, a drug commonly used following transplantation. Prophylactic use of antibiotics is usually recommended for transplant patients, but the possibility that patients will develop antibiotic-resistant strains of bacteria may be more important than the risk of infection. Steroid drugs, which transplant recipients usually receive, must be assessed to be sure they provide protection in case the patient suffers extreme stress due to dental phobia. Basic principles of dental management of immunosuppressed patients are provided, including consultation with physicians, strict adherence to infection control procedures, attention to the individual patient's medical status, and other guidelines. A case history is presented of a 58-year-old man who had received a heart transplant six months prior to his dental consultation. He received several crown restorations, dentures, and endodontic (tooth root and pulp) treatment. Instability in the patient's health forced the development of an alternative plan, focusing on areas of greatest need that could be treated quite rapidly. Results were good, and a more extensive plan was formulated when the patient's health became more stable. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Complications and side effects, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Immunosuppressive agents, Cardiac patients, Prosthodontics, Dental prostheses

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Using mineral trioxide aggregate as a pulp-capping material

Article Abstract:

An experimental material called mineral trioxide aggregate (MTA) appears to be superior to calcium hydroxide compounds when capping exposed tooth pulp. Researchers applied MTA or a calcium hydroxide preparation to 12 teeth with exposed pulp in 4 monkeys. After 5 months, 5 of 6 teeth capped with MTA had no evidence of inflammation and all 6 had developed a calcium bridge across the wound. All 6 teeth capped with calcium hydroxide were inflamed and only 2 had a calcium bridge. MTA is not water soluble and should not dissolve as calcium hydroxide preparations do.

Dental materials, Dental pulp

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Endodontic or dental implant therapy

Article Abstract:

Discussion on decision-making factors that aid in deciding whether to retain a tooth with pulpal or periapical disease through endodontic treatment or remove and replace it, is presented.

United States, Analysis, Endodontics, Pulpitis

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