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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Guidelines for screening, prevention, and management of late complications in patients with oral cGVHD

Guidelines for screening, prevention, and management of late complications in patients with oral cGVHD
Late complication Prevention Screening Management
Oral squamous cell carcinoma

Smoking cessation

Moderate alcohol consumption

Annual clinical examination

Biopsy of atypical/suspicious lesions
Referral to multidisciplinary head and neck oncology center
Rampant dental caries

Minimize intake of refined carbohydrates (especially sugar-containing soft drinks)

Brush at least twice daily, after eating when possible

Floss daily

Fluoride 1.1% gel paint on or in custom trays, daily

Remineralizing agent, apply with fluoride

Professional fluoride varnish application

Increased risk in patients with significant salivary gland cGVHD

Increased risk in patients with orofacial sclerotic cGVHD

Increased risk in patients were severe mucosal disease and avoidance of oral hygiene

Examine teeth for evidence of cervical demineralization/decay

Twice annual dental visits
  • Soft and hard tissue examination
  • Bitewing radiographs (annual)

Treat dental caries as soon as diagnosed

Careful follow-up for new or recurrent caries

Reinforce oral hygiene and dietary habits

Reinforce daily preventive measures
Fibrosis No known preventive measures

Ask patient if aware of tightness/limited opening

Extensive sclerotic skin disease, especially with neck involved

Examine for intraoral buccal fibrotic bands by palpation

Physical therapy

Intralesional steroid therapy

Surgery

Systemic therapy for systemic involvement
cGVHD: chronic graft versus host disease.
This research was originally published in Blood. Treister N, Duncan C, Cutler C, Lehmann L. How we treat oral chronic graft-versus-host disease. Blood 2012; 120:3407. Copyright © 2012 American Society of Hematology.
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