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Avalia??o cl?nica e microbiol?gica das condi??es de sa?de oral dos receptores de transplante renal do Hospital Universit?rio Onofre Lopes, Natal RN / Evaluation clinical and microbiological of oral health conditions in renal transplant recipients of Onofre Lopes University Hospital, Natal RN

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Previous issue date: 2009-03-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant / Introdu??o: A imunossupress?o cr?nica propicia o desenvolvimento de altera??es na cavidade oral de receptores de transplante renal (RTR), no entanto com exce??o do crescimento gengival, pouco se conhece em rela??o ? preval?ncia de les?es orais nessa popula??o. Objetivo: Avaliar a preval?ncia das condi??es cl?nicas e microbiol?gicas da cavidade oral dos receptores de transplante renal e os fatores associados. M?todos: tratou-se de um estudo seccional em que se examinou clinicamente 96 RTR e experimental onde se coletou saliva estimulada dos mesmos para identifica??o de Candida sp. A coleta dos dados foi realizada atrav?s de anamese e exame cl?nico dos pacientes, constando informa??es s?cio-demogr?ficas, aspectos cl?nicos do transplante, avalia??o estomatol?gica, condi??es de higiene oral e c?rie dent?ria, al?m de perguntas acerca do conhecimento das altera??es orais ap?s o transplante. Ap?s o exame, coletou-se saliva estimulada para identifica??o de Candida sp. Resultados: Do total, 66,7% dos RTR apresentaram algum tipo de manifesta??o oral. A mais freq?ente foi l?ngua saburrosa, seguida pelo crescimento gengival, estando ambas as manifesta??es bucais relacionadas ao sexo e ao uso concomitante de ciclosporina e nifedipina (p<0,05). O tacrolimus exibiu efeito protetor para o crescimento gengival (OR=0,13). A higiene oral esteve associada ? l?ngua saburrosa (p=0,03) e ? severidade do crescimento gengival (p=0,0001). Candid?ase oral foi diagnosticada em 17,7% dos pacientes e Candida albicans foi o isolado mais freq?ente na saliva dos RTR, com uma coloniza??o de 58,3%. O CPO-D m?dio aumentou com o avan?ar da idade. O m?todo de higiene oral mais usado era escova e creme dental para 61,5%. Altera??es na cavidade oral foi percebida por 54,2% dos RTR, citando como principais o crescimento gengival e as aftas. Instru??es de higiene oral ap?s o transplante foram negligenciadas para 61,5% dos RTR. Xerostomia e halitose foram relatadas em 30,2% e 36,5%, respectivamente. Conclus?es: Mais da metade dos receptores de transplante renal apresentaram pelo menos uma les?o de boca, as drogas imunossupressoras e higiene oral est?o relacionadas com essas altera??es. Estudos de coorte prospectivo s?o necess?rios para melhor elucidar a rela??o entre as manifesta??es orais e n?veis de droga e o risco das manifesta??es orais ocorrerem no decorrer do tempo. Os receptores de transplante renal mostraram-se conscientes das altera??es orais ocorridas ap?s o transplante e desinformados quanto ?s instru??es de higiene oral. No que diz respeito higiene, o ?ndice de c?rie foi considerado alto, condi??es de risco foram detectadas e melhorias na aten??o prim?ria devem ser refletidas e estimuladas no acompanhamento dos transplantados renais.

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13236
Date27 March 2009
CreatorsGondim, L?bia Augusta Maciel
ContributorsCPF:39817270459, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767285D3, Maciel, Shirley Suely Soares Veras, CPF:42637910453, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4773895T8, Oliveira, Patr?cia Teixeira de, CPF:70154422487, http://lattes.cnpq.br/4750650943248760, Ferreira, Maria ?ngela Fernandes
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, UFRN, BR, Ci?ncias da Sa?de
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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