Abstract
This paper describes a case in which dramatic improvement of severe gingival inflammation was achieved within a short time before pretransplant conditioning therapy in a patient scheduled to undergo hematopoietic stem cell transplantation. A 48-year-old female patient diagnosed as having acute myeloid leukemia (AML) had received hospital treatment for about six months. She had developed severe gingival inflammation and visited the dental department of the hospital. She received instructions to clean her oral cavity with mouthwash only, and not to use toothbrush. After a month, she was transferred to our hospital to receive hematopoietic stem cell transplantation, and was referred to our dental department for management of the severe gingival inflammation. We diagnosed her as having periodontitis associated with AML, with severe gingivitis caused by poor plaque control on account of fear of gingival bleeding. The initial treatments, including removal of subgingival plaques and necrotic debris, application of dental ointment containing minocycline hydrochloride, and use of a 3DS-retainer rapidly reduced her gingival inflammation and enabled her to brush her teeth again using a toothbrush. Then, we removed her subgingival calculi, which was followed by rapid improvement of her gingival condition. Since the serum CRP levels decreased significantly from 6.4 mg/dl to 1.3 mg/dl within 6 days of commencement of the treatment, she could receive pretransplant conditioning therapy for the hematologic malignancy. This case indicates the importance of proper oral management in AML patients with periodontitis.
Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 53(1) : 34-39,2011.
