Palabras clave
Tratamiento multidisciplinario odontología-oncología
Cómo citar
Tratamiento odontológico integral del paciente oncológico.: Parte I. (2019). Odontoestomatología, 13(17), 14-25. https://www.odon.edu.uy/ojs/index.php/ode/article/view/152
Resumen
El tratamiento odontológico del paciente oncológico es quizás uno de los mayores desafíos a los que se puede enfrentar el odontólogo, ya que ésta es una situación muy compleja, que requiere de una atención meticulosa, integral, ordenada y coordinada con la participación de un equipo multidisciplinario, cuya meta es la curación completa del paciente y con la menor cantidad posible de secuelas que causa la terapia oncológica. Para llegar a esta meta se debe seguir un protocolo de atención odontológica que se dividirá en tres etapas: pre, intra y post terapia oncológica que abarcan diversos tratamientos. Este trabajo está dirigido al odontólogo general, que muchas veces es el encargado de realizar algunos o la totalidad de estos tratamientos debido a que el paciente vive lejos del centro hospitalario y sólo acude a él para realizar el tratamiento oncológico específico. En este trabajo se describirán las patologías generadas por la terapia oncológica, como prevenirlas y tratarlas.
Referencias
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Gay Escoda C, Berini Aytés L, Sánchez Garcés Mª, Osteorradionecrosis. En:Gay Escoda C, Berini Aytés L. Cirugía Bucal. !ed. Madrid: Ediciones Ergón, 1999. 731-748.
Vassallo J A, Barrios E. Actualización ponderada de los factores de riesgo del cáncer. Las localizaciones de la enfermedad en el Uruguay, su distribución por incidencia y mortalidad. Comisión honoraria de lucha contra el cáncer. Uruguay. 2003. 11-13.
Vassallo J A, Barrios E. III Atlas de mortalidad por cáncer en el Uruguay. Comparación de dos quinquenios, 1994-1998 y 19992003. Comisión Honoraria de lucha contra el cáncer. Uruguay. 2005.
Barasch A, Peterson D E Risk factors for ulcerative oral mucositis in cancer patients: unanswered questions. Oral Oncol. 2003. 39 (2): 91-100.
De Vita Jr V T, Hellman S. Rosenberg, S. A. Cancer. Principles & practice of oncology. 5th. Lippincott-Raven Publishers. 1997.
Langdon J D, Henk J M Malignant tumours of the mouth, jaws et salivary glands. 2nd. England. Edward Arnold Editors. 1995.
Mealey B L, Semba, S E Hallmon W W. Dentistry and the cancer patient: Part 1-Oral manifestations and complications of chemotherapy. Compend. 1994. 15 (10): 12521261.
Rosenthal D I, Trotti A. Strategies for managing radiation-induced mucositis in head and neck cancer. Nat. Rev. Cancer. 2009. 19 (1):29-34.
Regezi J A, Sciubba, J J Patología bucal. Correlaciones clinicopatológicas. 3ª Edición. México. Mc Graw-Hill Interamericana. 2006.
Woo S B, Matin K, Off-site dental evaluation program for prospective bone marrow transplant recipients. I am dent assoc 1997; 128 (2): 189-193.
Silverman S Jr. Oral cancer: Complications of therapy. Oral Surg., Oral Med., Oral Pathol., Oral Radiol., Endod. 1999. 88 (2): 122-126.
Demarosi F, Bez C, Carrassi A. Prevenzione e trattamento della mucosite orale da chemio e radioterapia. Minerva Stomatol. 2002, 51 (5): 173-186.
Semba S E, Mealey B L, Hallmon W W. Dentistry and the cancer patient: Part 2-Oral health management of the chemotherapy patient. Compend. 1994. 15 (1): 1378-1387.
Akintoye S O, Brennan M T, Graber C J, et al. A retrospective investigation of advanced periodontal disease as a risk factor for septicaemia in hematopoietic stem cell and bone marrow transplant recipients. Oral Surg,Oral Med, Oral Pathol, Oral Radiol, Endod. 2002. 94 (5) p : 581- 588.
Lalla R V, Sonis S T, Peterson D E. Management of oral mucositis in patients who have cancer. Dent. Clin. North Am. 2008. 52 (1): 61-77.
Rubenstein E B, Peterson D E, Schubert M et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 2004. 100:2026-46.
Epstein J B, Vickars L, Spinelli J, et al. Efficacy of chlorhexidine and nystatin rinses in prevention of oral complications in leukemia and bone marrow transplantation. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 1992, 73 (6): 682-689.
Epstein, J B, Schubert M M. Orophryngeal mucositis in cancer therapy. Review of patho-genesis, diagnosis and management. Oncology. 2003; 17:1767-1779.
Peterson D E, Lalla R V. Oral mucositis: the new paradigms. Curr. Opin. Oncol. 2010. 22 (4): 318-22.
Garfunkel A A. Oral mucositis. Th e search for a solution. N. Eng. J. Med. 2004. 351 (25), 2649-2651
Peterson D E, Bensadoun R J, Roila F, et al. Management of oral and gastrointestinal mucositis: ESMO clinical recommendations. Ann. Oncol. 2009. (Suppl 4): 174-7.
Robbins S L, Cotran R S. Patología estructural y funcional. 7ª Ed. Barcelona: Elsevier. 2005.
Peterson D E, Barker N P, Akhmadullina L I, et al. Phase II, randomized, double-blind, placebo-controlled study of recombinant human intestinal trefoil factor oral spray for prevention of oral mucositis in patients with colorectal cancer who are receiving fl uorouracil-based chemotherapy. J. Clin. Oncol. 2009. 27 (26): 4333-8.
Vera-Llonch M, Oster G, Hagiwara M, et al. Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Risk factors and clinical consequences. Cancer. 2006. 106 (2): 329-336.
Lugliè P F, Mura G, Mura A, et al. Prevenzione delle paradontopatie e delle stomatomuco siti in corso di chemoterapia antineoplastica. Studio clinico. Minerva Stomatol. 2002, 51 (6): 231-239.
Clarkson J E, Worthington H V, Furness S et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cancer. 2010, 4(8): 15-19.
Spielberger R, Stiff P, Bensinger W, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 2004, 351(25): 2590- 2598.
Epstein J B. Mucositis in the cancer patient and immunosuppressed host. Infect Dis. Clin North Am. 2007; 21(2): 503-522.
Schmid I, Schmitt M, Streiter M, et al. Parenteral nutrition is not superior to replacement fluid therapy for the supportive treatment of chemotherapy induced oral mucositis in children. Eur J Cancer. 2006. 42 (2):205-211.
Jones L R, Torth B B, Keene H J. Eff ects of total body irradiation on salivary gland function and caries-associated oral microfl ora in bone marrow transplant patients. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 1992. 73 (6): 670-676.
Napeñas J J, Brennan M T, Mougeot F K, et al. Relationship between mucositis and changes in oral microfl ora during cancer chemotherapy. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 2007; 103(1): 48-59.
Gay Escoda C, Berini Aytés L, Sánchez Garcés Mª, Osteorradionecrosis. En:Gay Escoda C, Berini Aytés L. Cirugía Bucal. !ed. Madrid: Ediciones Ergón, 1999. 731-748.
Vassallo J A, Barrios E. Actualización ponderada de los factores de riesgo del cáncer. Las localizaciones de la enfermedad en el Uruguay, su distribución por incidencia y mortalidad. Comisión honoraria de lucha contra el cáncer. Uruguay. 2003. 11-13.
Vassallo J A, Barrios E. III Atlas de mortalidad por cáncer en el Uruguay. Comparación de dos quinquenios, 1994-1998 y 19992003. Comisión Honoraria de lucha contra el cáncer. Uruguay. 2005.
Barasch A, Peterson D E Risk factors for ulcerative oral mucositis in cancer patients: unanswered questions. Oral Oncol. 2003. 39 (2): 91-100.
De Vita Jr V T, Hellman S. Rosenberg, S. A. Cancer. Principles & practice of oncology. 5th. Lippincott-Raven Publishers. 1997.
Langdon J D, Henk J M Malignant tumours of the mouth, jaws et salivary glands. 2nd. England. Edward Arnold Editors. 1995.
Mealey B L, Semba, S E Hallmon W W. Dentistry and the cancer patient: Part 1-Oral manifestations and complications of chemotherapy. Compend. 1994. 15 (10): 12521261.
Rosenthal D I, Trotti A. Strategies for managing radiation-induced mucositis in head and neck cancer. Nat. Rev. Cancer. 2009. 19 (1):29-34.
Regezi J A, Sciubba, J J Patología bucal. Correlaciones clinicopatológicas. 3ª Edición. México. Mc Graw-Hill Interamericana. 2006.
Woo S B, Matin K, Off-site dental evaluation program for prospective bone marrow transplant recipients. I am dent assoc 1997; 128 (2): 189-193.
Silverman S Jr. Oral cancer: Complications of therapy. Oral Surg., Oral Med., Oral Pathol., Oral Radiol., Endod. 1999. 88 (2): 122-126.
Demarosi F, Bez C, Carrassi A. Prevenzione e trattamento della mucosite orale da chemio e radioterapia. Minerva Stomatol. 2002, 51 (5): 173-186.
Semba S E, Mealey B L, Hallmon W W. Dentistry and the cancer patient: Part 2-Oral health management of the chemotherapy patient. Compend. 1994. 15 (1): 1378-1387.
Akintoye S O, Brennan M T, Graber C J, et al. A retrospective investigation of advanced periodontal disease as a risk factor for septicaemia in hematopoietic stem cell and bone marrow transplant recipients. Oral Surg,Oral Med, Oral Pathol, Oral Radiol, Endod. 2002. 94 (5) p : 581- 588.
Lalla R V, Sonis S T, Peterson D E. Management of oral mucositis in patients who have cancer. Dent. Clin. North Am. 2008. 52 (1): 61-77.
Rubenstein E B, Peterson D E, Schubert M et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 2004. 100:2026-46.
Epstein J B, Vickars L, Spinelli J, et al. Efficacy of chlorhexidine and nystatin rinses in prevention of oral complications in leukemia and bone marrow transplantation. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 1992, 73 (6): 682-689.
Epstein, J B, Schubert M M. Orophryngeal mucositis in cancer therapy. Review of patho-genesis, diagnosis and management. Oncology. 2003; 17:1767-1779.
Peterson D E, Lalla R V. Oral mucositis: the new paradigms. Curr. Opin. Oncol. 2010. 22 (4): 318-22.
Garfunkel A A. Oral mucositis. Th e search for a solution. N. Eng. J. Med. 2004. 351 (25), 2649-2651
Peterson D E, Bensadoun R J, Roila F, et al. Management of oral and gastrointestinal mucositis: ESMO clinical recommendations. Ann. Oncol. 2009. (Suppl 4): 174-7.
Robbins S L, Cotran R S. Patología estructural y funcional. 7ª Ed. Barcelona: Elsevier. 2005.
Peterson D E, Barker N P, Akhmadullina L I, et al. Phase II, randomized, double-blind, placebo-controlled study of recombinant human intestinal trefoil factor oral spray for prevention of oral mucositis in patients with colorectal cancer who are receiving fl uorouracil-based chemotherapy. J. Clin. Oncol. 2009. 27 (26): 4333-8.
Vera-Llonch M, Oster G, Hagiwara M, et al. Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Risk factors and clinical consequences. Cancer. 2006. 106 (2): 329-336.
Lugliè P F, Mura G, Mura A, et al. Prevenzione delle paradontopatie e delle stomatomuco siti in corso di chemoterapia antineoplastica. Studio clinico. Minerva Stomatol. 2002, 51 (6): 231-239.
Clarkson J E, Worthington H V, Furness S et al. Interventions for treating oral mucositis for patients with cancer receiving treatment. Cancer. 2010, 4(8): 15-19.
Spielberger R, Stiff P, Bensinger W, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 2004, 351(25): 2590- 2598.
Epstein J B. Mucositis in the cancer patient and immunosuppressed host. Infect Dis. Clin North Am. 2007; 21(2): 503-522.
Schmid I, Schmitt M, Streiter M, et al. Parenteral nutrition is not superior to replacement fluid therapy for the supportive treatment of chemotherapy induced oral mucositis in children. Eur J Cancer. 2006. 42 (2):205-211.
Jones L R, Torth B B, Keene H J. Eff ects of total body irradiation on salivary gland function and caries-associated oral microfl ora in bone marrow transplant patients. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 1992. 73 (6): 670-676.
Napeñas J J, Brennan M T, Mougeot F K, et al. Relationship between mucositis and changes in oral microfl ora during cancer chemotherapy. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 2007; 103(1): 48-59.