بازسازی دهانی در بیمار مبتلا به بیماری پیوند علیه میزبان مزمن

Introduction: The graft-versus-host disease (GVHD) is an immune-mediated response that occurs after allogenic hematopoietic cell transplantation (alloHCT) in an immunocompromised host. GVHD patients have wide spectrum of complications including microstomia, xerostomia, reduced manual dexterity, progressive scleroderma, reduced retention and stabilization of complete denture. As result of these oral complications, usage of conventional dentures may become almost impossible and dental implant reconstruction could be indicated.• Case report: 35 Y/o male patient developed Chronic GVHD (cGVHD) years after undergoing alloHCT for acute myeloid lymphoma. He experienced liver enzymes elevation, systemic sclerosis, dyspigmentation, alopecia, poikiloderma, joint stiffness, nail dystrophy, xerophthalmia, entropion eyelid resulting in trichiasis and corneal perforation. All of his remaining teeth were in hopeless condition and were extracted. Due to reduction of vestibular depth, mouth opening restriction, xerostomia, short vertical dimension of occlusion and progressive scleroderma, the patient was not able to use his complete denture. Accordingly, dental implants were placed in his mandibular bone, ossteointegration of the implants was approved after months and porcelain fused to metal bridges were placed. He was followed up for two years. The clinical examination and radiographic findings showed sufficient osteointegration in the area of implant reconstruction. He underwent another surgical procedure for placement of endosseous root form implants in maxilla and fabrication of implant supported overdenture .The patient is in remission of cGVHD following years of alloHCT. However, he is under careful medical and dental care and is scheduled for every month routine recall appointments and professional dental implant cleaning.• Conclusion:This case illustrated that implant rehabilitation might be indicated in patients with cGVHD that are not able to use conventional dentures because of their oral complications. More studies and long-term follow-up periods are necessary to validate this treatment plan in patients with cGVHD.

کلیدواژه ها:

Scleroderma ، Graft vs Host Disease ، Dental Implants ، Cell Transplantation