Hematopoietic stem cell transplantation (HSCT) involves the administration of anticancer treatment at high doses that exceed the patient’s maximum required dose for total body irradiation, to eliminate malignancy and achieve myeloablation. Hematopoietic stem cells are then transfused to re-establish the lost hematopoietic function. The use of radiation, anticancer drugs, and immunosuppressive drugs can cause adverse events in the oral cavity such as mucositis, bleeding, opportunistic infections, and graft versus host disease. This collaborative report by the departments of hematology and oncology as well as dentistry and oral surgery at our institution discusses the perioperative oral functional management of patients undergoing HSCT. Subjects enrolled were 191 transplantation patients (52 autologous, 139 allogeneic) between 2008 and 2015. The subjects underwent professional tooth cleaning before commencing a transplant conditioning regimen. When the professional oral health care (POHC) treatment was completed, professional tooth cleaning (PTC), professional mechanical tooth cleaning (PMTC), and treatment with a dental drug delivery (3DS) system were provided. This perioperative oral functional management resulted in a decrease in the frequency of oropharyngeal candidiasis from 19.3% to 4.3%. We devised a standardized supportive oral care program from the preoperative period onward to minimize adverse oral events associated with HSCT. The program could effectively improve the quality of life of patients undergoing HSCT.

It has been reported that mucosal defects in the oral cavity caused by resection at a surgical site can be successfully repaired using a polyglycolic acid sheet, an absorbable artificial biomaterial, and fibrin glue spray. We report our experience of a case where bone surface coverage with a polyglycolic acid sheet and fibrin glue after exposure following resection of maxillary gingival leukoplakia led to a good outcome. The patient was a 64-year-old man with a keratotic white lesion on the right maxillary gingiva measuring 22 × 10 mm. He underwent resection of the lesion, which was diagnosed as maxillary gingival leukoplakia. The bone surface was exposed because of the operative extent and was covered with a polyglycolic acid sheet and fibrin glue. Wound healing progressed, and normal mucous membrane was seen at 5 weeks postoperatively. No relapse has occurred, and his progress is satisfactory.