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DRJ Dent Res J Dental Research Journal Dental Research Journal 1735-3327 2008-0255 Medknow Publications Pvt Ltd India DRJ-12-596 10.4103/1735-3327.170589 Letter to Editor Oral manifestations in liver transplant recipients Shanbhag Vagish-Kumar L Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India Address for correspondence:Vagish-Kumar Shanbhag, Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore - 575 018, Karnataka, India vagishkumar_12@rediffmail.com Nov–Dec 2015 12 6 596 596 Copyright: © Dental Research Journal 2015

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<p>Editor,</p> <p>The article "oral manifestation in transplant patients" was read with enthusiasm. <sup> <xref ref-type="bibr" rid="ref1">1</xref> </sup>However, the following points may be noted worthy. Fissured tongue, atrophy of tongue papillae, and angular cheilitis can be observed in liver transplant patients and these may be due to concurrent hyposalivation, due to intake of diuretic drugs such as thiazides and loop diuretics. <sup> <xref ref-type="bibr" rid="ref2">2</xref> </sup>, <sup> <xref ref-type="bibr" rid="ref3">3</xref> </sup>Excessive bleeding with serious complications are encountered in the liver transplant patients when they undergo simple procedures such as scaling, tooth extraction, minor periodontal surgery, and administration of local anesthetics. <sup> <xref ref-type="bibr" rid="ref4">4</xref> </sup>These patients exhibit hemostatic abnormalities such as prolonged prothrombin time, activated partial thromboplastin time; increased international normalized ratio and low platelet count. Primary wound closure, Vitamin K 10 mg intramuscularly, and use of topical thrombin and fibrin glue along with antifibrinolytic agents such as oxidized cellulose tranexamic acid and amino-caproic acid may be helpful to control oral bleeding due to dental procedures. <sup> <xref ref-type="bibr" rid="ref4">4</xref> </sup></p> <p>Financial support and sponsorship</p> <p>Nil.</p> <p>Conflicts of interest</p> <p>The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or non-financial in this article.</p> </sec> </body> <back> <ref-list> <ref id="ref1"> <label>1</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Nappalli</surname> <given-names>D</given-names> </name> <name> <surname>Lingappa</surname> <given-names>A</given-names> </name> </person-group> <article-title>Oral manifestations in transplant patients</article-title> <source>Dent Res J (Isfahan)</source> <year>2015</year> <volume>12</volume> <fpage>199</fpage> <lpage>208</lpage> </nlm-citation> </ref> <ref id="ref2"> <label>2</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Rojas</surname> <given-names>G</given-names> </name> <name> <surname>Bravo</surname> <given-names>L</given-names> </name> <name> <surname>Cordero</surname> <given-names>K</given-names> </name> <name> <surname>Sepúlveda</surname> <given-names>L</given-names> </name> <name> <surname>Elgueta</surname> <given-names>L</given-names> </name> <name> <surname>Díaz</surname> <given-names>JC</given-names> </name> <etal /> </person-group> <article-title>Integrity of the oral tissues in patients with solid-organ transplants</article-title> <source>J Transplant</source> <year>2012</year> <volume>2012</volume> <fpage>603769</fpage> </nlm-citation> </ref> <ref id="ref3"> <label>3</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Guggenheimer</surname> <given-names>J</given-names> </name> <name> <surname>Close</surname> <given-names>JM</given-names> </name> <name> <surname>Eghtesad</surname> <given-names>B</given-names> </name> <name> <surname>Shay</surname> <given-names>C</given-names> </name> </person-group> <article-title>Characteristics of oral abnormalities in liver transplant candidates</article-title> <source>Int J Organ Transplant Med</source> <year>2010</year> <volume>1</volume> <fpage>107</fpage> <lpage>13</lpage> </nlm-citation> </ref> <ref id="ref4"> <label>4</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Silva Santos</surname> <given-names>PS</given-names> </name> <name> <surname>Fernandes</surname> <given-names>KS</given-names> </name> <name> <surname>Gallottini</surname> <given-names>MH</given-names> </name> </person-group> <article-title>Assessment and management of oral health in liver transplant candidates</article-title> <source>J Appl Oral Sci</source> <year>2012</year> <volume>20</volume> <fpage>241</fpage> <lpage>5</lpage> </nlm-citation> </ref> <ref id="ref5"> <label>5</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"></person-group> <article-title></article-title> <source></source> <year></year> <volume></volume> <fpage></fpage> </nlm-citation> </ref> </ref-list> </back> </article>