Evaluation of the prevalence of periodontal disease as a non-classical risk factor in the group of patients undergoing hip and/or knee arthroplasty

Adamkiewicz, Karolina; Płatek, Anna E.; Łęgosz, Paweł; Czerniuk, Maciej R.; Małdyk, Paweł; Szymański, Filip M.

doi:10.5603/kp.a2017.0263

Cited by 9 publications

(26 citation statements)

References 9 publications

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“…Only a few studies have examined dental pathology in patients planning to have a hip or knee arthroplasty. These studies have found that 23% of patients required treatment for dental infection or caries (8), 12% had an infection requiring root canal treatment or tooth extraction (9), and 29% had clinically significant periodontal disease (10). Periodontal health has been shown to affect the incidence of daily oral bacteremia, and infection incorporating the entire periodontium is equivalent to a wound area of 20 cm 2 (11, 12).…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for dental pathology in patients planned for elective total hip or knee arthroplasty

et al. 2018

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Background and Aims: To prevent severe prosthetic joint infections, a dental examination is usually recommended prior to arthroplasty, even sometimes regarded resource- and time-consuming. The aim of this study was to determine whether a risk factor-based algorithm could be created to send only selected patients for dental clearance. Materials and Methods: A prospective study of 952 patients scheduled for elective arthroplasty was performed. Patients filled out a questionnaire regarding potential risk factors for dental infections, and dentists documented patients’ oral health and interventions performed (data available for 731 patients). Results: Of the patients, 215 (29.4%) failed dental clearance; a total of 432 teeth were extracted, 32 patients (4.4%) required root canal treatment, and 37 patients (5.1%) had severe periodontitis. Independent risk factors for failure were history of root canal treatment (odds ratio: 2.282, 95% confidence interval: 1.346–3.869, p = 0.020), use of tobacco products (odds ratio: 1.704, 95% confidence interval: 1.033–2.810, p = 0.037), dental visit indicated by oral symptoms within 3 months (odds ratio: 1.828, 95% confidence interval: 1.183–2.827, p = 0.007), or visit to a dentist within 6 months (odds ratio: 1.538, 95% confidence interval: 1.063–2.224, p = 0.022). Regular dental examination was a preventive factor (odds ratio: 0.519, 95% confidence interval: 0.349–0.773, p = 0.001). However, based on the examined risk factors, no sufficiently large group of patients at lesser risk for dental infections could be identified. Conclusion: Because of the high need for dental care revealed by our unselected patient population, the inspection and treatment of dental pathology of all patients are important interventions prior to elective arthroplasty.

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Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for dental pathology in patients planned for elective total hip or knee arthroplasty

et al. 2018

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“…Eight studies were included[12-19]. Of the 8, 7 (86%) included a dental evaluation performed by a dental professional[12-14,16-19] and five utilized questionnaires or interviews (71%)[13-17]. One paper used a questionnaire alone[15].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies focused on the prevalence of dental pathology and/or dental hygiene practices in patients to undergo TJA (Table 3)[12-15]. Adamkiewicz et al[12] had dental evaluations performed on patients admitted for TJA preoperative workup in Poland. They found that 28.5% had clinically significant periodontal disease.…”

Section: Resultsmentioning

confidence: 99%

“…When compared by region, TJA patients in American tertiary care centers had failure rates from 8.8% to 23%[13,16]. This is moderately higher than failure rates in Poland (28.5%)[12] and Finland (29.4%)[14]. However, it is difficult to pool data do to differences in baseline patient population oral health status and variation in dental evaluation practice.…”

Section: Discussionmentioning

confidence: 99%

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Impact of dental clearance on total joint arthroplasty: A systematic review

Frey¹,

Navarro²,

Blackwell³

et al. 2019

WJO

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Many orthopedic surgeons require that their patients obtain dental clearance before elective total joint arthroplasty (TJA). However, there is no consensus substantiating the practice. To this end, a systematic review on the prevalence of dental pathology in TJA patients, risk factors for failing dental screening, and impact of dental evaluations was performed. Literature was sourced from PubMed and Scopus databases. Six papers were sourced from the initial search, one study was extracted from the references of the original six manuscripts, and one new publication was retrieved from a second search conducted after the first. The prevalence of dental pathology ranged from 8.8% to 29.4% across studies. Two of four papers reported lower than average or improvements in post-operative infection with pre-operative dental evaluations while two found no such association. There is insufficient evidence to support universal dental clearance before TJA.

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“…Periodontal disease has also been identified as a non-classical risk factor that is highly prevalent in general population and especially significant in patients undergoing knee and hip replacement surgery [8]. It is hypothesised to contribute to cardiovascular risk through bacteria activating host inflammatory responses that can lead to systemic inflammation [9].…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein levels as a cardiovascular risk factor in patients with and without periodontal disease who are undergoing hip and/or knee arthroplasty

Evaluation of the prevalence of periodontal disease as a non-classical risk factor in the group of patients undergoing hip and/or knee arthroplasty

Abstract: In conclusion, periodontal diseases are highly prevalent in patients undergoing hip and/or knee replacement surgery. The presence of the periodontal disease is possibly associated with a worse prognosis and should be treated.

Cited by 9 publications

References 9 publications

Incidence and risk factors for dental pathology in patients planned for elective total hip or knee arthroplasty

Incidence and risk factors for dental pathology in patients planned for elective total hip or knee arthroplasty

Impact of dental clearance on total joint arthroplasty: A systematic review

C-reactive protein levels as a cardiovascular risk factor in patients with and without periodontal disease who are undergoing hip and/or knee arthroplasty

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