A prospective study to evaluate a new dental management protocol before hematopoietic stem cell transplantation

Yamagata, Kenji; Onizawa, Kojiro; Yanagawa, Toru; Hasegawa, Yoshinori; Kojima, Hiroshi; Nagasawa, Toshiro; Yoshida, Hiroshi

doi:10.1038/sj.bmt.1705429

Cited by 73 publications

(105 citation statements)

References 23 publications

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“…93.6% of patients had signs of mucosal or dental disease at initial consultation; this included candidal infection, periodontal disease, caries and periapical pathology. The overall incidence of dental disease was similar to those described by Yamagata et al, 11 who examined a similar study population. The overall incidence of periodontal diseases (79.5%), ranging from gingivitis to periodontal pockets greater than 6 mm, was also similar.…”

Section: Discussionsupporting

confidence: 73%

“…Levels of caries and periapical pathology were lower than those described by other authors investigating populations of stem cell transplant recipients. 11,12 Reported dental attendance compares favourably with the fi gures quoted in the Adult Dental Health Survey (ADHS) 1998, with two-thirds of patients reporting regular attendance. 15 In the current study population, as in the 1998 ADHS, patients attending the dentist only with trouble had signifi cantly higher odds of having decayed or unrestorable teeth, 16 which would then be judged in this study to require extraction.…”

Section: Discussionsupporting

confidence: 48%

“…9,10 Yamagata et al 11 recently reported that 92.7% of 41 patients due to receive stem cell transplants presented with one or more dental diseases. Dental assessment prior to HSCT should aim to identify and treat current and potential sources of infection and trauma that may affect the patient in the immediate term.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dental assessment prior to stem cell transplant: treatment need and barriers to care

Durey¹,

Patterson

Gordon

2009

Br Dent J

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 48%

See 1 more Smart Citation

Dental assessment prior to stem cell transplant: treatment need and barriers to care

Durey¹,

Patterson

Gordon

2009

Br Dent J

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“…Panoramic radiographs of all the patients were taken. The caries, apical and marginal periodontitis, and impacted third molar were managed according to our previous reports, [11][12][13] and all the dental management was completed before hematopoietic SCT. The details of the treatment are as follows.…”

Section: Methodsmentioning

confidence: 99%

The effect of oral management on the severity of oral mucositis during hematopoietic SCT

Yamagata

Arai

Sasaki

et al. 2011

Bone Marrow Transplant

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Oral mucositis (OM) is a frequent adverse effect of allogenic or autologous hematopoietic SCT. It results from direct toxic injury to the mucosal epithelial cells by the immunosuppressive regimen. Here, we compared the incidence and severity of OM between a group of 24 patients who received proper oral management during hematopoietic SCT and a group of 24 who did not. The oral management group received pre-hematopoietic SCT instruction on oral care and an oral examination in the clean room. Differences in the incidence and severity of OM between the two groups were examined statistically. OM was observed in 14 (58.3%) patients in the oral management group and 22 (91.6%) in the control group. The median of the OM score was 1 for the oral management group (range 0 to 3) and 2 for the control group (range 0 to 3). There was a significant difference in the OM score (Po0.05) and in the incidence of OM between the two groups (Po0.01). This study shows that oral management may decrease the occurrence of OM. Our results also suggest that it is important to include an oral management provider on the hematopoietic SCT team.

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“…Numerous chemotherapeutic regimens with various degrees of myelosuppression were classified into 4 categories (Akashi et al 2013). We then formulated a novel protocol for dental intervention by modifying a protocol described by Yamagata et al (2006) for patients who underwent hematopoietic stem cell transplantation. To verify our dental intervention protocol, we conducted the current prospective study, which evaluated the incidence of complications at each myelosuppressive grade of chemotherapy in patients with hematopoietic malignancy.…”

Section: Introductionmentioning

confidence: 99%

Prospective Study of Dental Intervention for Hematopoietic Malignancy

et al. 2014

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Various chemotherapeutic agents used in patients with hematopoietic malignancy cause serious side effects, including myelosuppression and immunosuppression. Immunosuppression makes patients more susceptible to infection, resulting in an increased risk of infectious complications, including the development of severe septicemia that may be life-threatening. It is necessary for dental staff to be familiar with an appropriate protocol in such cases and to share information about the chemotherapy with a hematologist. To verify the effectiveness of our dental intervention protocol, we conducted a prospective study on the incidence of complications for each myelosuppressive grade of chemotherapy in patients with hematopoietic malignancy. We compared the incidence of complications between treatment P (patients who finished all the dental treatments according to the protocol) and treatment Q (patients who did not) per grade (A, B, C, D) and incidence of systemic or oral findings. We also compared the incidence of oral complication related to the residual teeth between first chemo (patients who were undergoing chemotherapy for the first time) and prior chemo (not the first time). There were significant differences in inflammatory complications between treatment P and treatment Q. We found that both systemic and oral inflammatory complications increased with higher-grade myelosuppressive chemotherapy. Additionally, there was a significant difference between the incidence of oral complications related to the residual teeth between first chemo and prior chemo. Complete implementation of the dental intervention protocol was associated with fewer oral and systemic infectious and inflammatory complications in patients with hematopoietic malignancies undergoing chemotherapy. The incidence of oral and systemic complications also increased with grade of chemotherapy. These results support the validity of our dental intervention protocol. We should pay close attention to the oral state of de novo hematopoietic malignancy patients.

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A prospective study to evaluate a new dental management protocol before hematopoietic stem cell transplantation

Cited by 73 publications

References 23 publications

Dental assessment prior to stem cell transplant: treatment need and barriers to care

Dental assessment prior to stem cell transplant: treatment need and barriers to care

The effect of oral management on the severity of oral mucositis during hematopoietic SCT

Prospective Study of Dental Intervention for Hematopoietic Malignancy

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