Oral health in patients scheduled for hematopoietic stem cell transplantation in the Orastem study

Abstract

Despite advances in transplant medicine, prevalence of complications after hematopoietic stem cell transplantation (HSCT) remains high. The impact of pre-HSCT oral health factors on the incidence and severity of complications post-HSCT is poorly understood. The aim of this prospective, observational study was to analyze oral health in patients planned for HSCT. Patients ≥18 years requiring HSCT were included from five sites between 2011–2018. General health, oral findings and patient-reported symptoms were registered in 272 patients. Oral symptoms around disease onset were reported by 43 patients (15.9%) and 153 patients (58.8%) reported oral complications during previous chemotherapy. One third of patients experienced oral symptoms at the oral examination before conditioning regimen and HSCT. In total, 124 (46.1%) patients had dental caries, 63 (29.0%) had ≥one tooth with deep periodontal pockets, 147 (75.0%) had ≥one tooth with bleeding on probing. Apical periodontitis was observed in almost 1/4 and partially impacted teeth in 17 (6.3%) patients. Oral mucosal lesions were observed in 84 patients (30.9%). A total of 45 (17.4%) of 259 patients had at least one acute issue to be managed prior to HSCT. In conclusion, oral symptoms and manifestations of oral disease were prevalent in patients planned for HSCT. The extent of oral and acute dental diseases calls for general oral screening of patients pre-HSCT.

The prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation: a systematic review

“…The initial screening of databases resulted in 5,187 studies, of which 2,278 duplicates were excluded. Analysis of the titles and abstracts of the remaining 2,909 eligible papers resulted in 10 studies [ 15 16 17 18 19 20 21 22 23 24 ] that met the inclusion criteria and were selected for full text reading. Three studies were excluded: 1 case report [ 16 ] and 2 studies without a full text available [ 15 20 ].…”

“…Analysis of the titles and abstracts of the remaining 2,909 eligible papers resulted in 10 studies [ 15 16 17 18 19 20 21 22 23 24 ] that met the inclusion criteria and were selected for full text reading. Three studies were excluded: 1 case report [ 16 ] and 2 studies without a full text available [ 15 20 ]. A manual search of reference lists in the retrieved articles produced 1 additional study that met eligibility criteria and was included in this systematic review [ 25 ].…”