Dissociations of oral foci of infections with infectious complications and survival after haematopoietic stem cell transplantation

Abstract

IntroductionHaematopoietic stem cell transplantation (HSCT) recipients are at increased risk for severe infections. This study examined the associations of common oral infections with survival and infectious complications in HSCT recipients.Materials and methodsAll autologous and allogeneic HSCT recipients transplanted in the University Hospital of Basel, Switzerland, between 2008 and 2016 and referred to oral infection control pre-HSCT were included in this retrospective case-control study. All patients had a clinical and a panoramic radiological dental examination taken immediately prior to HSCT. Presence of acute or chronic oral foci of infections, decayed, missing or filled tooth index (DMFT) and radiological attachment loss (RAL) were examined. Survival and infections of the subjects were followed up for 6 months post-HSCT.ResultsAltogether 341 allogeneic and 125 autologous HSCT recipients were included in the study. Within 6 months post-HSCT, 47 (14%) of the allogeneic and 4 (3%) of the autologous recipients died. Oral foci of infections (acute or chronic), DMFT or periodontitis pre-HSCT were not associated with survival 6 months post-HSCT. Oral foci of infections were also not associated with hospital treated infectious diseases or blood culture positive bacteremia during the 6 month follow-up period. Untreated oral foci of infections were not associated with survival or severe infectious complications within 6 months post-HSCT.ConclusionThe results of this study suggest that radical dental interventions to chronic oral infections could be postponed until post-HSCT.

Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

“…A systematic review by Koka and Gupta also reported that a reduced tooth count was associated with higher mortality [ 35 ]. However, a recent retrospective case-control study recommended that radical dental interventions to chronic oral infections could be postponed until post-hematopoietic stem cell transplantation [ 36 ].…”

A condição de saúde bucal como fator de risco para as complicações precoces do transplante alogênico de células tronco hematopoiéticas

“…A relação entre alterações sistêmicas e a condição de saúde bucal tem sido relatada nos últimos anos. Neste contexto, já foram descritas associação entre doença periodontal e endocardite, doenças cardiovasculares, acidente vascular cerebral, artrite reumatoide, doenças do sistema respiratório, doença renal, parto prematuro e diabetes (Weidlich et al, 2008;Mauramo et al, 2019;Schuurhuis et al, 2016).…”

“…Mesmo a cavidade bucal sendo um potencial foco de infecção para o paciente criticamente imunossuprimido, há poucos estudos que relacionam a condição de saúde bucal com as complicações do TCTH. O único estudo que avaliou esta relação, foi a avaliação retrospectiva de 341 pacientes europeus submetidos ao TCTH alogênico realizada por Mauramo et al, (2019). Apesar de encontrarem má condição de saúde bucal, 7% apresentavam pelo menos um potencial foco infeccioso em cavidade bucal no pré-TCTH, 64% apresentavam doença periodontal e média de CPOD de 18,7.…”

“…Apesar de encontrarem má condição de saúde bucal, 7% apresentavam pelo menos um potencial foco infeccioso em cavidade bucal no pré-TCTH, 64% apresentavam doença periodontal e média de CPOD de 18,7. Os autores não encontraram relação entre condição de saúde bucal e a taxa de sobrevida em 6 meses pós TCTH (Mauramo et al, 2019).…”

“…(Genco and Sanz, 2020). Com exceção do estudo de Fernandes et al (2014) e de Hansen et al (2021), que realizaram sondagem periodontal, os demais que avaliaram a incidência de doença periodontal em TCTH também consideraram a perda óssea observada na radiografia panorâmica dos maxilares, não sendo realizada a sondagem periodontal (Durey et al, 2009;Mauramo et al, 2019;Elad et al, 2015).…”