Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant
- PDF / 520,553 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 15 Downloads / 204 Views
ORIGINAL ARTICLE
Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant Heidi J. Hansen 1 & Cherry Estilo 2 Joseph Huryn 2 & SaeHee K. Yom 2
&
Adepitan Owosho 3
&
Armand Karl Solano 2 & Joseph Randazzo 2 &
Received: 10 May 2020 / Accepted: 1 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Dental evaluation and management prior to hematopoietic stem cell transplant (HSCT) plays a vital role in identifying and treating infections that may be life-threatening. The purpose of this study is to describe the dental management of patients undergoing pre-HSCT examination with the Dental Service at Memorial Sloan Kettering Cancer Center (MSKCC) and to report on odontogenic complications. Methods Patients referred for evaluation as part of the standard preparation for HSCT were included. Following clinical and radiological examination, patients were assigned to one of three groups based on risk of odontogenic infection, and treatment was provided as indicated. Patients were followed, and their medical records were reviewed for odontogenic complications during the transplant admission. Results Of the 375 patients evaluated, 350 patients underwent HSCT: allogeneic 143 (40.9%) and autologous 207 (59.1%). The distribution of primary cancer diagnosis was as follows: multiple myeloma 104 (29.7%), leukemias 95 (27.1%), Hodgkin’s lymphoma 28 (8.0%), non-Hodgkin’s Lymphoma 99 (28.3%), and other conditions 24 (6.9%). The median time from dental evaluation to transplant was 29 days. The median Decayed, Missing, Filled Teeth Index was 17. The median Community Periodontal Index was 1. Based on dental status, 145 patients (41.4%) were classified as low risk, 133 (38%) as moderate risk and 72 (20.6%) as high risk of odontogenic infection. One hundred fourteen patients (32.6%) required dental treatment prior to HSCT, and 100 of these (28.6%) completed treatment. Two (0.57%) patients had odontogenic complications. Conclusions With conservative pre-HSCT dental treatment based on an infection risk classification system, a low odontogenic complication rate was observed. Keywords Hematopoietic stem cell transplant . Dental evaluation and management . Oral infection . Oral complications . Supportive care . Immunosuppression
Introduction Hematopoietic stem cell transplant (HSCT) is widely used in the management of a variety of malignant and non-malignant conditions for the purpose of immune system reconstitution
* Heidi J. Hansen [email protected] 1
Department of Surgery, Division of Oral & Maxillofacial Surgery and Dentistry, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
2
Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
3
Missouri School of Dentistry and Oral Health, Kirksville, MO, USA
following myeloablation and immunosuppression secondary to cytotoxic chemotherapy conditioning regimens. These regimens, in addition to the underlying disease and the transplant itself, can render pa
Data Loading...
