Schmalz Gerhard, Wendorff Horst, Berisha Lisa, Meisel Anja, Widmer Florian, Marcinkowski Anna, Teschler Helmut, Sommerwerck Urte, Haak Rainer, Kollmar Otto, Ziebolz Dirk
Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
Department of Pneumology, West German Lung Center, Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Transpl Infect Dis. 2018 Apr;20(2):e12832. doi: 10.1111/tid.12832. Epub 2018 Feb 21.
The aim of this study was to investigate the association of time after transplantation and different immunosuppressive medications with dental and periodontal treatment needs in patients after solid organ transplantation (SOT).
After lung, liver, or kidney transplantation, patients were included and divided into subgroups based on the time after SOT (0-1, 1-3, 3-6, 6-10, and >10 years) and immunosuppression (tacrolimus, cyclosporine, mycophenolate, glucocorticoids, sirolimus, and monotherapy vs combination). Dental treatment need was determined by the presence of carious lesions, while periodontal treatment need was diagnosed based on a Periodontal Screening index score of 3-4. The overall treatment need included both the dental and/or periodontal treatment needs. Statistical analysis was performed using the Kruskal-Wallis test and chi-squared test (P < .05).
A total of 169 patients were included after SOT. A dental treatment need of 44%, a periodontal treatment need of 71%, and an overall treatment need of 84% were detected in the total cohort. Only patients with >10 years after SOT had a lower dental treatment need compared to the other groups (P = .02). All other comparisons of dental, periodontal, and overall treatment needs were comparable between subgroups depending on time since SOT. Furthermore, no statistically significant differences were found in terms of the dental, periodontal, or overall treatment needs following the administration of different immunosuppressive medications.
The high treatment need of patients after SOT, irrespective of the time since transplantation, suggests insufficient dental and periodontal treatment before and maintenance after organ transplantation. Furthermore, immunosuppressive medication was not associated with the treatment need.
本研究旨在调查实体器官移植（SOT）患者移植后时间及不同免疫抑制药物与牙齿和牙周治疗需求之间的关联。
在肺、肝或肾移植后，纳入患者并根据SOT后的时间（0 - 1年、1 - 3年、3 - 6年、6 - 10年和>10年）以及免疫抑制情况（他克莫司、环孢素、霉酚酸酯、糖皮质激素、西罗莫司以及单药治疗与联合治疗）分为亚组。牙齿治疗需求通过龋损的存在来确定，而牙周治疗需求则根据牙周筛查指数评分为3 - 4来诊断。总体治疗需求包括牙齿和/或牙周治疗需求。使用Kruskal - Wallis检验和卡方检验进行统计分析（P <.05）。
SOT后共纳入169例患者。在整个队列中，检测到牙齿治疗需求为44%，牙周治疗需求为71%，总体治疗需求为84%。与其他组相比，仅SOT后>10年的患者牙齿治疗需求较低（P =.02）。根据SOT后的时间，亚组之间牙齿、牙周和总体治疗需求的所有其他比较均具有可比性。此外，在使用不同免疫抑制药物后，牙齿、牙周或总体治疗需求方面未发现统计学上的显著差异。
SOT后患者的高治疗需求，无论移植后的时间如何，表明器官移植前牙齿和牙周治疗不足以及移植后维护不足。此外，免疫抑制药物与治疗需求无关。
