造血干细胞移植患者的口腔状况与牙源性并发症风险。
Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant.
机构信息
Department of Surgery, Division of Oral & Maxillofacial Surgery and Dentistry, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA.
Dental Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
出版信息
Support Care Cancer. 2021 Apr;29(4):2231-2238. doi: 10.1007/s00520-020-05733-1. Epub 2020 Sep 8.
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.
目的
造血干细胞移植（HSCT）前的口腔评估和管理在识别和治疗可能危及生命的感染方面起着至关重要的作用。本研究的目的是描述 Memorial Sloan Kettering 癌症中心（MSKCC）牙科服务部门对接受 HSCT 前检查的患者的口腔管理，并报告牙源性并发症。
方法
纳入作为 HSCT 标准准备的一部分而接受评估的患者。在进行临床和影像学检查后，根据牙源性感染风险将患者分为三组，并根据需要进行治疗。对患者进行随访，并回顾其在移植住院期间的牙源性并发症的病历。
结果
在 375 名接受评估的患者中，有 350 名患者接受了 HSCT：异体 143 名（40.9%），自体 207 名（59.1%）。原发性癌症诊断的分布如下：多发性骨髓瘤 104 例（29.7%）、白血病 95 例（27.1%）、霍奇金淋巴瘤 28 例（8.0%）、非霍奇金淋巴瘤 99 例（28.3%）和其他疾病 24 例（6.9%）。从口腔评估到移植的中位时间为 29 天。中位数龋齿、缺失、补牙指数为 17。中位数社区牙周指数为 1。根据口腔状况，145 名患者（41.4%）被归类为低风险，133 名（38%）为中度风险，72 名（20.6%）为高风险牙源性感染。114 名患者（32.6%）在 HSCT 前需要口腔治疗，其中 100 名（28.6%）完成了治疗。有 2 名（0.57%）患者发生牙源性并发症。
结论
根据感染风险分类系统进行保守的 HSCT 前口腔治疗，观察到牙源性并发症发生率较低。
Zotero 插件