Schmalz Gerhard, Reuschel Florentine, Bartl Markus, Schmidt Laura, Runge Janine, Haak Rainer, Goralski Szymon, Roth Andreas, Ziebolz Dirk
Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany.
Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany.
J Clin Med. 2022 Jun 26;11(13):3686. doi: 10.3390/jcm11133686.
The aim of this cross-sectional cohort study was to evaluate a comprehensive dental examination and referral concept for patients prior to endoprosthesis (EP) implantation in an interdisciplinary setting.
Patients, who were prepared for EP surgery in the clinic for orthopaedics, were referred to the dental clinic for a dental examination. Thereby, dental and periodontal treatment need, radiographic and temporomandibular joint findings were assessed. Based on oral and radiographic investigation, a risk classification for potential source of prosthetic infection was performed. If potential oral foci of EP infection were present (e.g., apically radiolucent teeth, severe periodontitis or additional inflammatory findings), patients were classified as at high risk for EP infection with oral origin. Those individuals were allocated to their family dentist or special clinic for dental treatment prior to EP surgery.
A total of 311 patients were included (mean age: 67.84 ± 10.96 years, 51% male). A dental treatment need of 33% was found, while the periodontal treatment need was 83%. Thirty-one percent of patients showed at least one apical radiolucency (a sign of chronic infection/inflammation). Furthermore, additional findings such as radiographic signs of sinusitis maxillaris were found in 24% of patients. Temporomandibular disease was probable in 17% of individuals. One-third (34%) were assigned to the high risk group for an EP infection with oral origin.
German patients before EP have a high periodontal treatment need and show frequently (34%) a potential oral focus of infection, underlining the necessity of including dental examination and risk stratification as part of the pre-operative assessment prior to EP implantation. Therefore, an approach as applied in this study appears reasonable for those individuals.
这项横断面队列研究的目的是在多学科环境中评估假体植入术（EP）前患者的全面牙科检查和转诊方案。
准备在骨科诊所接受EP手术的患者被转诊至牙科诊所进行牙科检查。由此评估牙齿和牙周治疗需求、影像学检查结果以及颞下颌关节检查结果。基于口腔和影像学检查，对假体感染的潜在来源进行风险分类。如果存在EP感染的潜在口腔病灶（例如根尖透射区牙齿、重度牙周炎或其他炎症表现），则患者被归类为有口腔源性EP感染的高风险人群。这些患者在EP手术前被分配至其家庭牙医处或专科牙科诊所接受治疗。
共纳入311例患者（平均年龄：67.84±10.96岁，51%为男性）。发现33%的患者有牙齿治疗需求，而牙周治疗需求为83%。31%的患者至少有一处根尖透射区（慢性感染/炎症的迹象）。此外，24%的患者有其他检查结果，如上颌窦炎的影像学表现。17%的个体可能患有颞下颌疾病。三分之一（34%）的患者被归类为有口腔源性EP感染的高风险组。
EP手术前的德国患者有很高的牙周治疗需求，且经常（34%）表现出潜在的口腔感染病灶，这凸显了将牙科检查和风险分层纳入EP植入术前评估的必要性。因此，本研究中应用的方法对这些患者似乎是合理的。
