Division of Thoracic Surgery, LMU Klinikum, Ludwig Maximilian University of Munich, Munich, Germany.
Department of Oral & Maxillofacial Surgery, LMU Klinikum, Ludwig Maximilian University of Munich, Munich, Germany.
Oral Dis. 2024 Apr;30(3):1614-1621. doi: 10.1111/odi.14569. Epub 2023 Apr 3.
Poor oral hygiene can cause infections and inflammatory diseases. Data on its impact on outcome after lung transplantation (LuTX) is scarce. Most transplant centers have individual standards regarding dental care as there is no clinical guideline. This study's objective was to assess LuTX-listed patient's dental status and determine its effect on postoperative outcome.
Two hundred patients having undergone LuTX from 2014 to 2019 were selected. Collected data comprised LuTX-indication, periodontal status, and number of carious teeth/fillings. A preoperative panoramic dental X-ray and a dentist's consultative clarification were mandatory.
63.5% had carious dental status, differing significantly regarding TX-indication (p < 0.001; ILD: 41.7% vs. CF: 3.1% of all patients with carious teeth). Mean age at the time of LuTX differed significantly within these groups. Neither preoperative carious dental status nor periodontitis or bone loss deteriorated post-LuTX survival significantly. No evidence was found that either resulted in a greater number of deaths related to an infectious etiology.
This study shows that carious dental status, periodontitis, and bone loss do not affect post-TX survival. However, literature indicates that they can cause systemic/pulmonary infections that deteriorate post-LuTX survival. Regarding the absence of standardized guidelines regarding dental care and LuTX, we strongly recommend emphasizing research in this field.
不良的口腔卫生会导致感染和炎症性疾病。关于其对肺移植（LuTX）后结果影响的数据很少。由于没有临床指南，大多数移植中心对口腔护理都有自己的标准。本研究的目的是评估 LuTX 患者的口腔状况，并确定其对术后结果的影响。
选择了 2014 年至 2019 年期间接受 LuTX 的 200 名患者。收集的数据包括 LuTX 指征、牙周状况和龋齿/填充物数量。术前必须进行全景牙科 X 光检查和牙医咨询澄清。
63.5%的患者有龋齿状况，这与 TX 指征显著相关（p<0.001；ILD：41.7%，而 CF：所有患者中有龋齿的患者为 3.1%）。这些组内的 LuTX 时的平均年龄差异显著。术前龋齿状况、牙周炎或骨丢失均未显著影响 LuTX 后生存。没有证据表明它们导致了更多与感染病因相关的死亡。
本研究表明，龋齿状况、牙周炎和骨丢失不会影响术后生存。然而，文献表明它们会导致全身/肺部感染，从而恶化 LuTX 后生存。鉴于缺乏关于口腔护理和 LuTX 的标准化指南，我们强烈建议在这一领域加强研究。
