Impact of dental clearance on total joint arthroplasty: A systematic review

Table 3 Risk factors and epidemiology of total joint arthroplasty patients

Author	Model	n	Methods	Results	Conclusion
Adamkiewicz et al[12]	Patients at a tertiary University Hospital in Poland	228	Patients admitted for elective TJA received dental evaluation along with standard preoperative workup	Clinically significant periodontal disease was detected in 28.5% of patients	Periodontal disease is prevalent in patients undergoing TJA
Tokarski et al[13]	Patients at a tertiary care center in the United States	300	Patients answered a dental hygiene questionnaire then received dental evaluations and necessary interventions	12% failed dental clearance. Patients with one or more of: Narcotic use, tobacco use, or last dentist visit over one year ago, had a 22% risk of failure compared to 6% for patients with no risk factors	It may be reasonable to only screen high risk patients for dental pathology
Vuorinen et al[14]	Patients at a public, tertiary care hospital in Finland	731	Patients filled out a prospective dental health questionnaire and underwent a dental examination and necessary interventions	29.4% of patients failed dental clearance. 5.1% of patients had severe periodontitis. Tobacco use and root canal were risk factors. Regular dental examination was a preventive factor	The inspection and treatment of dental pathology is important prior to elective TJA
Wood et al[15]	Patients at a large academic center in Canada	453	Patients answered a dental hygiene survey at their 6 wk post-operative appointment	76% of patients had a cleaning within 12 mo. 5% did not visit a dentist. 49% were informed of the impact of dental hygiene in reducing PJI	Patients generally have good oral hygiene, but patient education is inconsistent

PJI: Periprosthetic joint infection; TJA: Total joint arthroplasty.