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

Table 4 Impact of dental clearance on infection

Author	Model	n	Methods	Results	Impact of clearance
Barrington et al[16]	Patients at a metropolitan, tertiary arthroplasty practice in the United States	100	Patients obtained dental clearance, cleaning, and dental interventions. On POD 1 or POD 2, patients were interviewed	23% were not cleared due to dental decay and were treated. There were no periprosthetic infections within 90 d. One in four patients had dental pathology	It is difficult to draw a definitive conclusion
Lampley et al[17]	Elective TJA and hip fracture patients in a tertiary arthroplasty practice in the United States	519	Patients obtained dental clearance, cleaning, and interventions. On POD 1 or POD 2, patients were interviewed	Early postoperative infection rate was significantly lower in the clearance group. Only one infection had a possible dental source	Dental clearance and interventions did not reduce early postoperative infection
Tai et al[18]	Patients s/p resection arthroplasty and uninfected TKA controls from the Taiwanese NHIRD	6295	Patients with removal of infected TKA were matched with TKA patients without infections from the NHIRD and retrospectively analyzed	Compared to patients who did not receive scaling, those who received scaling once and 5-6 times in the previous three years had 20% and 31% less risk of TKA infection, respectively	Dental scaling was associated with lower risk of infection
Sonn et al[19]	Elective TJA patients at an unspecified location	2457	The data for a consecutive TJA patients was retrospectively analyzed	There were no significant associations between complication and dental evaluation or extraction	Dental evaluation +/- extraction did not improve complication rates

POD: Post op day; NHIRD: National health insurance research database; TKA: Total knee arthroplasty; TJA: Total joint arthroplasty.