Frey C, Navarro SM, Blackwell T, Lidner C, Del Schutte Jr H. Impact of dental clearance on total joint arthroplasty: A systematic review. World J Orthop 2019; 10(12): 416-423 [PMID: 31908990 DOI: 10.5312/wjo.v10.i12.416]
Corresponding Author of This Article
Christopher Frey, MD, Doctor, Department of Orthopedic Surgery, Stanford Medicine, 50 Broadway Street Pavilion C, 4th Floor, Redwood City, CA 94063, United States. chris1fr@stanford.edu
Research Domain of This Article
Orthopedics
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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
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
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
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
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
Citation: Frey C, Navarro SM, Blackwell T, Lidner C, Del Schutte Jr H. Impact of dental clearance on total joint arthroplasty: A systematic review. World J Orthop 2019; 10(12): 416-423