A systematic review of dental disease management in cancer patients

作者：Hong Catherine H L^*; Hu Shijia; Haverman Thijs; Stokman Monique; Napenas Joel J; Bos den Braber Jacolien; Gerber Erich; Geuke Margot; Vardas Emmanouil; Waltimo Tuomas; Jensen Siri Beier; Saunders Deborah P

来源：Supportive Care in Cancer, 2018, 26(1): 155-174.

DOI：10.1007/s00520-017-3829-y

• Dental caries
• Periodontal disease
• Anti-neoplastic agents
• Hematopoietic stem cell transplantation

This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review.
A literature search was conducted in the databases MEDLINE/PubMed and EMBASE for articles published between 1 January 2009 and 30 June 2016. Each study was assessed by 2 reviewers and the body of evidence for each intervention was assigned an evidence level.
After examination of the abstracts and full-text articles, 59 articles satisfied the inclusion criteria. The weighted prevalence of dental infections and pericoronitis during cancer therapy was 5.4 and 5.3%, respectively. The frequency of dental-related infections during intensive chemotherapy after complete, partial, and minimal pre-cancer dental evaluation/treatment protocols ranged from 0 to 4%. Protocols involving third molars extractions had the highest complications (40%).
In view of the low prevalence of infections and the potential for complications after third molar extractions, it is suggested that partial dental evaluation/treatment protocols prior to intensive chemotherapy; whereby minor caries (within dentin), asymptomatic third molars or asymptomatic teeth without excessive probing depth (< 8 mm), mobility (mobility I or II) or with periapical lesions of < 5 mm were observed; is a viable option when there is insufficient time for complete dental evaluation/treatment protocols. The use of chlorhexidine, fluoride mouth rinses as well as composite resin, resin-modified glass ionomer cement (GIC), and amalgam restorations over conventional GIC in post head and neck radiation patients who are compliant fluoride users is recommended.

• 出版日期2018-1