Endodontic Treatment in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study.

Abstract

Introduction: This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT).

Methods: One hundred patients were selected. Clinical data, oncologic and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP were investigated. Leukocyte/neutrophil and C-reactive protein levels were evaluated before and after RCT.

Results: One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (≥5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (P = .012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. C-reactive protein levels were ≥1 mg/dL in 54.9% of the individuals 1 month before RCT and <1 mg/dL in 64.6% 6 months after treatment (P > .05).

Conclusions: RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.