Changes in the periodontal status of patients undergoing bone marrow transplantation.
BACKGROUND
Patients receiving an HLA-matched bone marrow transplant (BMT) from a relative or unrelated donor undergo a permanent alteration of their immune system, followed by a prolonged period of immunodeficiency. This study aimed to examine alterations in the periodontal status of patients over 6 months post-bone marrow transplantation.


METHODS
Thirty-seven patients scheduled for bone marrow transplantation participated in this study. One calibrated examiner carried out periodontal examinations (clinical and radiographic) immediately prior to and at 3 and 6 months after transplantation. All patients followed an intense oral care program. Subgingival plaque samples were analyzed by enzyme-linked immunosorbent assay (ELISA) for the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Prevotella intermedia. Data were subjected to statistical analyses to determine the relationships between the frequency distribution of the radiographic and clinical variables over time.


RESULTS
Gains in clinical attachment level (CAL) of > or =2 mm at 4 or more sites from baseline to 6 months post-BMT were noted in 9/16 patients (56%), while 6/16 (38%) patients experienced a loss of CAL > or =2 mm at 4 or more sites in the same period. At a site level, 4.8% of sites exhibited a gain in CAL > or =2 mm between baseline and 3 months post-BMT while 2.3% of sites showed a loss of CAL > or =2 mm in the same period. From baseline to 6 months, a gain in CAL of > or =2 mm was recorded at 3.1% of sites, and 2.4% of sites experienced a loss of > or =2 mm. A significant improvement in the gingival index occurred between all sequential time periods when assessed at a site level. At a patient level, 11/18 (61%) patients showed a significant change in gingival index between baseline and 3 months and 10/16 (63%) between baseline and 6 months. There was no significant relationship between clinical changes and the prevalence of the periodontal pathogens at the various time periods.


CONCLUSIONS
An improvement in periodontal health was recorded between baseline and 6 months post-transplantation. Most of the improvement in periodontal status was noted in the first 3 months after BMT, with a slight decline in periodontal health between 3 and 6 months post-transplant. No significant alteration was noted in the prevalence of periodontal pathogens during the study period.
Pattni
R
R
University of Queensland, Department of Dentistry, Brisbane, Australia.
Walsh
L J
LJ
Marshall
R I
RI
Cullinan
M P
MP
Seymour
G J
GJ
Bartold
P M
PM
D000293:Adolescent; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D016301:Alveolar Bone Loss / Q000145:classification / Q000000981:diagnostic imaging; D016026:Bone Marrow Transplantation / Q000276:immunology; D002138:Calibration; D016009:Chi-Square Distribution; D003773:Dental Plaque / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000145:classification / Q000473:pathology; D010510:Periodontal Diseases / Q000145:classification* / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D010512:Periodontal Index; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification; D011446:Prospective Studies; D011862:Radiography, Panoramic; D015203:Reproducibility of Results
D006680:HLA Antigens