Prospective study establishing a management plan for impacted third molar in patients undergoing hematopoietic stem cell transplantation.
OBJECTIVE
Although dental treatment before hematopoietic stem cell transplantation (HSCT) is essential to prevent serious infections from oral sources, the best management plan for impacted third molar (ITM) is unclear.


METHODS
This study was planned to establish a management plan for ITM. Eighty-four candidates for HSCT therapy were consecutively enrolled in the prospective trial. The management plan, which was evidence based and prospectively decided, was to extract the symptomatic ITMs and to leave the asymptomatic ones untreated, regardless of their impacted position.


RESULTS
Eighty-seven ITMs were observed in 35 patients. The ITMs were in the maxilla of 25 patients and the mandible of 28 patients. Dental extraction of 7 teeth was performed in 6 patients without complications. All of the patients received the scheduled HSCT therapy and none experienced odontogenic infection while myelosuppressed.


CONCLUSIONS
This management plan for ITM appears to be appropriate for pre-HSCT patients. Moreover, the experienced dental provider is suggested as a necessary and valuable part of the HSCT team.
Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan. y-kenji@md.tsukuba.ac.jp
Kenji
K
Yamagata
Kojiro
K
Onizawa
Toru
T
Yanagawa
Yasutoshi
Y
Takeuchi
Yuichi
Y
Hasegawa
Shigeru
S
Chiba
Hiroki
H
Bukawa
D000293:Adolescent; D000328:Adult; D002985:Clinical Protocols; D017742:Dental Care for Chronically Ill / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000150:complications / Q000517:prevention & control / Q000601:surgery; D015397:Program Evaluation; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult