Oral health status in adult patients with newly diagnosed acute leukemia.

BACKGROUND: The aim of this cross-sectional study was to evaluate the oral health of adult patients with newly diagnosed acute leukemia. METHODS: Patients with initially diagnosed acute myeloid (AML) or lymphocytic (ALL) leukemia and a matched healthy control (HC) group were included. The oral investigation comprised inspection of the oral mucosa; the decayed (D), missing (M), and filled (F) teeth (DMF-T) index; and a detailed periodontal status. Subgingival biofilm samples were analyzed (polymerase chain reaction) for the presence of selected potentially periodontal pathogenic bacteria. Statistical analysis was performed using Fisher's exact test, chi-squared test, and Mann-Whitney U test (significance level α = 5%). RESULTS: Thirty-nine patients with leukemia (AML 26, ALL 13) and 38 HCs were included. Oral mucosal findings were present in 62% of L compared to 0% of HC patients, whereby gingival hyperplasia was the most detected finding. Furthermore, a higher caries prevalence in leukemia patients was shown (D value 3.64 ± 3.98 vs. 0.72 ± 1.72, p < 0.01). The periodontal parameters were poorer in leukemia patients. No substantial differences in microbiological findings of selected bacteria were detected within L group and between L and HC patients. CONCLUSION: The high prevalence of oral diseases supports the demand of an early and consequent dental treatment of leukemia patients, especially considering subsequent therapy.

Oral Health-Related Quality of Life in Adult Patients with Newly Diagnosed Acute Leukaemia.

PURPOSE: Knowledge about oral health-related quality of life (OHRQoL) in adult patients with leukaemia is still limited. Accordingly, aim of this cross-sectional study was to assess OHRQoL and its associations to different parameters in adult patients with newly diagnosed acute leukaemia. MATERIALS AND METHODS: Participants with first diagnosis of acute leukaemia were consecutively recruited in the Clinic of Hematology and Oncology of the University Medical Center Goettingen. OHRQoL was assessed using the German short form of oral health impact profile (OHIP-G14). Presence of oral initial symptoms, dental health (decayed- [D-T], missing- [M-T] and filled-teeth index [DMF-T]), dental behaviour and periodontal disease severity were assessed. For comparison, a healthy control group (HC) was recruited. RESULTS: Thirty-nine patients with leukaemia and 38 HC were included. In the leukaemia group, a statistically significant and clinically relevant higher OHIP-sum score compared to HC was found (6.13 [3; 0-7] vs 0.87 [0; 0-2], p <0.01). The different subaspects of OHRQoL (patterns) 'oral function' and 'orofacial appearance' were statistically significantly worse in the leukaemia group (p <0.01). Time since diagnosis showed a clinically relevant association to the pattern 'psychosocial impact' (p = 0.06). Patients with oral initial symptoms had a statistically significantly worse OHIP-sum score (p <0.04, V = 0.775). DMF-T (p = 0.03, r = 0.242) and M-T (p = 0.03, r = 0.252) showed an association to OHIP sum score. Moreover, D-T (p = 0.03, r = 0.253) and M-T (p = 0.01, r = 0.296) were associated to orofacial appearance. Additionally, M-T showed an association to pattern 'oral function' (p = 0.01, r = 0.277). CONCLUSION: Patients with newly diagnosed acute leukaemia show a reduced OHRQoL. This might be particularly caused by oral health situation, especially oral initial symptoms as well as missing teeth.

Dental and Periodontal Treatment Need after Dental Clearance Is Not Associated with the Outcome of Induction Therapy in Patients with Acute Leukemia: Results of a Retrospective Pilot Study.

This retrospective pilot study aimed to detect whether remaining dental/periodontal treatment need and periodontal inflammation after dental clearance would be associated with the initial therapy outcome of adult patients with acute leukemia undergoing induction chemotherapy. Different parameters were assessed from the patients' records: initial blood parameters, blood parameters during initial chemotherapy, leukemia/therapy related complaints, duration of fever, microbiological findings (blood and urine), as well as patients' survival. Dental treatment need was defined as the presence of at least one carious tooth; periodontal treatment need was determined by the presence of probing depth ≥3.5 mm in at least two sextants. To reflect periodontal inflammation, the periodontal inflamed surface area (PISA) was applied. Thirty-nine patients were included. A dental treatment need of 75% and periodontal treatment need of 76% as well as an average PISA of 153.18 ± 158.09 were found. Only two associations were detected: periodontal treatment need was associated with thrombocyte count after 7 days (p=0.03), and PISA was associated with erythrocyte count three days after induction of therapy (p=0.01). It can be concluded that remaining dental and periodontal treatment need as well as periodontal inflammation after dental clearance is not associated with the outcome of induction therapy in adult patients with acute leukemia.