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Objectives <p>This systematic review aimed to investigate the frequency, characteristics, and clinical outcomes of complications arising from endodontic and periodontal infections in patients undergoing hematopoietic stem cell transplantation (HSCT) and to evaluate their potential impact on transplant prognosis.</p> Materials and methods <p>A comprehensive search was initially conducted in PubMed/MEDLINE, Scopus, Embase, and ProQuest databases up to and including July 2025, and subsequently updated to include studies published up to and including October 2025. The eligibility criteria included clinical studies addressing endodontic or periodontal complications in the context of HSCT. Case reports and conference abstracts were excluded. Two independent reviewers performed data extraction and assessed the risk of bias using the Newcastle–Ottawa Scale.</p> Results <p>Of 1,385 studies initially identified, six met the inclusion criteria, comprising 1,730 participants and 53 individuals presenting with endodontic or periodontal complications. Endodontic complications, including acute and chronic apical abscesses, were reported across all HSCT phases: pre-conditioning, hospitalization, and beyond day + 100. Several cases required intravenous antibiotics or extraction, underscoring the risk of infection progression under immunosuppression. Periodontal complications such as gingivitis, periodontitis, abscesses, and swelling were also described.</p> Conclusions <p>Evidence indicates that endodontic and periodontal infectious complications may arise during HSCT, requiring interventions such as dental extraction or intravenous antibiotic therapy. These events underscore the importance of preventive oral care and interdisciplinary collaboration among dental, hematology, and infectious disease teams. Comprehensive pre-transplant screening and management should be standardized to identify and treat odontogenic infections before conditioning, ensuring safer and more predictable transplant outcomes.</p> Clinical relevance <p>Endodontic and periodontal infections are clinically relevant yet preventable complications in HSCT. Comprehensive and personalized dental care, including early diagnosis, appropriate treatment of odontogenic infections, and continuous monitoring tailored to each patient’s transplant phase, is essential to minimize systemic complications and ensure transplant safety. Incorporating structured and individualized dental management as a mandatory component of multidisciplinary HSCT care can reduce morbidity, shorten hospitalization, and improve long-term outcomes.</p>

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Systemic implications of endodontic and periodontal infections in hematopoietic stem cell transplantation: a systematic review

  • 期刊论文

  • 发表日期：

    2025年11月19日

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  • Maria Emília Mota,
  • Fábio Abreu Alves,
  • Juliana Bertoldi Franco,
  • Jayr Schmidt Filho,
  • Maria Stella Moreira

摘要

Objectives

This systematic review aimed to investigate the frequency, characteristics, and clinical outcomes of complications arising from endodontic and periodontal infections in patients undergoing hematopoietic stem cell transplantation (HSCT) and to evaluate their potential impact on transplant prognosis.

Materials and methods

A comprehensive search was initially conducted in PubMed/MEDLINE, Scopus, Embase, and ProQuest databases up to and including July 2025, and subsequently updated to include studies published up to and including October 2025. The eligibility criteria included clinical studies addressing endodontic or periodontal complications in the context of HSCT. Case reports and conference abstracts were excluded. Two independent reviewers performed data extraction and assessed the risk of bias using the Newcastle–Ottawa Scale.

Results

Of 1,385 studies initially identified, six met the inclusion criteria, comprising 1,730 participants and 53 individuals presenting with endodontic or periodontal complications. Endodontic complications, including acute and chronic apical abscesses, were reported across all HSCT phases: pre-conditioning, hospitalization, and beyond day + 100. Several cases required intravenous antibiotics or extraction, underscoring the risk of infection progression under immunosuppression. Periodontal complications such as gingivitis, periodontitis, abscesses, and swelling were also described.

Conclusions

Evidence indicates that endodontic and periodontal infectious complications may arise during HSCT, requiring interventions such as dental extraction or intravenous antibiotic therapy. These events underscore the importance of preventive oral care and interdisciplinary collaboration among dental, hematology, and infectious disease teams. Comprehensive pre-transplant screening and management should be standardized to identify and treat odontogenic infections before conditioning, ensuring safer and more predictable transplant outcomes.

Clinical relevance

Endodontic and periodontal infections are clinically relevant yet preventable complications in HSCT. Comprehensive and personalized dental care, including early diagnosis, appropriate treatment of odontogenic infections, and continuous monitoring tailored to each patient’s transplant phase, is essential to minimize systemic complications and ensure transplant safety. Incorporating structured and individualized dental management as a mandatory component of multidisciplinary HSCT care can reduce morbidity, shorten hospitalization, and improve long-term outcomes.