Association between dental procedures and periprosthetic joint infection: A case-crossover study

Area of Science:

• Orthopedics
• Infectious Diseases
• Dental Medicine

Background:

• Dental procedures can cause bacteremia, but their link to late periprosthetic joint infection (LPJI) is not well-established.
• Limited evidence exists on the association between dental interventions and LPJI risk.

Purpose of the Study:

• To investigate if dental procedures are associated with an elevated risk of late periprosthetic joint infection (LPJI).

Main Methods:

• A case-crossover study utilized a Japanese claims database from April 2014 to September 2021.
• Adult patients hospitalized for LPJI were analyzed, comparing dental procedure exposure in the 1-4 weeks before admission (case period) to 9-12 and 17-20 weeks prior (control periods).
• Conditional logistic regression calculated odds ratios (ORs) and 95% confidence intervals (CIs) for LPJI associated with dental procedures.

Main Results:

• The study included 241 patients with LPJI.
• Dental procedures were performed in 19.1% during the case period and 31.1% during control periods.
• The odds ratio for LPJI following dental procedures was 0.96 (95% CI, 0.61-1.53), indicating no significant association (p=0.88).

Conclusions:

• Dental procedures do not appear to be associated with an increased risk of late periprosthetic joint infection (LPJI).
• These findings may prompt a re-evaluation of routine antibiotic prophylaxis recommendations before dental procedures for patients with joint implants.