Endodontic Treatment in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study

This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT).

One hundred patients were selected. Clinical data, oncologic and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP were investigated. Leukocyte/neutrophil and C-reactive protein levels were evaluated before and after RCT.

One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (≥5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (P = .012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. C-reactive protein levels were ≥1 mg/dL in 54.9% of the individuals 1 month before RCT and <1 mg/dL in 64.6% 6 months after treatment (P > .05).

RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.