Preoperative Oral Health Screening in Patients Undergoing Hip and Knee Arthroplasty: A Cross-Sectional Study

Aim of study was to assess the prevalence and distribution of oral infections potentially leading to bacteriemia in patients scheduled for hip and knee arthroplasty.

This prospective research was performed on a study group of 51 patients (mean age 67.51+/-5.78 years; 21-males, 30-females) diagnosed with hip osteoarthritis and knee osteoarthritis, scheduled for hip or knee arthroplasty in Clinical Rehabilitation Hospital (Iasi, Romania). A dental specialist performed a standardized clinical and paraclinical intraoral examination on all patients. The following conditions were assessed as oral sources of infection: chronic periapical lesions, endo-periodontal lesions, deep periodontal pockets, residual roots, fixed prosthetic restorations with inadequate marginal adaptation.

All patients were diagnosed with periodontal disease. Chronic periapical lesions (23.5%) and endo-periodontal lesions (41.2%) were frequently in maxillary molars. Residual roots were detected in 84.3% of patients (mostly in mandibular molars) while ill-fitting fixed prosthetic restorations in 64.7% of patients. Periodontal treatment of deep periodontal pockets was the most commonly treatment need, followed by replacement of ill-fitted fixed prosthetic restorations, and tooth extraction.

Oral infectious foci-associated pathologies were frequent among patients scheduled for hip or knee arthroplasty, with deep periodontal pockets being the most frequent source of oral infection, followed by residual roots and ill-fitted fixed prosthetic restorations. Our results emphasize the necessity of the preoperative oral health evaluations for patients scheduled for hip and knee arthroplasty, a therapeutic approach required especially in the case of those with comorbidities or with risk of systemic bacteriemia of dental origin.