Preventive Dental Strategies to Minimize Oral Health Complications After Renal Transplantation: A Systematic Review

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI:10.1016/j.transproceed.2026.04.036

Hany M. El Hennawy, Maryam H. El Hennawy, Omar Safar, Tariq M Jaber, Ghaleb A Aboalsamh, Muhammed Awais, Ibrahim Tawahri, Mohamed E. Balla, Abdullah H. Almalki

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引用次数: 0

Abstract

Background

Kidney transplantation dramatically improves survival and life quality in patients with end-stage renal disease, yet it imposes a substantial and often overlooked oral health burden. Immunosuppressive therapy, comorbidities, and residual renal dysfunction increase susceptibility to periodontal disease, oral candidiasis, mucosal lesions, and drug-induced gingival overgrowth, which may contribute to systemic complications and negatively affect patient well-being. This review synthesizes evidence on oral complications and evaluates preventive strategies.

Methods

A comprehensive systematic review with qualitative evidence synthesis was conducted using PubMed, Scopus, Google Scholar, and the Cochrane Library, encompassing studies published over the last 20 years. Observational studies and randomized trials were analyzed, with risk-of-bias assessment using ROBINS-I and Cochrane RoB tools. Due to heterogeneity in study design, outcome definitions, and reporting methods, a quantitative meta-analysis was not feasible.

Results

Oral complications arise from the interplay of immunosuppression, comorbidities, and insufficient oral care. Periodontal disease affects up to 87% of recipients, with xerostomia, candidiasis, and gingival overgrowth commonly reported. Preventive measures, including pretransplant dental clearance, individualized hygiene programs, antifungal prophylaxis, fluoride use, and structured post-transplant monitoring, are associated with reductions in oral infections and inflammatory complications reported across multiple studies. Evidence gaps persist, particularly in low-resource settings, standardized protocols, and patient-reported outcomes such as oral health–related quality of life (OHRQoL).

Conclusion

Oral health is an important component of kidney transplant care. Integrating structured, patient-centered dental protocols within transplant programs may help reduce oral morbidity and support overall patient health, although direct causal effects on graft outcomes remain incompletely established in current literature. Future research should focus on longitudinal outcomes and OHRQoL metrics to guide precision, holistic transplant care.

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预防牙科策略以减少肾移植后口腔健康并发症：系统回顾。

背景：肾移植可显著提高终末期肾病患者的生存率和生活质量，但同时也造成了严重且经常被忽视的口腔健康负担。免疫抑制治疗、合并症和残留的肾功能障碍增加了对牙周病、口腔念珠菌病、粘膜病变和药物引起的牙龈过度生长的易感性，这可能导致全身并发症并对患者的健康产生负面影响。这篇综述综合了有关口腔并发症的证据并评估了预防策略。方法：使用PubMed、Scopus、谷歌Scholar和Cochrane Library进行全面的系统评价，并进行定性证据合成，包括过去20年发表的研究。对观察性研究和随机试验进行分析，并使用ROBINS-I和Cochrane RoB工具进行偏倚风险评估。由于研究设计、结果定义和报告方法的异质性，定量荟萃分析不可行。结果：口腔并发症是免疫抑制、合并症和口腔护理不足共同作用的结果。牙周病影响多达87%的接受者，通常报道有口干症、念珠菌病和牙龈过度生长。多项研究报告，包括移植前牙齿清除、个体化卫生计划、抗真菌预防、氟化物使用和移植后结构化监测在内的预防措施与口腔感染和炎症并发症的减少有关。证据差距仍然存在，特别是在资源匮乏的环境、标准化方案和患者报告的结果，如口腔健康相关生活质量（OHRQoL）。结论：口腔健康是肾移植护理的重要组成部分。在移植方案中整合结构化的、以患者为中心的牙科方案可能有助于降低口腔发病率，并支持患者的整体健康，尽管目前文献中对移植结果的直接因果关系尚未完全确定。未来的研究应侧重于纵向结果和OHRQoL指标，以指导精确、全面的移植护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.