Oral health-related quality of life and dental treatment need 5 to 10 years after hematopoietic cell transplantation

This study investigates patient-reported oral health-related quality of life 5 to 10 years after hematopoietic cell transplantation (HCT), and its association with type of HCT and dental treatment needs. All adult post- autologous or allogeneic HCT survivors treated at the Radboud university medical center, Nijmegen, The Netherlands between 2012 and 2017 were invited for this research. Patients who were already enrolled in the prospective ORASTEM/HOME-(2) study were excluded. Eligible patients were contacted by telephone to obtain informed consent and to confirm their current address. Patients who not gave informed consent or were unattainable after multiple calls were excluded.
Oral health-related quality of life was determined using the OHIP-14, Summated XI, OES and the first nine questions of the MFIQ questionnaires. These questionnaires were sent on paper to all patients between June 2023 and October 2023. No reminders were sent. With the questionnaires, all patients were also sent a form where they could fill in their current dentist and give consent to obtain dental records of their dentist. After consent, the dental records were asked from their treating dentist. In case of no response from the dental office, a reminder was sent after a few weeks.
From the dental records the number of natural teeth, excluding third molars, around the date of answering the questionnaires were determined. Counting from the HCT date, the number of years with dental visits was determined from the dental records. A year was included only if entries for routine check-ups or oral hygiene sessions were present; otherwise, that year was not counted as visited the dentist. The number of restorations and extractions were noted in the period from 7 years before HCT (excluding the year before HCT) to 10 years after HCT. For restorations the billing-codes V15, V71, V72, V73, V74, V81, V82, V83, V84, V91, V92, V93 and V94 were counted. For extractions the billing-codes H11, H16 and H35 were counted and the files were searched for mentions of referrals to an oral surgeon, to include also the more complicated extractions performed by the oral surgeon. Extractions or restorations performed in third molars were excluded.

本研究旨在探究造血细胞移植（hematopoietic cell transplantation, HCT）后5至10年患者报告的口腔健康相关生活质量，及其与HCT类型和牙科治疗需求的关联。2012年至2017年间，在荷兰奈梅亨拉德堡德大学医学中心接受治疗的所有成年自体或异基因造血细胞移植幸存者均被纳入本研究邀请范围。已参与前瞻性ORASTEM/HOME-(2)研究的患者被排除。研究人员通过电话联系符合条件的患者，以获取知情同意并确认其当前住址。未提供知情同意或多次联系未果的患者被排除。

口腔健康相关生活质量通过OHIP-14、Summated XI、OES及MFIQ问卷的前9个问题进行评估。2023年6月至10月，所有患者均收到纸质版问卷，且未发送随访提醒。随问卷一同寄送的还有一份表格，患者可填写当前就诊牙医的信息，并授权研究人员获取其牙科诊疗记录。在获得授权后，研究人员向患者的接诊牙医申请调取其牙科记录。若牙科诊所未予回复，则于数周后发送随访提醒。

从牙科记录中，统计患者在填写问卷当日左右的天然牙（第三磨牙除外）数量。以HCT日期为起点，从牙科记录中统计患者有牙科就诊记录的年份：仅当存在常规检查或口腔卫生诊疗记录的年份方可计入，否则不计入该年度就诊次数。统计范围为HCT前7年（不含移植前1年）至HCT后10年期间的修复治疗与拔牙操作数量。修复治疗对应的收费编码为V15、V71、V72、V73、V74、V81、V82、V83、V84、V91、V92、V93及V94；拔牙操作对应的收费编码为H11、H16及H35，同时检索病历中提及转诊至口腔外科的记录，以纳入由口腔外科医师实施的复杂拔牙操作。第三磨牙相关的拔牙或修复操作均被排除。