Influence of Oral Hygiene after Orthodontic Appliance Removal in Children Candidates to Hematopoietic Stem Cell Transplantation: A 10 Years’ Experience

Objective: This cohort study aims to evaluate the impact of oral appliance removal on oral hygiene grade in children candidates to hematopoietic stem cell transplantation (HSCT) over a 10-year period. Materials and methods: The following data from 213 medical records of children candidates to HSCT for newly diagnosed hemato-oncologic diseases were collected: age, type of hemato-oncologic disease, presence of removable or fixed orthodontic appliance, debonding protocol, simplified oral hygiene index (OHI-S) before debonding (T0) and after 7 days (T1). Results: Out of 213 children candidates to HSCT, 44 patients (16.9%) wore an orthodontic device, in detail: 8 children wore a mobile appliance and 36 a fixed one. The removal of the fixed appliance was requested in six cases before performing magnetic resonance imaging (MRI) and in 30 cases before the conditioning. All the children underwent the same oral hygiene protocol after removing the fixed appliance. The OHI-S resulted significantly lower 7 days after the debonding procedure. Conclusion: The removal of the orthodontic appliance before HSCT increases the oral hygiene grade of the children candidates to transplantation. A correct protocol must be followed in order to respect the hard and soft tissues. Clinical significance: Orthodontic appliance removal before HSCT in children is recommended to ameliorate the oral hygiene grade of the patients, in addition, to prevent any form of traumatism on the oral mucosa. Keywords: Appliance, Children, Cohort study, Transplant.