Introduction: Numerous articles have documented the safety of intravenous moderate sedation when used as an adjunct for dental procedures. These articles have traditionally focused on surgical procedures and demonstrate significant differences in duration for periodontal versus oral surgery cases. Periodontal procedures typically last longer than oral surgery procedures, and, when using intravenous moderate sedation, these time differences can be critical because longer procedures require additional medication use and place patients in prolonged periods of altered consciousness.
Case Series: The goal of this retrospective review is to analyze intravenous moderate sedation records from multiple private practicing periodontists to evaluate a variety of data and how they relate to periodontal procedures. Evaluated data included patient demographics, procedure type, procedure duration, medication dosages, fluid administration, hemodynamic changes, respiratory changes, and complications. Intravenous sedation cases performed during the past 5 years at five private periodontal practices were evaluated.
Conclusions: Intravenous moderate sedation using fentanyl and versed is a safe and effective adjunct for periodontal surgical procedures with minimal complications. Predictable changes in hemodynamic and respiratory levels will ensue when using these agents. Finally, practitioners using intravenous moderate sedation should schedule an additional 30 minutes of procedure time to account for preoperative and postoperative patient management.
Introduction: Healing complications associated with androgenic anabolic steroid (AAS) abuse have received minimal attention in the periodontal literature. This case report describes an adverse healing event after palatal subepithelial connective tissue graft (SECTG) harvest associated with AAS abuse.Case Presentation: A 35-year-old white male was treated with an SECTG procedure to address gingival recession on the facial aspect of teeth #24 and #25. Donor tissue was harvested from the left hard palate via a single incision technique. The procedure was completed without complication. One week postoperatively, the patient presented with a large asymptomatic overgrowth of tissue from the palatal harvest site. Over the following 5 weeks of continued observation, the lesion demonstrated progressive, spontaneous resolution. Investigation of possible etiology revealed the subject was a recreational bodybuilder with admitted AAS abuse.Conclusions: Post-surgical healing can be influenced by AAS abuse. Alterations in connective tissue metabolism and fibroblast activity are known sequelae of AAS abuse; however, patients may be reluctant to admit to steroid abuse during the presurgical interview. Surgeons should suspect the possibility of AAS abuse when postoperative complications present in a patient of muscular body type. Clin Adv Periodontics 2011;1:23-28.
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