Capacity of dental equipment to interfere with cardiac implantable electrical devices

Abstract

Lahor-Soler E, Miranda-Rius J, Brunet-Llobet L, Sabat e de la Cruz X. Capacity of dental equipment to interfere with cardiac implantable electrical devices. Eur J Oral Sci 2015; 00: 000-000. © 2015 Eur J Oral SciPatients with cardiac implantable electrical devices should take precautions when exposed to electromagnetic fields. Possible interference as a result of proximity to electromagnets or electricity flow from electronic tools employed in clinical odontology remains controversial. The objective of this study was to examine in vitro the capacity of dental equipment to provoke electromagnetic interference in pacemakers and implantable cardioverter defibrillators. Six electronic dental instruments were tested on three implantable cardioverter defibrillators and three pacemakers from different manufacturers. A simulator model, submerged in physiological saline, with elements that reproduced life-size anatomic structures was used. The instruments were analyzed at differing distances and for different time periods of application. The dental instruments studied displayed significant differences in their capacity to trigger electromagnetic interference. Significant differences in the quantity of registered interference were observed with respect to the variables manufacturer, type of cardiac implant, and application distance but not with the variable time of application. The electronic dental equipment tested at a clinical application distance (20 cm) provoked only slight interference in the pacemakers and implantable cardioverter defibrillators employed, irrespective of manufacturer.

Risk of electromagnetic interference induced by dental equipment on cardiac implantable electrical devices

“…The results of the bivariate analysis referring to electromagnetic interference, adjusted according to the dental equipment tested, are summarized in Table . The results for the variables CIED type/make, application distance (dA), application time (tA), state of the insulation of the electrode leads, and dental equipment for all CIEDs, were reported in detail in the first part of the study .…”

“…At present there is some controversy in the literature with respect to the effect of the possible interference of such electronic equipment with PMs and/or ICDs. However, in the first part of this investigation, following the same protocol, it was concluded that dental equipment tested at a clinical application distance (20 cm) provoked only slight interference in the CIEDs analysed .…”

Influence and safety of electronic apex locators in patients with cardiovascular implantable electronic devices: a systematic review

“…A total of 445 studies were excluded, and the full-text of 15 studies were assessed for eligibility. Among these 15 articles, seven fulfilled the inclusion criteria: five in vitro [1,3,10,15,20]; and two in vivo [21,22] studies. Figure 1 summarizes the details and results of the search strategy.…”

“…The quality of each study included in this review was given a grad out of 9. Four in vitro studies [1,3,15,20] reported that electronic apex locators do not interfere with cardiovascular implantable electronic devices and can be used safely. One in vitro study [10], however, reported that electronic apex locators caused electromagnetic interference without altering cardiovascular implantable electronic devices function and suggested that electronic devices should be kept to use at minimum distances.…”

“…The results of four in vitro studies demonstrated that electronic apex locators did not interfere with cardiovascular implantable electronic devices function and can be used safely [1,3,15,20]. …”