Perioperative dental screening and treatment in patients undergoing cardio-thoracic surgery and interventional cardiovascular procedures. A consensus report based on RAND/UCLA methodology

Cotti, Elisabetta; Cairo, Francesco; Bassareo, Pier Paolo; Fonzar, Federica; Venturi, Marco; Landi, Luca; Parolari, Alessandro; Franco, Vittorio; Fabiani, C.; Barili, Fabio; Lenarda, Andrea Di; Gulizia, Michele Massimo; Borzi, Mauro; Campus, Guglielmo; Musumeci, Francesco; Mercuro, Giuseppe

doi:10.1016/j.ijcard.2019.06.041

Cited by 17 publications

(17 citation statements)

References 67 publications

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“….A systematic review published in 2017 (Cotti et al) Assessed whether there was a consensus on perioperative dental screening and management of patients undergoing cardiothoracic, vascular and other invasive cardiovascular procedures. Cotti et al (2017) observed that there is still no consensus on the need for dental care before invasive cardiovascular procedures.…”

Section: Discussionmentioning

confidence: 99%

Oral health and incidence of nosocomial infection and mortality in patients undergoing elective cardiac surgery

Gehring

Costa

Cardoso

et al. 2021

RSD

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Objective: To analyze the relationship between oral disease and the risk of developing hospital pneumonia, mediastinitis, endocarditis, surgical site infection and hospital death in patients undergoing elective cardiac surgery. Assess which risk factors would be related to the risk of nosocomial infection and death after cardiac surgery. Methodology: It was an analytical, observational, prospective study, carried out from January to December 2018. The study included 46 patients candidates for elective cardiac surgery and evaluated as to the type of heart disease, type of surgery, associated comorbidities, age, NYHA classification, BMI, ICU stay days, oral health assessment by a dental surgeon, occurrence of infection and hospital death. The analysis was done through analysis of absolute and relative frequencies, estimation of odds ratios, chi-square test and Mann-Whitney test. Results: Of the 46 patients analyzed, 11 (23.9%) of them had hospital infections and 4 (8.7%) died, there was no statistically significant difference in the variables studied with the occurrence of infection or death. The heterogeneity of the findings in the oral evaluation that ranged from edentulous patients with partial or total dentures, partial edentulous with or without prosthesis and varying degrees of oral disease that ranged from gingivitis, periodontitis to abscesses. The prostheses had varying degrees of conservation and hygiene. This great variability of findings may have implied no statistical significance in the variables. Conclusion: There was no statistical difference in the occurrence of hospital pneumonia, mediastinitis, endocarditis, surgical site infection and hospital death according to the patients' oral health condition.

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Section: Discussionmentioning

confidence: 99%

Oral health and incidence of nosocomial infection and mortality in patients undergoing elective cardiac surgery

Gehring

Costa

Cardoso

et al. 2021

RSD

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“…Dental screening and management of oral infections such as caries, endodontic infections, periodontal infections and so forth, prior to any invasive cardiovascular procedure is controversial due to the available guidelines lacking detailed information in this regard [6]. However, several studies have indicated an extensive preoperative extra-and intraoral examination for the detection of any infection, overall assessment of oral hygiene and sensibility testing for every individual tooth along with radiographic examination for detection of any teeth with irreversible pulpitis, pulp necrosis, apical periodontitis, acute apical abscess and chronic apical abscess requiring endodontic treatment [30].…”

Section: Guidelines For Timing Of Dental Screening Treatment and Favourable Outcome Before Invasive Cardiovascular Surgerymentioning

confidence: 99%

“…These guidelines ignore the fact that it is often challenging to make an accurate diagnosis or a definite conclusion regarding the outcome of dental treatment [6]. Unfortunately, dentists are usually the last to be informed of the timing of the cardiac intervention, which makes it difficult to assess the outcome of the treatment [30]. As reported by the European Society of Endodontology, the favourable outcome of endodontic treatment could be assessed one year after the completion of root canal treatment.…”

Section: Guidelines For Timing Of Dental Screening Treatment and Favourable Outcome Before Invasive Cardiovascular Surgerymentioning

confidence: 99%

“…In a recent consensus report which included cardiologists, endodontists and periodontists, it was concluded that to assess the outcome of endodontic treatment in cases of irreversible pulpitis, pulp necrosis, apical periodontitis, acute apical abscess and chronic apical abscess, follow-up time requires ranges from one week for the patient's symptoms up to one year for radiographic evaluation. The consensus stressed the need for the development of a protocol to aid both cardiologists and dentists during the perioperative preparation phase [30]. Furthermore, in a recent study done to analyse the attitude of cardiologists and cardiovascular surgeons towards the management of endodontic infections and oral health, cardiologists believed that the cardiac health of patients with heart diseases along with endodontic infections could be negatively affected by chronic root canal infection; also, most cardiac specialists emphasised the importance of managing endodontic diseases [32].…”

Section: Guidelines For Timing Of Dental Screening Treatment and Favourable Outcome Before Invasive Cardiovascular Surgerymentioning

confidence: 99%

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A Review of Guidelines for Antibiotic Prophylaxis before Invasive Dental Treatments

et al. 2020

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Bacteraemia associated with invasive dental treatments can propagate infective endocarditis in high-risk cardiac patients. Over the past decade, antibiotic prophylaxis before dental treatment has been questioned. This review aims to compare the variations between the UK, European and American antibiotic prophylaxis guidelines before dental treatments. Antibiotic prophylaxis guidelines by the National Institute for Health and Care Excellence (NICE)—Clinical Guideline 64, Scottish Dental Clinical Effectiveness Programme (SDCEP), American Heart Association (AHA), European Society of Cardiology (ESC), European Society of Endodontology (ESE) and Belgian Health Care Knowledge Centre (KCE) position statements were compared regarding the indications, high-risk patients and prophylaxis regimens before dental treatments. In the United Kingdom, the NICE—Clinical Guideline 64 and SDCEP—Implementation Advice do not advise the prescription of prophylactic antibiotics for the majority of high-risk cardiac patients undergoing routine dental treatments. On the contrary, the AHA, ESC and KEC recommend the prescription of antibiotics prior to invasive dental procedures in high-risk cardiac individuals. The ESE also indicates prophylaxis before endodontic procedures for patients with other conditions, including impaired immunologic function, prosthetic joint replacement, high-dose jaw irradiation and intravenous bisphosphonates. Among these guidelines, there are variations in antibiotic prophylaxis regimens. There are variations regarding the indications and antibiotic prophylaxis regimens before invasive dental treatments among these available guidelines.

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“…(AKASHI et al, 2018). Não existe um protocolo padrão para triagem odontológica que relacione o controle de infecções e o período adequado para realização dos procedimentos antes da cirurgia cardiovascular (COTTI et al, 2019). A inexistência de um protocolo padrão está associada, principalmente, à desvinculação vigorosa entre o corpo e a boca reforçada por profissionais de saúde, onde o conhecimento das condições bucais é visto por profissionais da área médica como limitados aos profissionais de odontologia (FONSECA et al, 2016).…”

Section: Introductionunclassified

Manejo Daansiedade Na Clínica De Odontopediatria

Venâncio¹,

Silva²,

Rodrigues³

et al. 2021

Ensino, Pesquisa E Contribuições Científicas Em Odontologia

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Ensino, pesquisa e contribuições científicas em odontologia -Volume I está licenciado sob CC BY 4.0.Esta licença exige que as reutilizações deem crédito ao criador. Ele permite que os reutilizadores distribuam, remixem, adaptem e construam o material em qualquer meio ou formato, mesmo para fins comerciais. O conteúdo da obra e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, não representando a posição oficial da Editora Amplla. É permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores. Todos os direitos para esta edição foram cedidos à Editora Amplla.

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Perioperative dental screening and treatment in patients undergoing cardio-thoracic surgery and interventional cardiovascular procedures. A consensus report based on RAND/UCLA methodology

Cited by 17 publications

References 67 publications

Oral health and incidence of nosocomial infection and mortality in patients undergoing elective cardiac surgery

Oral health and incidence of nosocomial infection and mortality in patients undergoing elective cardiac surgery

A Review of Guidelines for Antibiotic Prophylaxis before Invasive Dental Treatments

Manejo Daansiedade Na Clínica De Odontopediatria

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