Dental extractions in patients with cardiac sarcoidosis.
OBJECTIVE
To present data on hemodynamic changes during dental extractions in 5 patients with cardiac sarcoidosis, performed with electrocardiogram, heart rate, and blood pressure monitoring throughout the procedures, and to discuss the problems relating to the disease and dental extraction.


METHODS
The medical data for 5 patients, including medical records, physician correspondence, and laboratory data before the treatments, were assessed. Seven dental extractions were then performed while monitoring and recording the hemodynamic conditions. Heart rate, blood pressure, rate pressure products, and electrocardiographic findings were analyzed. Finally, posttreatment evaluations of the general and local conditions of the patients were conducted.


RESULTS
All dental extractions were performed in nonactive stable periods, with no remarkable hemodynamic changes or complications, while maintaining a stable hemodynamic state throughout the extraction procedure. All patients received a pretreatment supplement of corticosteroid. Wound healing was similar to that in normal patients under antibiotic prophylaxis against infection originating from the dental extraction wound and the original dental lesion.


CONCLUSIONS
Pretreatment general evaluation of patients with cardiac sarcoidosis should be performed through various examinations and physician consultation, and a stable hemodynamic change during the surgical procedure should be maintained under any hemodynamic monitors. Corticosteroid supplement and antibiotic coverage are also necessary for safe dental extraction and suitable healing.
Yoshimura
Yasuro
Y
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Shimane University, Izumo City, Shimane, Japan. omfs1@med.shimane-u.ac.jp
Nariai
Yoshiki
Y
Yoshimura
Hitoshi
H
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental / Q000379:methods; D019072:Antibiotic Prophylaxis / Q000379:methods; D009202:Cardiomyopathies / Q000150:complications*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications*; D013610:Tachycardia / Q000209:etiology / Q000517:prevention & control; D014081:Tooth Extraction / Q000009:adverse effects*; D018879:Ventricular Premature Complexes / Q000209:etiology / Q000517:prevention & control