[The influence of surgical and restorative dental treatment prior to cardiac valve surgery on the long-term demand of dental treatment: a prospective clinical study].
The study objective was to evaluate the long-term influence of non-radical surgical and restorative dental treatment modalities prior to elective cardiac valve replacement on the subsequent dental treatment demand. A total of 305 patients preceding cardiac valve surgery were screened and the appropriate dental treatment was initiated. After 36 months 80 patients were re-evaluated clinically, of which 60 required dental restorations of 155 teeth, mostly due to periodontal pathology. Independent of the sub-group there was a statistically substantial increase of the treatment demand compared to the time of initial examination. In addition, at the time of final re-evaluation the definite treatment need significantly increased far beyond anticipation, potentially due to inadequate dental procedures during the follow-up interval. Irrespective of any dental treatment or antibiotic application, endocarditis did not occur in any patient. Non-radical dental restoration prior to cardiac valve replacement can only be successful, if a standardized dental follow-up with common monitoring forms is provided. The risk of prosthetic valve infective endocarditis based on a dental focus is probably overestimated.
Kolk
Andreas
A
Klinik und Poliklinik für Mund-Kiefer- und Gesichtschirurgie der Technischen Universität München, Klinikum rechts der Isar, München, Germany. andreas.kolk@gmx.de
Pautke
Christoph
C
Hall
Donald
D
Wagenpfeil
Stefan
S
Wolff
Klaus-Dietrich
KD
Deppe
Herbert
H
D019072:Antibiotic Prophylaxis; D002423:Cause of Death; D003729:Dental Care / Q000379:methods*; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000517:prevention & control; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D008403:Mass Screening; D009911:Oral Hygiene Index; D019647:Oral Surgical Procedures / Q000379:methods*; D010510:Periodontal Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors