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Dental implants in patients at high risk for infective endocarditis: a preliminary study

  • M. Findler
    Affiliations
    Department of Oral Medicine, The Hebrew University – Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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  • T. Chackartchi
    Affiliations
    Department of Periodontology, The Hebrew University – Hadassah Faculty of Dental Medicine, Jerusalem, Israel
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  • E. Regev
    Correspondence
    Address: E. Regev, Department of Oral and Maxillofacial Surgery, The Hebrew University-Hadassah Medical Center and Faculty of Dental Medicine, POB 12272, Jerusalem 91120, Israel. Tel: +972 2 6776148; Fax: +972 2 6779110.
    Affiliations
    Department of Oral and Maxillofacial surgery, The Hebrew University – Hadassah Medical Center and Faculty of Dental Medicine, Jerusalem, Israel
    Search for articles by this author

      Abstract

      The safety of dental implant placement in patients at high risk for infective endocarditis (IE) has never been shown. The outcome of osseointegrated implants in patients with artificial heart valves or with a history of an infected valve is not known. In this article we describe our experience of dental implant placement in patients at high risk for IE. A retrospective study was conducted on patients at high risk for IE who underwent dental implant placement. All the patients received prophylactic antibiotic treatment before the surgical procedure, in accordance with the relevant American Heart Association guidelines. A total 13 patients underwent 16 surgical procedures for the placement of 57 dental implants over a period of 17 years. Within the follow-up period, no case of IE was reported. Two implants failed before exposure in one patient, one patient suffered from mitral valve thrombosis 14 days after the dental procedure, and another patient suffered a stroke 6 months following treatment. Despite the limitation of the small group of patients and the known low incidence of IE, dental implants may be regarded as a legitimate procedure for patients at high risk for IE.

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      References

        • Karchmer A.W.
        Infective endocarditis.
        in: Longo D.L. Fauci A.S. Kaspar D.L. Hauser S.L. Jameson J.L. Loscalzo J. Harrison's principals of internal medicine. 18th ed. McGraw Hill Medical, New York2012: 1065
        • Little J.W.
        • Falace D.A.
        • Miller C.S.
        • Rhodus N.L.
        Dental management of the medically compromised patient.
        8th ed. Mosby Evolve Elsevier, St Louis2013: 20-36
        • Karchmer A.W.
        Infective endocarditis.
        in: Bonow R.O. Mann D.L. Zipes D.P. Libby P. Braunwald's heart disease: a textbook of cardiovascular medicine. 9th ed. Saunders Elsevier, Philadelphia2012: 1713-1738
        • Gould F.K.
        • Elliott T.S.
        • Foweraker J.
        • Fulford M.
        • Perry J.D.
        • Roberts G.J.
        • et al.
        Working Party of the British Society for Antimicrobial Chemotherapy. Guidelines for the prevention of endocarditis: report of the Working Party of the British Society for Antimicrobial Chemotherapy.
        J Antimicrob Chemother. 2006; 57: 1035-1042
        • Wilson W.
        • Taubert K.A.
        • Gewitz M.
        • Lockhart P.B.
        • Baddour L.M.
        • Levison M.
        • et al.
        • American Heart Association Rheumatic Fever; Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group
        Prevention of infective endocarditis. Guidelines from the American Heart Association. A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease of the Young and the Council on Clinical Cardiology, the Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcome Research Interdisciplinary Working Group.
        Circulation. 2007; 116: 1736-1754
        • National Institute for Health and Clinical Excellence
        Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures.
        NICE, London, UK2008 (CG64, Available at: http://www.nice.org.uk/cg064 [accessed 16.04.14])
        • Habib G.
        • Hoen B.
        • Tornos P.
        • Thuny F.
        • Prendergast B.
        • Vilacosta I.
        • et al.
        • ESC Committee for Practice Guidelines
        Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer.
        Eur Heart J. 2009; 30: 2369-2413
        • Piñeiro A.
        • Tomás I.
        • Blanco J.
        • Alvarez M.
        • Seoane J.
        • Diz P.
        Bacteraemia following dental implants’ placement.
        Clin Oral Implants Res. 2010; 21: 913-918
        • Bölükbaşı N.
        • Özdemir T.
        • Öksüz L.
        • Gürler N.
        Bacteremia following dental implant surgery: preliminary results.
        Med Oral Pathol Oral Cir Bucal. 2012; 17: e69-e75
        • Zitzmann N.U.
        • Berglundh T.
        Definition and prevalence of peri-implant diseases.
        J Clin Periodontol. 2008; 35: 286-291
        • Algraffee H.
        • Borumandi F.
        • Cascarini L.
        Peri-implantitis.
        Br J Oral Maxillofac Surg. 2012; 50: 689-694
        • Dajani A.S.
        • Taubert K.A.
        • Wilson W.
        • Bolger A.F.
        • Bayer A.
        • Ferrieri P.
        • et al.
        Prevention of bacterial endocarditis: recommendations by the American Heart Association.
        Clin Infect Dis. 1997; 25: 1448-1458
        • Tomás I.
        • Alvarez M.
        • Limeres J.
        • Potel C.
        • Medina J.
        • Diz P.
        Prevalence, duration and aetiology of bacteremia following dental extractions.
        Oral Dis. 2007; 13: 56-62
        • Otten J.E.
        • Pelz K.
        • Christmann G.
        Aerobic bacteremia following tooth extraction and removal of osteosynthesis plates.
        J Oral Maxillofac Surg. 1987; 45: 477-480
        • Takai S.
        • Kuriyama T.
        • Yanagisawa M.
        • Nakagawa K.
        • Karasawa T.
        Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2005; 99: 292-298
        • Lang N.P.
        • Berglundh T.
        Peri-implant diseases: where are we now? Consensus of the Seventh European Workshop on Periodontology.
        J Clin Periodontol. 2011; 38: 178-181
        • Madrid C.
        • Sanz M.
        What influence do anticoagulants have on oral implant therapy? A systematic review.
        Clin Oral Implants Res. 2009; 20: 96-106
        • Bacci C.
        • Berengo M.
        • Favero L.
        • Zanon E.
        Safety of dental implant surgery in patients undergoing anticoagulation therapy: a prospective case–control study.
        Clin Oral Implants Res. 2011; 22: 151-156
        • Steckelberg J.M.
        • Wilson W.R.
        Risk factors for infective endocarditis.
        Infect Dis Clin North Am. 1993; 7: 9-19