Friday, May 13, 2011

Prevalence of periodontitis and optimal timing of dental treatment in patients undergoing heart valve surgery

Interact CardioVasc Thorac Surg 2011;12:696-700. doi:10.1510/icvts.2010.255943
Yoshitsugu Nakamuraa,*, Osamu Tagusaria, Yoshimasa Seikea, Yujiro Itoa, Ken-ichi Saitob, Ryozo Miyamotob, Kiyoharu Nakanoc and Fumiaki Shikatad
a Department of Cardiovascular Surgery, NTT Medical Center Tokyo, 5-9-22 Higashigotanda, Shinagawa-ku, Tokyo 141-8625, Japan
b Department of Dentistry and Oral Surgery, NTT Medical Center Tokyo, 5-9-22 Higashigotanda, Shinagawa-ku, Tokyo 141-8625, Japan
c Department of Cardiovascular Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, Japan
d Department of Cardiovascular Surgery, Ehime University School of Medicine, Toon, Ehime, Japan
*Corresponding author. Tel.: +81-3-3448-6565 (Business), +81-3-5421-3567 (Home); fax: +81-3-3448-6566.

E-mail address: ystgnkmr@gmail.com (Y. Nakamura).
We investigated the prevalence, risk factors, and optimal timing of treatment for advanced periodontitis in patients undergoing elective heart valve surgery. Dental examinations were given to 209 patients (aged 65±10 years) scheduled for valve surgery. Patients with no or mild periodontitis were assigned as controls (n=105). Patients with advanced periodontitis underwent tooth extraction and curettage (n=104), 68 of whom underwent tooth extraction within two weeks (short wait) and 36 of whom underwent extraction longer than two weeks, before surgery. The three groups (control, short, and long wait) were similar in age, gender, diseased valve, and type of surgery received. The average number of teeth extracted was 2.3±2.3. In both univariate and multivariate analysis, risk factors for advanced periodontitis were history of smoking and heart failure. No complications arose from the extractions. Length of postoperative hospital stay, intrafebrile days, white blood cell count and serum C-reactive protein (assessed at postoperative days 1, 3 and 7) were similar among the three groups. During the mean follow-up period of 60±16 months, no patient developed prosthetic valve endocarditis, and there were no postoperative deaths. In conclusion, we found no evidence that receipt and timing of dental treatment affected surgical success rates and postoperative course.

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