Oral Health Clearance Outcomes for Cardiovascular Surgery.

Objective: To determine the risk of morbidity and mortality in patients receiving dental extractions before planned cardiovascular surgery (CVS) and examine factors that may affect the chance of oral health clearance. Patients and Methods: A retrospective medical record review was performed of patients who underwent dental screening before CVS from January 1, 2015, to December 31, 2021, at a major medical institution. A total of 496 patients met the inclusion criteria and were divided into 2 groups. Group 1 patients were cleared to advance to planned CVS (n=390). Group 2 patients were not cleared for surgery and subsequently underwent dental extractions before planned CVS (n=106). Results: Six patients (5.7%) experienced postoperative complications after dental extraction that resulted in an emergency room visit. No deaths occurred after dental extraction before CVS. However, 4 patients died within 30 days of CVS, 3 from Group 1 (0.77%) and 1 from Group 2 (0.94%). Dental extraction before planned CVS showed a borderline significant association with death based on unadjusted (P=.06) and age-adjusted analysis (P=.05). Patients who reported seeing a dentist routinely had a significantly higher chance of oral health clearance (P <.001). No differences were noted between the 2 groups with regard to age, sex, or 30-day hospital readmission rate. Conclusion: Patients who had dental extractions completed before planned CVS may be at an increased risk of mortality. Further studies are needed to examine this relationship. Emphasis should be on prioritization of routine dental visits before planned CVS.

Probing Depth and Peri-implant Health as Related to Buccal and Lingual Bone Thickness Around Dental Implants: An Experimental Study.

A retrospective chart review was conducted of CBCT images captured between November 2019 and April 2021 on patients who underwent dental implant placement and had a periodontal charting. The buccal and lingual bone thickness around the implants was measured as an average of three measurements taken from the buccal and lingual aspects of implants. Implants with peri-implantitis were placed in Group 1, and implants with peri-implant mucositis or good peri-implant health were placed in Group 2. Wilcoxon rank sum test was used to compare the differences between the bone thicknesses of the groups. In total, 93 CBCT radiographs were screened, and 15 CBCT images with both an implant and corresponding periodontal charting were analyzed. Of the 15 implants examined, 5 presented with peri-implantitis (33%), 1 with peri-implant mucositis, and 9 with good peri-implant health. Within the limitations of this study, buccal bone thickness averaging ≥ 1.10 mm or midlingual probing depths ≤ 3.4 mm correlates with a more favorable peri-implant response. Larger studies are needed to substantiate these findings.

The influence of antimicrobial varnish on peri-implant soft tissue health: case report.

Bacterial biofilm in the oral cavity and around dental implants may trigger an inflammatory response of the peri-implant soft tissue. Emerging antimicrobial products have been developed to combat peri-implant soft tissue pathology; however, limited evidence is available evaluating their effectiveness. To the best of the authors' knowledge, this is the first documented case report in the literature assessing the effect of Cervitec Plus around dental implants. This case report provides an example of a patient presenting to a periodontal specialty clinic with peri-implant pathology and subsequently treated with antimicrobial varnish following dental hygiene peri-implant therapy. The report serves to evaluate the efficacy of peri-implant soft tissue pathology utilizing antimicrobial varnish as measured by percent of bleeding upon probing, presence of suppuration, and changes in implant probing depths. Understanding the impact of bacterial plaque on peri-implant soft tissue and the effectiveness of antimicrobial products in conjunction with dental hygiene peri-implant therapy may provide patients with optimal peri-implant health and long-term success of dental implants.

Teledentistry in the management of a non-Hodgkin's lymphoma manifesting as a gingival swelling: A case report.

Oral cavity lymphomas constitute only 3% of all lymphomas in the general population but are the third most common oral malignancy. A 67-year-old female with a history of osteoporosis, Graves' disease and non-Hodgkin's lymphoma was referred to the Department of Dental Specialties with a chief complaint of persistent soft tissue swelling facial to the maxillary incisors of possible non-odontogenic origin. To expedite care, the patient was first seen via teledentistry and subsequently appointed for an in-person evaluation and treatment. Examination revealed 1-3 mm probing depths and a firm, non-tender, non-fluctuant mass in the facial soft tissues approximating teeth nos. 7-10. Biopsy of the affected area was performed. A diagnosis of recurrent follicle center cell lymphoma, a form of non-Hodgkin's lymphoma, was rendered. The patient was subsequently referred to the Oncology and Hematology team, followed for 6 weeks and remained symptom-free. This case underlies the importance of teledentistry to expedite care and manage patient expectations. Additionally, it also underscores the importance of microscopic examination of tissue samples from oral lesions that appear non-odontogenic in nature and reinforces the role of dentistry in uncovering the oral-systemic link.

Viewpoint: Periprosthetic joint infection and dental antibiotic prophylaxis guidelines.

The purpose of this viewpoint is to provide a framework that is used within the Mayo Clinic to align recommendations from infectious disease experts, dental specialists, and orthopedic surgeons with regards to need for antibiotic prophylaxis prior to invasive dental procedures.