Impact of cone-beam computed tomography for the identification and management of an oral portal of entry in patients with infective endocarditis. A Delphi study.
Med Oral Patol Oral Cir Bucal
; 27(1): e42-e50, 2022 Jan 01.
Article
en En
| MEDLINE
| ID: mdl-34564684
ABSTRACT
BACKGROUND:
Infective endocarditis (IE) is a rare and life-threatening disease. Cutaneous portal of entry (POE) is predominant for IE, but an oral POE is the second most frequent source. Thus looking for and treating an oral POE in IE patients is of critical importance in order to reduce the risk of IE relapse or recurrence. The objectives of this study were 1) To reach a consensus on decision-making following the detection of an oral POE on cone-beam computed tomography (CBCT) while they were not identified using the current recommended approach in IE patients (oral examination and orthopantomogram OPT). 2) To determine whether this consensus differs when regarding the microbiology of IE. MATERIAL ANDMETHODS:
Twenty oral or maxillofacial surgeons participated to this Delphi study. The questionnaire was based on five radiological cases (OPT and matching CBCT) with two scenarios according to the objectives of detecting oral POE in an IE patient (curative in case of oral causative microorganism, and preventive if not) and different therapeutic approaches (surgical or conservative treatment, no treatment) for each of them. Consensus was defined as an agreement rate of ≥75%.RESULTS:
The response rate was≥85%. After four rounds, consensus was achieved for all proposals. CBCT changed the decision-making of experts in four cases. In one case, the decision was influenced by the IE microbiology toward a more radical approach in case of oral causative microorganism.CONCLUSIONS:
In IE patients, CBCT changed markedly the decision-making of experts by eradicating more oral POE than when using OPT. This could reduce the risk of IE relapse and recurrence.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Endocarditis
/
Tomografía Computarizada de Haz Cónico
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
Idioma:
En
Revista:
Med Oral Patol Oral Cir Bucal
Asunto de la revista:
ODONTOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Francia