Amado-Cuesta Susana, Valmaseda-Castellón Eduardo, Berini-Aytés Leonardo, Gay-Escoda Cosme
Facultad de Odontología, Universidad de Barcelona, Barcelona, Spain.
Med Oral. 2004 May-Jul;9(3):253-62.
Serious systemic disorders such as hypertension, cerebrovascular or heart disease, diabetes and psychiatric problems are common in elderly patients, and lead to the prescription of different drugs. This may in turn influence oral health, and the dentist should be familiarized with these situations when providing dental treatment in elderly patients. A retrospective study was made of 196 patients over age 65 years to evaluate the type of ambulatory surgery performed under locoregional anesthesia, taking into account the presence of background systemic pathology, multiple drug therapy, oral and dental health, the cause of consultation and the type of anesthesia used, relating these parameters to the development of intra- or postoperative systemic and/or local complications. Some systemic disease was documented in 88% of the patents-- hypertension being the most frequent disorder (in 45% of subjects with systemic disease). On the other hand, 78% of the patients used some medication, and 77% presented for hard-tissue treatment (tooth extractions, bone remodeling, etc.); 61% of all treatments comprised the removal of root fragments (54% of all hard-tissue interventions), symptomatic third molars (15%) or other dental inclusions. Only mild or moderate complications were recorded (13%) -- either local (n = 25) or systemic (n = 1). No significant relation was observed between the development of intra- or postoperative complications and the type of treatment provided or the medication used by these patients. Only diabetes was associated with a significant increase in intra- and postoperative local complications (p<0.003).
严重的全身性疾病,如高血压、脑血管疾病或心脏病、糖尿病和精神问题在老年患者中很常见,并导致不同药物的处方。这反过来可能会影响口腔健康,并且牙医在为老年患者提供牙科治疗时应熟悉这些情况。对196名65岁以上的患者进行了一项回顾性研究,以评估在局部麻醉下进行的门诊手术类型,同时考虑到背景全身性病理状况、多种药物治疗、口腔和牙齿健康、就诊原因以及所使用的麻醉类型,将这些参数与术中或术后全身性和/或局部并发症的发生情况相关联。88%的患者记录有某种全身性疾病——高血压是最常见的疾病(在患有全身性疾病的患者中占45%)。另一方面,78%的患者使用了某种药物,77%的患者前来接受硬组织治疗(拔牙、骨重塑等);所有治疗中有61%包括牙根碎片的拔除(占所有硬组织干预的54%)、有症状的第三磨牙(15%)或其他牙齿内含物。仅记录到轻度或中度并发症(13%)——局部并发症(n = 25)或全身并发症(n = 1)。在这些患者中,术中或术后并发症的发生与所提供的治疗类型或所使用的药物之间未观察到显著关系。只有糖尿病与术中及术后局部并发症的显著增加相关(p<0.003)。