Miranda-Rius Jaume, Lahor-Soler Eduard, Brunet-Llobet Lluís, Sabaté de la Cruz Xavier
Departament d'Odontostomatologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.
Servei d'Odontologia, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Eur J Oral Sci. 2016 Dec;124(6):559-565. doi: 10.1111/eos.12313. Epub 2016 Oct 17.
Patients with cardiac implantable electrical devices should take special precautions when exposed to electromagnetic fields. Proximity to equipment used in clinical dentistry may cause interference. This study evaluated in vitro the risks associated with different types/makes of cardiac devices and types of dental equipment. Six electronic dental tools were tested on three implantable cardioverter defibrillators and three pacemakers made by different manufacturers. Overall, the risk of interference with the pacemakers was 37% lower than with the implantable cardioverter defibrillators. Regarding the types/makes of cardiac devices analysed, that from Boston Scientific had a five-fold greater risk of interference than did that from Biotronik [prevalence ratio (PR) = 5.58]; there was no difference between that from Biotronik and that from Medtronic. Among the dental equipment, the electric pulp tester had the greatest risk of inducing interference and therefore this device was used as the benchmark. The electronic apex locator (PR = 0.29), Periotest M (PR = 0.47), and the ultrasonic dental scaler (PR = 0.59) were less likely to induce interference than the electric pulp tester. The risk was lowest with the electronic apex locator. Pacemakers presented a lower risk of light to moderate interference (PR = 0.63). However, the risk of severe electromagnetic interference was 3.5 times higher with pacemakers than with implantable cardioverter defibrillators (PR = 3.47).
植入式心脏电子设备患者在暴露于电磁场时应采取特殊预防措施。靠近临床牙科使用的设备可能会引起干扰。本研究在体外评估了不同类型/品牌的心脏设备与牙科设备类型相关的风险。对六种电子牙科工具在不同制造商生产的三台植入式心律转复除颤器和三台起搏器上进行了测试。总体而言,起搏器受到干扰的风险比植入式心律转复除颤器低37%。关于所分析的心脏设备的类型/品牌,波士顿科学公司生产的设备受到干扰的风险比百多力公司生产的设备高五倍[患病率比(PR)=5.58];百多力公司生产的设备与美敦力公司生产的设备之间没有差异。在牙科设备中,牙髓电活力测试仪引发干扰的风险最大,因此该设备被用作基准。电子根尖定位仪(PR = 0.29)、牙周膜测试仪(PR = 0.47)和超声波洁牙机(PR = 0.59)引发干扰的可能性低于牙髓电活力测试仪。电子根尖定位仪的风险最低。起搏器出现轻度至中度干扰的风险较低(PR = 0.63)。然而,起搏器出现严重电磁干扰的风险比植入式心律转复除颤器高3.5倍(PR = 3.47)。