Findler M, Galili D, Meidan Z, Yakirevitch V, Garfunkel A A
Oral Medicine Service, Faculty of Dental Medicine, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
Oral Surg Oral Med Oral Pathol. 1993 Sep;76(3):298-300. doi: 10.1016/0030-4220(93)90257-5.
A new method of predental treatment and management for patients with active ischemic heart disease is reported. Patients with unstable angina pectoris or who have just had a myocardial infarction underwent full treatment for pain-induced dental problems, with the use of an incremental three-level antiangina and antianxiety medication: before dental treatment; in the waiting room, and c) during dental treatment. The setting was a tertiary referral oral medical service and hospital dental clinic. Twenty-six patients were treated, 16 men, 10 women, ranging in age from 45 to 68 years. Ten patients with unstable angina pectoris and 16 patients less than 3 months after a myocardial infarction. All patients underwent comprehensive dental treatment. Good cardiovascular control was achieved, and all the procedures were uneventfully completed. This study indicates the need to reconsider the absolute versus relative contraindications for dental treatment in patients with active ischemic heart disease and recommends the use of a gradual three-level therapy.
报告了一种针对活动性缺血性心脏病患者的牙科治疗前处理和管理的新方法。不稳定型心绞痛患者或刚发生心肌梗死的患者，针对疼痛引起的牙科问题接受了全面治疗，采用递增式三级抗心绞痛和抗焦虑药物治疗：a）牙科治疗前；b）在候诊室时；c）牙科治疗期间。治疗地点为三级转诊口腔医疗服务机构和医院牙科诊所。共治疗26例患者，男性16例，女性10例，年龄在45至68岁之间。其中10例为不稳定型心绞痛患者，16例为心肌梗死后不到3个月的患者。所有患者均接受了全面的牙科治疗。实现了良好的心血管控制，所有操作均顺利完成。本研究表明有必要重新考虑活动性缺血性心脏病患者牙科治疗的绝对与相对禁忌证，并推荐使用逐步三级治疗法。
