Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (2): 390-395. doi: 10.19723/j.issn.1671-167X.2021.02.026

Previous Articles     Next Articles

Blood pressure and heart rate changes of 640 single dental implant surgeries

LIU Xiao-qiang,YANG Yang,ZHOU Jian-feng,LIU Jian-zhang,TAN Jian-guo()   

  1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2019-01-29 Online:2021-04-18 Published:2021-04-21
  • Contact: Jian-guo TAN E-mail:tanwume@vip.sina.com
  • Supported by:
    National Natual Science Foundation of China(81701003);Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-19A03)

RICH HTML

   

PDF (PC)

Abstract:

Objective: To investigate the blood pressure and heart rate changes and influencing factors during single dental implant surgery. Methods: A retrospective cohort study was conducted. Six hundred and forty cases underwent single dental implant placement in Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2016 to December 2016 were recruited in this study according to the inclusion and exclusion criteria. They were divided into different groups according to the exposure factors which were patient characteristics (gender, age) and surgical procedures (immediate placement, flap elevation, bone grafting). The correlation between blood pressure and heart rate variability during single dental implant surgery and the patient characteristics and surgical procedures were analyzed. Results: The average systolic blood pressure variability was 9.47%±6.45% (maximum 46.04%), the average diastolic blood pressure variability was 12.18%±9.39% (maximum 88.00%), and the average heart rate variability was 10.59%±7.68% (maximum 49.12%). The effects of age and bone grafting on blood pressure variability, and of gender and immediate placement on heart rate variability, were statistically significant (P<0.05), respectively. The incidence of abnormal intraoperative blood pressure rise was 4.69%, of which there were 4 cases (0.63%) of systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. The incidence of abnormal intraoperative heart rate rise was 6.72%. Hierarchical analysis showed a higher risk of abnormal intraoperative blood pressure rise in the elderly (≥60 years) male patients [P<0.05, RR=3.409 (95%CI: 1.155-10.062) ] and flap elevation with bone grafting cases [P<0.05, RR=2.382 (95%CI: 1.126-5.040)], respectively. There was no statistically significant association between abnormal heart rate rise and patient characteristics or surgical procedures (P>0.05). Conclusion: There was a certain risk of blood pressure and heart rate variability during dental implant surgery. Elderly male patients and flap elevation with bone grafting were risk factors of abnormal intraoperative blood pressure rise.

Key words: Dental implantation, Blood pressure, Heart rate, Risk factors, Cohort studies

CLC Number: 

  • R783

Table 1

Effects of patient characteristics and surgical procedures on blood pressure and heart rate changes"

Groups Hemodynamic changes/%
Systolic blood pressure Diastolic blood pressure Heart rate
Gender Female (n=356) 8.97 ± 6.14 12.41 ± 9.06 11.26 ± 8.15
Male (n=284) 9.87 ± 6.67 11.89 ± 9.79 9.74 ± 6.96
t -1.781 -0.700 -2.534
P 0.075 0.484 0.012
Age ≥60 years (n=89) 11.55 ± 8.30 12.33 ± 13.07 9.30 ± 7.32
<60 years (n=551) 9.13 ± 6.04 12.16 ± 8.67 10.79 ± 7.72
t 2.637 0.123 -1.704
P 0.010 0.902 0.089
Immediate placement Yes (n=69) 9.87 ± 6.29 13.55 ± 9.41 13.03 ± 9.21
No (n=571) 9.42 ± 6.48 12.01 ± 9.38 10.29 ± 7.43
t 0.551 1.280 2.382
P 0.582 0.201 0.020
Flap surgery Yes (n=593) 9.56 ± 6.57 12.16 ± 9.38 10.46 ± 7.48
No (n=47) 8.39 ± 4.73 12.46 ± 9.68 12.16 ± 9.75
t 1.571 -0.216 -1.164
P 0.121 0.829 0.250
Bone grafting Yes (n=197) 10.89 ± 7.46 13.43 ± 9.90 11.29 ± 8.06
No (n=443) 8.84 ± 5.85 11.62 ± 9.11 10.27 ± 7.49
t 3.412 2.250 1.555
P 0.001 0.025 0.120

Table 2

Effects of patient characteristics and surgical procedures on abnormal blood pressure and heart rate rise"

Groups Abnormal blood pressure rise, n Abnormal heart rate rise, n
(+) (-) (+) (-)
Gender Female (n=356) 15 341 22 334
Male (n=284) 15 269 21 263
χ2 0.403 0.372
P 0.525 0.542
Age ≥60 years (n=89) 7 82 7 82
<60 years (n=551) 23 528 36 515
χ2 2.336 0.217
P 0.126 0.642
Immediate placement Yes (n=69) 4 65 3 66
No (n=571) 26 545 40 531
χ2 0.213 0.694
P 0.644 0.405
Flap surgery Yes (n=593) 28 565 39 554
No (n=47) 2 45 4 43
χ2 0.021 0.260
P 0.884 0.610
Bone grafting Yes (n=197) 14 183 16 181
No (n=443) 16 427 27 416
χ2 3.728 0.894
P 0.054 0.344

Table 3

Hierarchical analysis of effects of gender and age on abnormal blood pressure and heart rate rise"

Groups Abnormal blood pressure rise, n Abnormal heart rate rise, n
(+) (-) (+) (-)
Female ≥60 years (n=39) 1 38 1 38
<60 years (n=317) 14 303 21 296
χ2 0.295 0.988
P 0.587 0.320
RR (95%CI) 0.570 (0.073-4.454) 0.371 (0.049-2.836)
Male ≥60 years (n=50) 6 44 6 44
<60 years (n=234) 9 225 15 219
χ2 5.475 1.880
P 0.019 0.170
RR (95%CI) 3.409 (1.155-10.062) 1.991 (0.732-5.415)

Table 4

Effects of surgical trauma on abnormal blood pressure and heart rate rise"

Groups Abnormal blood pressure rise, n Abnormal heart rate rise, n
(+) (-) (+) (-)
Flap elevation and bone grafting (n=186) 14 172 13 173
Others (n=454) 15 439 28 426
χ2 5.439 0.149
P 0.020 0.700
RR (95%CI) 2.382 (1.126-5.040) 1.143 (0.579-2.259)
[1] Bystritsky A, Kronemyer D. Stress and anxiety: counterpart elements of the stress/anxiety complex[J]. Psychiatr Clin North Am, 2014,37(4):489-518.
doi: 10.1016/j.psc.2014.08.002 pmid: 25455062
[2] Fukayama H, Yagiela JA. Monitoring of vital signs during dental care[J]. Int Dent J, 2006,56(2):102-108.
doi: 10.1111/j.1875-595x.2006.tb00081.x pmid: 16620039
[3] Brand HS, Abraham-Inpijn L. Cardiovascular responses induced by dental treatment[J]. Eur J Oral Sci, 1996,104(3):245-252.
pmid: 8831058
[4] 中国心胸血管麻醉学会, 北京高血压防治协会. 围术期高血压管理专家共识[J]. 临床麻醉学杂志, 2016,32(3):295-297.
[5] Getsios D, Wang Y, Stolar M, et al. Improved perioperative blood pressure control leads to reduced hospital costs[J]. Expert Opin Pharmacother, 2013,14(10):1285-1293.
pmid: 23656583
[6] Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension[J]. J Hypertens, 2014,32(1):3-15.
pmid: 24270181
[7] Montebugnoli L, Servidio D, Miaton RA, et al. Heart rate variability: A sensitive parameter for detecting abnormal cardiocirculatory changes during a stressful dental procedure[J]. J Am Dent Assoc, 2004,135(12):1718-1723.
[8] Kim YK, Kim SM, Myoung H. Musical intervention reduces patients’ anxiety in surgical extraction of an impacted mandibular third molar[J]. J Oral Maxillofac Surg, 2011,69(4):1036-1045.
pmid: 20708320
[9] Lin CS, Wu SY, Yi CA. Association between anxiety and pain in dental treatment: A systematic review and meta-analysis[J]. J Dent Res, 2017,96(2):153-162.
doi: 10.1177/0022034516678168 pmid: 28106507
[10] Salma RG, Abu-Naim H, Ahmad O, et al. Vital signs changes during different dental procedures: A prospective longitudinal cross-over clinical trial[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2019,127(1):30-39.
pmid: 30219249
[11] Alemany-Martinez A, Valmaseda-Castellon E, Berini-Aytes L, et al. Hemodynamic changes during the surgical removal of lower third molars[J]. J Oral Maxillofac Surg, 2008,66(3):453-461.
pmid: 18280377
[12] Matsumura K, Miura K, Takata Y, et al. Changes in blood pressure and heart rate variability during dental surgery[J]. Am J Hypertens, 1998,11(11 Pt 1):1376-1380.
pmid: 9832183
[13] Wada M, Miwa S, Mameno T, et al. A prospective study of the relationship between patient character and blood pressure in dental implant surgery[J]. Int J Implant Dent, 2016,2(1):21.
pmid: 27807782
[14] Nichols C. Dentistry and hypertension[J]. J Am Dent Assoc, 1997,128(11):1557-1562.
pmid: 9368441
[15] Campbell NRC, Zhang XH. Hypertension in China: Time to transition from knowing the problem to implementing the solution[J]. Circulation, 2018,137(22):2357-2359.
pmid: 29844071
[16] Silvestre FJ, Salvador-Martinez I, Bautista D, et al. Clinical study of hemodynamic changes during extraction in controlled hypertensive patients[J]. Med Oral Patol Oral Cir Bucal, 2011,16(3):e354-358.
pmid: 21196862
[17] Ogunlewe MO, James O, Ajuluchukwu JN, et al. Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia[J]. West Indian Med J, 2011,60(1):91-95.
pmid: 21809720
[18] 范少光, 汤浩. 人体生理学[M]. 3版. 北京: 北京大学医学出版社, 2008.
[19] Hollander MH, Schortinghuis J, Vissink A. Changes in heart rate during third molar surgery[J]. Int J Oral Maxillofac Surg, 2016,45(12):1652-1657.
pmid: 27575392
[20] Svorc P Jr, Bacova I, Svorc P, et al. Autonomic nervous system under ketamine/xylazine and pentobarbital anaesthesia in a Wistar rat model: A chronobiological view[J]. Prague Med Rep, 2013,114(2):72-80.
doi: 10.14712/23362936.2014.25 pmid: 23777798
[1] Zhicun LI, Tianyu WU, Lei LIANG, Yu FAN, Yisen MENG, Qian ZHANG. Risk factors analysis and nomogram model construction of postoperative pathological upgrade of prostate cancer patients with single core positive biopsy [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 896-901.
[2] Ye YAN,Xiaolong LI,Haizhui XIA,Xuehua ZHU,Yuting ZHANG,Fan ZHANG,Ke LIU,Cheng LIU,Lulin MA. Analysis of risk factors for long-term overactive bladder after radical prostatectomy [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 589-593.
[3] Yan CHEN,Kuangmeng LI,Kai HONG,Shudong ZHANG,Jianxing CHENG,Zhongjie ZHENG,Wenhao TANG,Lianming ZHAO,Haitao ZHANG,Hui JIANG,Haocheng LIN. Retrospective study on the impact of penile corpus cavernosum injection test on penile vascular function [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 680-686.
[4] Bo PANG,Tongjun GUO,Xi CHEN,Huaqi GUO,Jiazhang SHI,Juan CHEN,Xinmei WANG,Yaoyan LI,Anqi SHAN,Hengyi YU,Jing HUANG,Naijun TANG,Yan WANG,Xinbiao GUO,Guoxing LI,Shaowei WU. Personal nitrogen oxides exposure levels and related influencing factors in adults over 35 years old in Tianjin and Shanghai [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 700-707.
[5] Jing HE,Zhongze FANG,Ying YANG,Jing LIU,Wenyao MA,Yong HUO,Wei GAO,Yangfeng WU,Gaoqiang XIE. Relationship between lipid metabolism molecules in plasma and carotid atheroscle-rotic plaques, traditional cardiovascular risk factors, and dietary factors [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 722-728.
[6] Shan CAI,Yihang ZHANG,Ziyue CHEN,Yunfe LIU,Jiajia DANG,Di SHI,Jiaxin LI,Tianyu HUANG,Jun MA,Yi SONG. Status and pathways of factors influencing physical activity time among elementary and junior high school students in Beijing [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 403-410.
[7] Zuhong ZHANG,Tianjiao CHEN,Jun MA. Associations between puberty timing and cardiovascular metabolic risk factors among primary and secondary students [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 418-423.
[8] Tianjing ZHOU,Qiuping LIU,Minglu ZHANG,Xiaofei LIU,Jiali KANG,Peng SHEN,Hongbo LIN,Xun TANG,Pei GAO. Comparison of initiation of antihypertensive therapy strategies for primary prevention of cardiovascular diseases in Chinese population: A decision-analytic Markov modelling study [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 441-447.
[9] Yuting LIN,Huali WANG,Yu TIAN,Litong GONG,Chun CHANG. Factors influencing cognitive function among the older adults in Beijing [J]. Journal of Peking University (Health Sciences), 2024, 56(3): 456-461.
[10] Jinrong ZHU,Yana ZHAO,Wei HUANG,Weiwei ZHAO,Yue WANG,Song WANG,Chunyan SU. Clinical characteristics of COVID-19 infection in patients undergoing hemodialysis [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 267-272.
[11] Zhanhong LAI,Jiachen LI,Zelin YUN,Yonggang ZHANG,Hao ZHANG,Xiaoyan XING,Miao SHAO,Yuebo JIN,Naidi WANG,Yimin LI,Yuhui LI,Zhanguo LI. A unicenter real-world study of the correlation factors for complete clinical response in idiopathic inflammatory myopathies [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 284-292.
[12] Xiaoqian SI,Xiujuan ZHAO,Fengxue ZHU,Tianbing WANG. Risk factors for acute respiratory distress syndrome in patients with traumatic hemorrhagic shock [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 307-312.
[13] Yangyang LI,Lin HOU,Zijun MA,Shanyamei HUANG,Jie LIU,Chaomei ZENG,Jiong QIN. Association of pregnancy factors with cow's milk protein allergy in infants [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 144-149.
[14] Xiaoqiang LIU,Yin ZHOU. Risk factors of perioperative hypertension in dental implant surgeries with bone augmentation [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 93-98.
[15] Liang LUO,Yun LI,Hong-yan WANG,Xiao-hong XIANG,Jing ZHAO,Feng SUN,Xiao-ying ZHANG,Ru-lin JIA,Chun LI. Anti-endothelial cell antibodies in predicting early miscarriage [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1039-1044.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd