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

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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)

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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)
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