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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 93-98. doi: 10.19723/j.issn.1671-167X.2024.01.015

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Risk factors of perioperative hypertension in dental implant surgeries with bone augmentation

Xiaoqiang LIU1,Yin ZHOU2,*()   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
    2. Department of Anesthesiology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2022-10-10 Online:2024-02-18 Published:2024-02-06
  • Contact: Yin ZHOU E-mail:zhouyin@bjmu.edu.cn
  • Supported by:
    the Chinese Stomatological Association Research Fund(CSA-SIS2022-18);Research Seed Fund of Peking University First Hospital(2019SF36)

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Abstract:

Objective: To investigate the characteristics and risk factors of perioperative hypertension during dental implant surgeries with bone augmentation. Methods: A retrospective cohort study was conducted. Seven hundred and twenty-eight cases underwent dental implant placement and bone augmentation in Peking University School and Hospital of Stomatology from September 2021 to August 2022 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 gender, age, surgical time, and surgical approach. The correlation between perioperative hypertension and the exposure factors was analyzed. Results: The average systolic blood pressure variability was 9.93%±6.63% (maximum 50.41%), the average diastolic blood pressure variability was 12.45%±8.79% (maximum 68.75%), and the average mean arterial pressure variability was 10.02%±6.61% (maximum 49.48%). The incidence rate of perioperative hypertension was 26.77%. Male, age ≥ 60 years, and surgical time > 60 minutes were risk factors for perioperative hypertension (P < 0.05), and the relative risks (95%CI) were 1.74 (1.21-2.50), 2.35 (1.54-3.58), and 1.65 (1.15-2.38), respectively. There was no significant difference in the incidence of perioperative hypertension among the guided bone regeneration, sinus floor elevation with transalveolar approach, and sinus floor elevation with lateral window approach (P>0.05). However, the risk factors varied according to bone augmentation approaches. For the patients underwent guided bone rege-neration, the risk factors for perioperative hypertension included male, age ≥ 60 years, and surgical time > 60 minutes (P < 0.05). For the patients underwent maxillary sinus lift with transalveolar approach, the risk factor for perioperative hypertension was age ≥60 years (P < 0.05). For the patients underwent maxillary sinus lift with lateral window approach, male, age ≥60 years, and surgical time >60 minutes were not risk factors for perioperative hypertension (P>0.05). Conclusion: There was a certain risk of perioperative hypertension in oral implantation with bone augmentation. The influence of male, age ≥60 years and surgical time > 60 minutes on perioperative hypertension was related to the approach of bone augmentation.

Key words: Dental implantation, Bone regeneration, Blood pressure, Risk factors, Cohort studies

CLC Number: 

  • R782.12

Table 1

Characteristics and influencing factors of perioperative blood pressure changes (n = 728)"

Items Hemodynamic changes/%
Systolic blood pressure Diastolic blood pressure Mean arterial pressure
Gender
  Male (n=318) 9.23±5.83 11.84±7.87 9.51±5.92
  Female (n=410) 10.47±7.16 12.93±9.42 10.42±7.07
  t -2.574 -1.710 -1.887
  P 0.010 0.088 0.060
Age
  ≥60 years (n=166) 10.79±6.94 11.68±7.57 9.93±6.28
  ＜60 years (n=562) 9.67±6.53 12.68±9.11 10.05±6.70
  t -1.915 1.438 0.202
  P 0.056 0.152 0.840
Surgical time
  ＞60 min (n=380) 10.44±7.16 12.37±8.70 10.11±6.82
  ≤60 min (n=348) 9.37±5.96 12.54±8.89 9.92±6.37
  t -2.209 0.264 -0.402
  P 0.028 0.792 0.688
Bone augmentation
  GBR (n=540) 9.74±6.59 12.30±8.50 9.87±6.62
  SFE-TA (n=143) 10.63±6.83 13.09±9.84 10.59±6.52
  SFE-LW (n=45) 10.01±6.48 12.23±8.70 9.95±6.75
  F 1.023 0.471 0.665
  P 0.360 0.625 0.515

Table 2

Characteristics and influencing factors of perioperative hypertension in the patients with preoperative normotensive blood pressure (n = 609)"

Items Perioperative hypertension χ2 P RR (95%CI)
(+) (-)
Gender 9.147 0.002 1.74 (1.21-2.50)
  Male (n=253) 84 (33.20) 169 (66.80)
  Female (n=356) 79 (22.19) 277 (77.81)
Age 16.267 ＜0.001 2.35 (1.54-3.58)
  ≥60 years (n=118) 49 (41.53) 69 (58.47)
  ＜60 years (n=491) 114 (23.22) 377 (76.78)
Surgical time 7.304 0.007 1.65 (1.15-2.38)
  ＞60 min (n=311) 98 (31.51) 213 (68.49)
  ≤60 min (n=298) 65 (21.81) 233 (78.19)

Bone augmentation approach
 0.242 0.886 -
  GBR (n=457) 120 (26.26) 337 (73.74)
  SFE-TA (n=117) 33 (28.21) 84 (71.79)
  SFE-LW (n=35) 10 (28.57) 25 (71.43)

Table 3

Characteristics and influencing factors of perioperative hypertension during guided bone regeneration (n = 457)"

Items Perioperative hypertension χ2 P RR (95%CI)
(+) (-)
Gender 6.827 0.009 1.75 (1.15-2.67)
  Male (n=179) 59 (32.96) 120 (67.04)
  Female (n=278) 61 (21.94) 217 (78.06)
Age 10.184 0.001 2.22 (1.35-3.64)
  ≥60 years (n=85) 34 (40.00) 51 (60.00)
  ＜60 years (n=372) 86 (23.12) 286 (76.88)
Surgical time 7.291 0.007 1.80 (1.17-2.77)
  ＞60 min (n=245) 77 (31.43) 168 (68.57)
  ≤60 min (n=212) 43 (20.28) 169 (79.70)

Table 4

Characteristics and influencing factors of perioperative hypertension during sinus floor elevation with transalveolar approach (n = 117)"

Items Perioperative hypertension χ2 P RR (95%CI)
(+) (-)
Gender 2.600 0.107 1.95 (0.86-4.44)
  Male (n=57) 20 (35.09) 37 (64.91)
  Female (n=60) 13 (21.67) 47 (78.33)
Age 7.083 0.008 3.42 (1.34-8.77)
  ≥60 years (n=24) 12 (50.00) 12 (50.00)
  ＜60 years (n=93) 21 (22.58) 72 (77.42)
Surgical time 1.002 0.317 1.53 (0.66-3.56)
  ＞60 min (n=38) 13 (34.21) 25 (65.79)
  ≤60 min (n=79) 20 (25.32) 59 (74.68)

Table 5

Characteristics and influencing factors of perioperative hypertension during sinus floor elevation with lateral window approach (n = 35)"

Group Perioperative hypertension P RR (95%CI)
(+) (-)
Gender >0.999 1.08 (0.25-4.70)
  Male (n=17) 5 (29.41) 12 (70.59)
  Female (n=18) 5 (27.78) 13 (72.22)
Age 0.694 1.36 (0.26-6.94)
  ≥60 years (n=9) 3 (33.33) 6 (66.67)
  ＜60 years (n=26) 7 (26.92) 19 (73.08)
Surgical time >0.999 1.00 (0.16-6.26)
  ＞60 min (n=28) 8 (28.57) 20 (71.43)
  ≤60 min (n=7) 2 (28.57) 5 (71.43)
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