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

  • Xiao-qiang LIU ,
  • Yang YANG ,
  • Jian-feng ZHOU ,
  • Jian-zhang LIU ,
  • Jian-guo TAN
Expand
  • 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 date: 2019-01-29

  Online published: 2021-04-21

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)

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.

Cite this article

Xiao-qiang LIU , Yang YANG , Jian-feng ZHOU , Jian-zhang LIU , Jian-guo TAN . Blood pressure and heart rate changes of 640 single dental implant surgeries[J]. Journal of Peking University(Health Sciences), 2021 , 53(2) : 390 -395 . DOI: 10.19723/j.issn.1671-167X.2021.02.026

References

[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.
[2] Fukayama H, Yagiela JA. Monitoring of vital signs during dental care[J]. Int Dent J, 2006,56(2):102-108.
[3] Brand HS, Abraham-Inpijn L. Cardiovascular responses induced by dental treatment[J]. Eur J Oral Sci, 1996,104(3):245-252.
[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.
[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.
[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.
[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.
[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.
[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.
[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.
[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.
[14] Nichols C. Dentistry and hypertension[J]. J Am Dent Assoc, 1997,128(11):1557-1562.
[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.
[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.
[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.
[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.
[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.
Outlines

/