Journal of Disability and Oral Health

cover art

Cover Date:
April 2005
Print ISSN:
1470-8558
Electronic ISSN:
1754-2758
Vol:
6
Issue:
1

Study of the value of the panoramic radiographic examination in special risk patients with a history of infective endocarditis

Individuals with a history of infective endocarditis (IE) may be at increased risk of further episodes of endocarditis arising from a bacteraemia associated with invasive dental treatment or oral infections. Detailed oral assessment to exclude oral pathology is thus important to identify potential sources of bacteraemia, however the selection criteria for radiographic views when examining patients at risk of IE are not clear. Objective: To determine the frequency and nature of oral and dental lesions detected by dental panoramic tomograms (DPTs) which would not have been detected by clinical history, examination and bite-wing radiographs, in a group of patients with a history of known IE. Methods: DPTs of patients with a history of IE were examined retrospectively by three observers for oral and dental disease likely to be a source of bacteraemia. The patientsÂ’ clinical notes were then reviewed to determine whether the findings from the DPTs affected the treatment the patients received. Results: Twenty of 30 (66%) DPTs revealed additional pathology which would not have been detected by routine history and clinical examination, even when augmented with bitewing radiographs. Eleven out of twenty (55%) of the detected pathologies demonstrated suspected periapical inflammatory pathology and hence a potential source of bacteraemia. Of these, four of the patients did not undergo any further investigation or treatment, although the involved teeth were closely reviewed, while periapical radiographs were taken for the remaining seven patients. Three occult periapical lesions, which would not otherwise have been detected, were confirmed and these teeth were subsequently extracted. Three of the patients (10%) had treatment modified as a result of the panoramic radiograph. Conclusions: The clinical history with examination and bitewing radiographs alone may not be sufficient to detect all potentially bacteraemic pathology in patients with a history of IE. In view of the substantial morbidity and mortality associated with a further episode of IE, the dental assessment of these patients should include a more extensive radiographic survey such as DPT supplemented with selected intraoral radiographs, rather than the reliance upon bitewing radiographs alone. Key words: Infective endocarditis, radiographs, special needs

Article Price
£15.00
Institution Article Price
£15.00
Page Start
16
Page End
20
Authors
Stephen R Porter, Roger Davies, Kalpesh Patel, Jackie Brown, Navdeep Kumar, David Townsend

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  1. Editorial - Emily is Emily
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  1. Developing an Undergraduate Curriculum in Special Care Dentistry
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  1. Study of the value of the panoramic radiographic examination in special risk patients with a history of infective endocarditis
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  1. Dental care for children (and the not so young) with intellectual disabilities
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  1. Case report – Treatment of localised, moderately deep periodontal pockets in an HIV-positive patient with minimal intervention
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  1. BSDH News
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