[Updated on Apr. 18] Integration of CiNii Articles into CiNii Research

Use of an Apex Locator and Ultrasonic Irrigation for Patients with Implanted Cardiac Pacemaker or Cardioverter Defibrillator: Two Case Reports

DOI
  • Yoshiyuki KUDO
    Division of Operative Dentistry and Endodontics, Department of Conservative Dentistry, School of Dentistry, Iwate Medical University
  • Hideto SAKURAI
    Division of Operative Dentistry and Endodontics, Department of Conservative Dentistry, School of Dentistry, Iwate Medical University
  • Nobuo OKADA
    Division of Operative Dentistry and Endodontics, Department of Conservative Dentistry, School of Dentistry, Iwate Medical University
  • Mamoru NODA
    Division of Operative Dentistry and Endodontics, Department of Conservative Dentistry, School of Dentistry, Iwate Medical University
  • Kenji NAKAI
    Japanese Red Cross Iwate Blood Center

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Other Title
  • 植込み型電子機器装着者に電気的根管長測定と超音波洗浄を行った2例

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Abstract

 Purpose: The aim of this study was to evaluate by multi-channel electrocardiograph (Dream ECG) the occurrence of fatal arrhythmia in patients with an implanted cardiac heart device during root canal treatment using an electronic apex locator and/or ultrasonic irrigation.<br> Materials and Methods: In this study, we observed two patients, one with an implanted cardiac pacemaker (PM) and the other with a cardioverter defibrillator (ICD), who underwent root canal treatment using an apex locator and/or ultrasonic irrigation. Before dental treatment, a cardiologist and dental anesthesiologist asked the patients detailed questions and confirmed the absence of the following within the last four weeks: inappropriate ICD shock: fatal arrhythmia; myocardial ischemia; and congestive heart failure (NYHA Ⅲ or above). In the case of complications, a cardiologist and dental anesthesiologist observed the patients during dental treatment, and prepared emergency medicine and an AED at the chairside. In Case 1, a 54-year-old male patient had a prior myocardial infarction, ventricular fibrillation, and an implanted ICD. His dental diagnosis was chronic apical periodontitis of the lower left first molar. In Case 2, an 80-year-old female patient had severe aortic stenosis, sick sinus syndrome, and an implanted pacemaker. Her dental diagnosis was chronic apical periodontitis of the upper left first molar. In these cases, an apex locator (RootZX; Morita) and/or ultrasonic irrigation device (OSADA Enac 10W; Osada) were used during the root canal treatment.<br> Results: In these cases, slight noise was observed by Dream ECG. However, no significant lethal arrhythmia was observed during dental treatment of the patients by Dream ECG.<br> Conclusion: The results suggest the possibility of providing safe dental treatment to patients with an implanted PM or ICD by carefully asking detailed questions and confirming stable heart condition in the past four weeks, as well as by monitoring by Dream ECG.

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