Prevalence of Systemic Diseases in Patients Planning Dental Implant Treatment：Comparison of Contents of Patient Medical History Forms and Preoperative Examinations

Abstract

The purpose of the present study was to compare preoperative data from examinations, including (1) electrocardiogram (ECG) , (2) chest X-ray, (3) blood tests, (4) urinalysis, and (5) blood pressure with medical history completed by patients.
The subjects were 178 patients who presented to our department for implant treatment between January 2008 and December 2009. They were 66 men and 112 women (mean age: 57.0± 13.20 years). Comparisons were made between preoperative test results and the contents of preoperative medical history forms.
The results of this clinical investigation were that 53 patients answered "yes" to the question, "Do you have a chronic disease or a recently diagnosed disease?" These included 24 patients with hypertension, 7 patients with diabetes, 9 patients with heart disease, 2 patients with cerebral infarction, and 2 patients with thyroid disease. There were 125 patients who answered "no" to this question, of whom 75 had abnormal test results. They included 2 patients with positive HBs antigen results, 2 patients with positive HCV antibody results, and 2 patients with TPHA positive results. There were 11 patients whose fasting glucose level exceeded 110 mg/dL. There were 29 patients who had abnormal ECG results and required intraoperative ECG monitoring. One among these patients underwent re-examination using a Holter ECG system. Careful intraoperative monitoring and countermeasures for arrhythmia were indicated in this patient based on the re-examination results. In addition, two patients developed intraoperative arrhythmia despite no abnormal preoperative test results. Twenty-eight patients had systolic blood pressure of 140 mmHg or more and diastolic pressure of 90 mmHg or more at a preoperative evaluation. There were 2 patients whose surgery was cancelled based on their attending internist's decision. One patient had sick sinus syndrome and the other had severe diabetes.
A high percentage of patients (60%) had abnormal test results despite their answering "no disease" in the medical history form. If systemic health problems are overlooked, patients can develop intraoperative abnormalities, postoperative infection, or other complications. Our results suggest that a preoperative medical history form alone should not be used to fully evaluate systemic health, and indicate the importance of preoperative tests.