Identificação de condições de saúde bucal em pacientes submetidos à cirurgia cardíaca: monitoramento de prováveis fatores de risco para endocardite infecciosa

Abstract

Infective endocarditis (IE) is a serious disease that affects the surface of the endocardium. The spread of microorganisms from the oral cavity has been associated with the occurrence of EI. To analyze the possible causal association between oral health status and occurrence of EI in patients underwent cardiac valve surgery (CVS). A retrospective study was completed by analyzing medical and dental history from patients undergoing valve surgery from 2004 to 2014. The sample consisted of 482 patients who underwent surgery valvar divided into two groups: patients undergoing dental treatment prior CVS (n=111) and patients undergoing CVS without prior dental (371). Of total sample, 38 patients (8%) were diagnosed with IE. The results showed no significant difference (p = 0.482) comparing the occurrence of EI in the group with dental preparation (6.3%) and the group without dental preparation (8.4%) prior CVS. The mortality of the patients with IE was 19% the group without dental preparation and 14% in the group with dental preparation. There was an elevated demand for dental procedures in the group with dental preparation as extractions (68.6%), periodontal treatment (49.5%) and restorative procedures (32.4%). Most of patients needed 1-3 dental sessions prior CVS, with no significant differences comparing patients with or without EI outcome. The blood culture results indicated qualitative differences comparing patients underwent or no dental treatment, especially in Staphylococcus sp., and Streptococcus sp.. The results do not allow establishing a direct relationship between oral health and the occurrence of EI. However, it is not possible to exclude the potential beneficial effects of dental treatment in the prevention of EI.