中华民国口腔颚面外科专科医师.pptVIP

林聰勝 革民國腔顎一象 面外科專科醫師 口腔顎面外 牙醫診所 口外臨床指 警師 醫大口腔醫學 院任助理教授 Ankylos臺灣區教 育訓練講師 南台灣牙醫植體  Considerations of systemic disease in OMFS 林聰勝  Considerations of systemic disease in OMFs Rheumatic fever and rheumatic heart disease.. infective endocarditis(2g PC Congenital heart disease .. infective endocarditis, prolong bleeding time(thrombosis in small vessels Surgical corrected cardiovascular lesions.. anticoagulant prolong bleeding time, endocarditis  Considerations of systemic disease in OMFs Artificial heart valves.. anticoagulant prolong bleeding time, endocarditis Premedication amoxicillin 2g, child 50mg/kg Heart transplant: suppression of immune anticoagulant, high steroid, may need supplementation  AHA Prevention of Infective Endocarditis guideline(2007) Conclusions! The major changes in the updated recommendations include the Committee concluded that only an extremely small number of of infective endocarditis might be prevented by antibiotic prophyll procedures even if such prophylactic therapy were 100% effective(2) Infective endocarditis prophylaxis for dental procedures is reasonable only for patients with lying cardiac conditions associated with the highest risk of adverse outcome docarditis. (3) For patients with these underlying cardiac conditions rophylaxis is reasonable for all dental procedures that involve manipulation of ngival tissue or the periapical region of teeth or perforation of the oral mucosa. (4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis (5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure. These changes are intended to define more clearly when infective endocarditis prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations  Table 5. Regimens for a Dental Procedure Situation Ag