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ANGINA PECTORIS
It is a myocardial ischemia resulting from imbalance between coronary blood flow & oxygen demand
MYOCARDIAL INFARCTION
It results from occlusion of coronary artery By a thrombus so deficient coronary arterial blood supply to a region of myocardium that results in a cellular death & necrosis.
Periodontal management:
As angina pectoris except; Drugs used in treatment.
Periodontal management:
Same as angina except; 1.preoperative antibiotic. 2. Drugs used in treatment. 3. Management of complications if developed (attack)
HYPERTENSIVE DISEASES
Hypertension is used to describe patient with blood pressure more than 140/90 mmHg
Periodontal management:
Same as angina except; 1. Local anesthesia. 2. General anesthesia. 3. treatment procedure.
IF PATIENT IS ALLERGIC:
Adult --------- Clindamycin 600 mg OR Asathromycin 500 mg OR Cephazolin 1 gm (1 hour before ttt. Orally) ( ,,, ,,,, ,,, injection)
2. Under G.A
a)Adults----- 1gm Amoxicillin I.V at induction.
OR 3gm Amoxicillin orally 4 hours before induction followed by 3gm Amoxicillin immediately after recovery. OR 300mg Clindamycin I.M hour before induction. OR 300mg Clindamycin I/V at induction
RESPIRATORY DISORDERS
Common symptoms:
1. cough. 2. wheezing. 3. cyanosis. 4. finger clubbing. AVOID 1. General anesthesia: leads to hypoxia . 2. Analgesics & narcotics: leads to respiratory depressants.
BRONCHIAL ASTHMA
It is due to bronchospasm or hyperirritability of the tracheo_bronchial tree. Patient is treated by: 1. Corticosteroids inhalators. 2. Bronchodilator. 3. Beta adrenergic stimulator.
Periodontal management
1. Medical consultation.
3. Local anesthesia.
4. General anesthesia.
TUBERCULOSIS
Can affect any organ. Highly infectious. Caused by Mycobacterium T.B. Transmitted by air born droplets.
Periodontal management:
1. Patient with active T.B.
2. Patient with past history of T.B. 3. Patient with positive tuberculin test.
LIVER DISORDERS
Advanced liver diseases include: Liver cirrhosis - Jaundice
Potential complications: 1. Impaired drug detoxication e.g. sedative, analgesics, general anesthesia. 2. Bleeding disorders ( decrease clotting factors, excess fibrinolysis, impaired vitamin K absorption). 3. Transmission of viral hepatitis.
Periodontal management
1. Medical consultation. 2. Avoid drugs metabolized in liver: L.A------- Lidocaine, Mepicaine Sedatives-------- Valium antibiotics-------- Ampicillin Analgesics------- Aspirin 3. Vit.k ----- 10 mg/day before surgery. 4. G.A ------ cause bleeding.
VIRAL HEPATITIS
Periodontal management:
1. Patient with active hepatitis 2. Carriers: a. low risk patient. b. high risk patient.
DIABETUS MELLITUS
It is characterized by persistent increase of blood glucose level. It is the result of absolute or relative deficiency of insulin.
Oral manifestation:
1. Gingivitis 2. Alveolar bone resorption 3. Xerostomia 4. Delayed wound healing 5. Pulpitis in non carious tooth 6. Burning sensation in tongue 7. Acetone smell in breath
Periodontal management:
1. Appointment.
2. Premeditation
3. Local anesthesia. 4. Treatment procedure.
5. Patient assessment.
Potential problems:
1. Precipitation of the attack. 2. Problems of drugs taken a) Dilantin------- gingival hyperplasia b) Depakene------- bleeding tendancy
Periodontal management:
1.Past medical history.
2.In case of controlled patient.
N.B:
Dentist is no longer treating teeth in patients, but rather patients who have teeth.
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