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Niu Y, Chen Y, Li W, Xie R, Deng X. Electromagnetic interference effect of dental equipment on cardiac implantable electrical devices: A systematic review. Pacing Clin Electrophysiol 2020; 43:1588-1598. [PMID: 32852847 DOI: 10.1111/pace.14051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The electromagnet interference (EMI) effect resulting from using dental equipment near cardiovascular implantable electronic devices (CIEDs) is controversial based on in vitro and in vivo studies. We aimed to summarize the available evidence to investigate the safety of using dental equipment on patients with CIEDs. METHODS An electronic search was performed in PubMed, Embase, MEDLINE Ovid, and the Cochrane Library for relevant studies published between January 2000 and May 2020. The search strategy centered on terms related to dental devices and CIEDs. Two independent reviewers determined the final inclusion of the studies in the systematic review. The EMI effect was summarized based on different dental instruments detected in in vitro or in vivo studies. RESULTS The primary search identified 84 articles, and 18 studies were finally included in this systematic review after exclusions. Most in vitro studies (n = 12) reported background noise or severe EMI affecting CIED function at a close distance from the lead tip or at a high sensitivity setting of CIEDs. In in vivo studies (n = 6), EMI that altered CIED function was not detected at clinical distance and sensitivity settings. The summary, based on electronic apex locators, ultrasonic devices, and electric pulp testers, demonstrated the compatibility of these common dental devices with CIEDs. CONCLUSIONS This systematic review indicates that most dental instruments can be used safely in routine dental practice. The EMI effect of dental equipment depends on the exposure distance and lead-related parameters of the CIEDs.
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Affiliation(s)
- Yuting Niu
- Faculty of Stomatology, The First Clinical Medical School, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Yufei Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjing Li
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ruiqin Xie
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuliang Deng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
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Conde-Mir I, Miranda-Rius J, Trucco E, Lahor-Soler E, Brunet-Llobet L, Domingo R, Tolosana JM, Mont L. In-vivo compatibility between pacemakers and dental equipment. Eur J Oral Sci 2018; 126:307-315. [PMID: 29972599 DOI: 10.1111/eos.12534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2018] [Indexed: 11/29/2022]
Abstract
In-vitro studies suggest that electromagnetic interference can occur under specific conditions involving proximity between electronic dental equipment and pacemakers. At present, in-vivo investigations to verify the effect of using electronic dental equipment in clinical conditions on patients with pacemakers are scarce. This study aimed to evaluate, in vivo, the effect of three commonly used electronic dental instruments - ultrasonic dental scaler, electric pulp tester, and electronic apex locator - on patients with different pacemaker brands and configurations. Sixty-six consecutive non-pacemaker-dependent patients were enrolled during regular electrophysiology follow-up visits. Electronic dental tools were operated while the pacemaker was interrogated, and the intracardiac electrogram and electrocardiogram were recorded. No interferences were detected in the intracardiac electrogram of any patient during the tests with dental equipment. No abnormalities in pacemaker pacing and sensing function were observed, and no differences were found with respect to the variables, pacemaker brands, pacemaker configuration, or mode of application of the dental equipment. Electromagnetic interferences affecting the surface electrocardiogram, but not the intracardiac electrogram, were found in 25 (37.9%) patients, especially while using the ultrasonic dental scaler; the intrinsic function of the pacemakers was not affected. Under real clinical conditions, none of the electronic dental instruments tested interfered with pacemaker function.
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Affiliation(s)
- Isabel Conde-Mir
- Servei d'Odontologia, Centre d'Atenció Primària Montnegre, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain
| | - Jaume Miranda-Rius
- Departament d'Odontoestomatologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Emilce Trucco
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Cardiology, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Eduard Lahor-Soler
- Departament d'Odontoestomatologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Lluís Brunet-Llobet
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain.,Servei d'Odontologia, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Rebeca Domingo
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José M Tolosana
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Lluís Mont
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Dadalti MTDS, da Cunha AJLA, Araújo MCPD, Moraes LGBD, Risso PDA. Electromagnetic interference of dental equipment with implantable cardioverter defibrillators. Acta Odontol Scand 2017; 75:584-587. [PMID: 28799814 DOI: 10.1080/00016357.2017.1364419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Implantable cardioverter defibrillators (ICDs) are subject to electromagnetic interference (EMI). The aim of this study was to assess both the EMI of dental equipments with ICDs and related factors. MATERIALS AND METHODS High- and low-speed handpieces, an electric toothbrush, an implant motor and two types of ultrasonic devices were tested next to an ICD with different sensitivity settings. The ICD was immersed in a saline solution with electrical resistance of 400-800 ohms to simulate the resistance of the human body. The dental equipments were tested in both horizontal (0°) and vertical (90°) positions in relation to the components of the ICD. The tests were performed with a container containing saline solution, which was placed on a dental chair in order to assess the cumulative effect of electromagnetic fields. RESULTS The dental chair, high- and low-speed handpieces, electric toothbrush, implant motor and ultrasonic devices caused no EMI with the ICD, irrespective of the program set-up or positioning. No cumulative effect of electromagnetic fields was verified. CONCLUSIONS The results of this study suggest that the devices tested are safe for use in patients with an ICD.
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Affiliation(s)
| | | | - Marcos César Pimenta de Araújo
- a Department of Clinical Dentistry, School of Dentistry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - Luis Gustavo Belo de Moraes
- c Department of Cardiology, School of Medicine , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - Patrícia de Andrade Risso
- a Department of Clinical Dentistry, School of Dentistry , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
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Abstract
The ability to light cure resins 'on demand' in the mouth has revolutionized dentistry. However, there is a widespread lack of understanding of what is required for successful light curing in the mouth. Most instructions simply tell the user to 'light cure for xx seconds' without describing any of the nuances of how to successfully light cure a resin. This article provides a brief description of light curing. At the end, some recommendations are made to help when purchasing a curing light and how to improve the use of the curing light.
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Affiliation(s)
- Richard B T Price
- Department of Dental Clinical Sciences, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
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Moraes AP, Silva EJ, Lamas CC, Portugal PH, Neves AA. Influence of electronic apex locators and a gutta-percha heating device on implanted cardiac devices: an in vivo study. Int Endod J 2015; 49:526-32. [PMID: 26105663 DOI: 10.1111/iej.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/17/2015] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the potential for electromagnetic interference (EMI) of electronic apex locators (EALs) and a gutta-percha heating device (HD) in patients with implantable cardiac pacemakers (ICPs) or cardioverter-defibrillators (ICDs). METHODOLOGY Two types of EALs (Romiapex A-15 and Novapex) and a HD (Touch'n Heat) were tested in patients followed in an outpatient clinic for cardiac arrhythmias. The heart rhythm was monitored on a computer screen during all experimental phases. After baseline data collection, the patient held each appliance (turned on) for 30 s, simulating their clinical use. If background noise was detected on the cardiac monitor, the sensitivity of the ICP/ICD was lowered by the cardiologist to evaluate the intensity of the detected EMI. RESULTS Twelve patients were evaluated (5 female and 7 male), and in nine instances, background noise in their cardiac devices related to the use of the endodontic devices was detected (6 patients). After lowering the sensitivity of the cardiac implants, three patients had more severe EMI in six instances, including pauses in ICP function. The presence of a symptomatic or asymptomatic pause was related to the patient's underlying heart rhythm. The HD device produced background noise more often compared to EALs. These were associated with more severe types of EMI. CONCLUSION The EALs and gutta-percha HD were capable of causing background noise detection or pauses in cardiac implants in vivo. The use of electronic dental devices nearby patients with cardiac implants should be carefully considered in clinical practice.
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Affiliation(s)
- A P Moraes
- Escola de Ciências da Saúde, Universidade do Grande Rio, Duque de Caxias, Brazil
| | - E J Silva
- Escola de Ciências da Saúde, Universidade do Grande Rio, Duque de Caxias, Brazil
| | - C C Lamas
- Escola de Ciências da Saúde, Universidade do Grande Rio, Duque de Caxias, Brazil.,Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - P H Portugal
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - A A Neves
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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