Carranza’s Clinical Periodontology, 12th Ed-Chapter 37

Caption: Figure 37-1: Coronary angiogram. Atherosclerosis can result in narrowing of the coronary arteries and onset of signs and symptoms of ischemic heart disease.

Insight: A thorough medical evaluation of patients prior to periodontal therapy is critical. Due to the surgical nature of periodontics, managing stress is vital especially in select group of patients in whom, stress can be extremely deleterious. Patients with a past history of ischemic heart disease, that includes angina pectoris and myocardial infarction certainly belong to this high risk group. Using appropriate stress reduction protocol, adequate anesthesia, conscious sedation and supplemental oxygen delivery are some of the ways of managing these patients.

Carranza’s Clinical Periodontology, 12th Ed
Chapter 37. Periodontal Treatment of Medically
Compromised Patients
Perry R. Lokkevold
Brian L. Mealey
Joan Otomo-Corgel