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Cardiovascular effect of epinephrine in endodontic microsurgery: a review

Authors
 Youngjune Jang ; Euiseong Kim 
Citation
 Restorative Dentistry and Endodontics, Vol.38(4) : 187~193, 2013 
Journal Title
 Restorative Dentistry and Endodontics 
ISSN
 2234-7658 
Issue Date
2013
Abstract
Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/88608
DOI
10.5395/rde.2013.38.4.187
Appears in Collections:
1. 연구논문 > 2. College of Dentistry > Dept. of Conservative Dentistry
Yonsei Authors
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