Elective edentulation after 7 episodes of infective endocarditis: A clinical report

Abstract

aResident, Prosthodontics & Maxillofacial Prosthetics, Division of Prosthetic and Esthetic Dentistry. bAssociate Professor, College of Medicine, Division of Prosthetic and Esthetic Dentistry. cProfessor, College of Medicine, Chair, Division of Prosthetic and Esthetic Dentistry. (J Prosthet Dent 2011;106:1-5) A 3-year clinical follow-up is presented of a patient who underwent elective extraction of the remaining natural dentition, followed by rehabilitation with maxillary and mandibular complete dentures after 7 documented episodes of infective endocarditis. The patient was diagnosed with congenital ventricular septal and valvular defect and was treated in 1984 with a prosthetic aortic valve replacement secondary to idiopathic infective endocarditis due to Haemophilus influenzae. From 1984 to 2007, the patient experienced 7 episodes of infective endocarditis associated with various microorganisms, all of oral flora origin. In the 3 years after elective extraction of the remaining natural dentition, the patient had not experienced any episodes of infective endocarditis. In light of recent changes and controversy in the recommendations for the prevention of bacterial endocarditis, the question arises as to whether the efforts of dental providers to maintain the dentition of high risk patients outweighs the associated increased risks of morbidity and mortality. While the guidelines attempt to assist health care providers in clinical decision making, there are certain instances where a patient-centered approach necessitates alternative options.