Impact of cone-beam computed tomography for the identification and management of an oral portal of entry in patients with infective endocarditis. A Delphi study

xlomafota13 shared this article with you from Inoreader Impact of cone-beam computed tomography for the identification and management of an oral portal of entry in patients with infective endocarditis. A Delphi study Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Sep 25:24885. doi: 10.4317/medoral.24885. Online ahead of print. ABSTRACT BACKGROUND: Infective endocarditis (IE) is a rare and life-threatening disease. Cutaneous portal of entry (POE) is predominant for IE, but an oral POE is the second most frequent source. Thus looking for and treating an oral POE in IE patients is of critical importance in order to reduce the risk of IE relapse or recurrence. The objectives of this study were: 1) To reach a consensus on decision-making following the detection of an oral POE on cone-beam computed tomography (CBCT) while they were not identified using the current recommended approach in IE patients (oral examination and orthopantomogram: OPT). 2) To determine whether this consensus differs when regarding the microbiology of IE. MATERIAL AND METHODS: Twenty oral or maxillofacial surgeons participated to this Delphi study. The questionnaire was based on five r adiological cases (OPT and matching CBCT) with two scenarios according to the objectives of detecting oral POE in an IE patient (curative in case of oral causative microorganism, and preventive if not) and different therapeutic approaches (surgical or conservative treatment, no treatment) for each of them. Consensus was defined as an agreement rate of ≥75%. RESULTS: The response rate was≥85%. After four rounds, consensus was achieved for all proposals. CBCT changed the decision-making of experts in four cases. In one case, the decision was influenced by the IE microbiology toward a more radical approach in case of oral causative microorganism. CONCLUSIONS: In IE patients, CBCT changed markedly the decision-making of experts by eradicating more oral POE than when using OPT. This could reduce the risk of IE relapse and recurrence. PMID:34564684 | DOI:10.4317/medoral.24885 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.