Daisuke Ueno

Publications (2)4.38 Total impact

• Article: Effects of implant surgery on blood pressure and heart rate during sedation with propofol and midazolam.

  Daisuke Ueno, Junichi Sato, Jun Nejima, Keisuke Maruyama, Mariko Kobayashi, Toshikazu Iketani, Rei Sekiguchi, Hiroshi Kawahara
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  ABSTRACT: Purpose: Intravenous (IV) sedation is commonly used in dentistry. However, no report has yet been published regarding age, hypertension, and antihypertensive drugs during implant surgery and their relationship with changes in blood pressure (BP) and heart rate in implant surgery under IV sedation with propofol and midazolam. Materials and Methods: Medical records of 252 patients who underwent implant surgery were retrospectively analyzed. Patients were classified into four groups according to their age (in years) and hypertension status: A = ≤ 64, no hypertension; B = ≥ 65, no hypertension; C = ≤ 64, hypertension; or D = ≥ 65, hypertension. Hypertensive patients were further characterized by their antihypertensive medications: E = calcium channel blockers (CCBs), F = angiotensin II receptor blockers (ARBs), G = CCBs+ARBs, or H = no medication. IV sedation was administered in two stages. After midazolam injection to prevent angialgia, propofol was infused at the rate of 4 mg/kg/h, followed by a dose reduction. Systolic and diastolic BP and heart rate were recorded before, during, and after surgery. Results: Systolic BP increased significantly after patients were draped in groups A, C, and D, with group D showing the most pronounced increase. Sedatives decreased BP in all groups. Diastolic BP in group F decreased significantly compared to group H after induction and before infiltration of local anesthetic. After infiltration, systolic BP decreased more significantly in group G than in group H. Intraoperative hypotension was observed in 25% of patients. The incidence of intraoperative hypertension in group D was markedly higher than in group A (23% vs 4%). Conclusion: IV sedation using midazolam and propofol reduces hypertensive risks during implant surgery. Nevertheless, care must be taken, especially in older hypertensive patients and in hypertensive patients on ARBs or ARBs+CCBs.
  The International journal of oral & maxillofacial implants 11/2012; 27(6):1520-6. · 1.78 Impact Factor
• Article: Accuracy of oral mucosal thickness measurements using spiral computed tomography.

  Daisuke Ueno, Junichi Sato, Chinami Igarashi, Shohei Ikeda, Masayuki Morita, Shinji Shimoda, Takaaki Udagawa, Kazunari Shiozaki, Mariko Kobayashi, Kaoru Kobayashi
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  ABSTRACT: Assessment of oral mucosal thickness is important in implant surgery; however, examining the soft tissue three dimensionally is difficult. A reamer method is invasive, and a non-invasive ultrasonic method produces only low-resolution images depending on anatomic variations. The emerging technology of spiral computed tomography (CT) is an alternative to the conventional methods. Spiral CT has been a useful diagnostic tool in implant surgery. Although it delivers high radiation doses, spiral CT provides three-dimensional imaging of low-contrast structures. The purpose of the present study is to assess the accuracy of oral mucosal measurements using spiral CT. Thickness of maxillary oral mucosa was measured in five cadavers. The measurement sites were set up in buccal, palatal, and middle of the crest in the missing tooth area in the incisor, canine, premolar, and molar regions. Each cadaver was exposed to spiral CT after installing the measurement guide. After that, each site was physically measured by reamer. Linear regression and correlation analysis were performed to describe the association between radiographic and physical measurements. A total of 114 measurements were performed with statistical analyses. Mean values and standard deviations of physical and radiographic measurements were 3.12 ± 1.43 and 2.83 ± 1.70 mm, respectively. The radiographic and physical measurements demonstrate strong correlation (r = 0.90; P <0.01). Measurement error was 0.52 ± 0.36 mm. According to the regions, the measurements in buccal, palatal, and missing tooth region depicted a significant correlation (r = 0.92, r = 0.85, and r = 0.91, respectively). The boundary of the bone and mucosa was indistinguishable at 23 buccal sites. Twenty-three measurements that could not be distinguished with CT had a mean of 0.69 and standard deviation ± 0.13 mm. The correlation between spiral CT and physical measurement was high except in sites of very thin mucosa. Spiral CT can be considered an alternative method for the measurement of oral mucosal thickness. Because of the higher radiation exposure, caution should be exercised and radiation dosage versus clinical benefit assessment is required.
  Journal of Periodontology 11/2010; 82(6):829-36. · 2.60 Impact Factor