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      Management of hyperthyroid patients in dental emergencies: a case report

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          Abstract

          The prevalence of thyroid disease, particularly hyperthyroidism, has rapidly increased in Korea in the past 10 years. Therefore, it is important to consider the complete medical history including thyroid disease in patients under dental treatment. Both the drugs used for dental treatment and psychological symptoms associated with treatment can induce emergencies in hyperthyroid patients. This case report considers emergency situations during dental treatment for hyperthyroid patients, and discusses risk factors and related concerns.

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          Most cited references 11

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          Thyroid and the heart.

          Thyroid hormones modulate every component of the cardiovascular system necessary for normal cardiovascular development and function. When cardiovascular disease is present, thyroid function tests are characteristically indicated to determine if overt thyroid disorders or even subclinical dysfunction exists. As hypothyroidism, hypertension, and cardiovascular disease all increase with advancing age, monitoring of thyroid-stimulating hormone, the most sensitive test for hypothyroidism, is important in this expanding segment of our population. A better understanding of the impact of thyroid hormonal status on cardiovascular physiology will enable health care providers to make decisions about thyroid hormone evaluation and therapy in concert with evaluating and treating hypertension and cardiovascular disease. The goal of this review is to access contemporary understanding of the effects of thyroid hormones on normal cardiovascular function and the potential role of overt and subclinical hypothyroidism and hyperthyroidism in a variety of cardiovascular diseases. Copyright © 2014 Elsevier Inc. All rights reserved.
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            Diagnosis and classification of Graves' disease.

            Graves' disease (GD) is an autoimmune disorder involving the thyroid gland, typically characterized by the presence of circulating autoantibodies that bind to and stimulate the thyroid hormone receptor (TSHR), resulting in hyperthyroidism and goiter. Organs other than the thyroid can also be affected, leading to the extrathyroidal manifestations of GD, namely Graves' ophthalmopathy, which is observed in ~50% of patients, and Graves' dermopathy and acropachy, which are quite rare. Presumably, the extrathyroidal manifestations of GD are due to autoimmunity against antigens common to the thyroid and other affected organs. Although its exact etiology remains to be completely understood, GD is believed to result from a complex interaction between genetic susceptibility and environmental factors. Clinically, GD is characterized by the manifestations of thyrotoxicosis as well as by its extrathyroidal features when present, the latter making the diagnosis almost unmistakable. In the absence of ophthalmopathy, the diagnosis is generally based on the association of hyperthyroidism and usually diffuse goiter confirmed with serum anti-TSHR autoantibodies (TRAbs). Hyperthyroidism is generally treated with anti-thyroid drugs, but a common long term treatment strategy in patients relapsing after a course of anti-thyroid drugs (60-70%), implies the use of radioactive iodine or surgery. Copyright © 2014 Elsevier B.V. All rights reserved.
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              An update on local anesthetics in dentistry.

               Andreas Haas (2002)
              Local anesthetics are the most commonly used drugs in dentistry. This article provides a brief update on the pharmacology, adverse effects and clinical applications of these drugs, as well as the role of vasoconstrictors.
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                Author and article information

                Journal
                J Dent Anesth Pain Med
                J Dent Anesth Pain Med
                JDAPM
                Journal of Dental Anesthesia and Pain Medicine
                The Korean Dental Society of Anesthsiology
                2383-9309
                2383-9317
                June 2016
                30 June 2016
                : 16
                : 2
                : 147-150
                Affiliations
                Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Korea.
                Author notes
                Corresponding Author: Eun-Jung Kwak, Department of Advanced General Dentistry, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-8982, Fax: +82-2-2227-8906, puttiquak2@ 123456yuhs.ac

                *These authors contributed equally to this work.

                Article
                10.17245/jdapm.2016.16.2.147
                5564085
                6964c41c-7ba2-437d-8f97-9f3515406f6f
                Copyright © 2016 Journal of Dental Anesthesia and Pain Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Case Report

                dental emergency, graves' disease, hyperthyroidism

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