Cho Yong-Wook, Kim Euiseong
Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea.
Restor Dent Endod. 2013 Aug;38(3):113-8. doi: 10.5395/rde.2013.38.3.113. Epub 2013 Aug 23.
Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.
如今，口服抗凝剂被广泛用于众多患者以预防心血管意外，如血栓栓塞。抗凝剂的一个重要副作用是抗凝血。在大手术中，术前必须改变口服抗凝治疗（OAT）方案以适当控制术后出血。然而，在小型牙科手术和牙髓手术中，改变或停用OAT的必要性存在争议。在本研究中，对后果的风险进行了权衡和分析。在停用OAT的患者中，血栓栓塞并发症的发生率很低，但后果是致命的。在继续OAT的患者中，通过局部止血措施可以很好地控制术后出血。在牙髓手术中，几乎没有关于这个问题的研究。由于牙髓手术过程精细且敏感，如使用牙科显微镜检查切除的牙根表面和逆行充填，术中出血控制尤为重要。从牙髓手术的角度来看，关于这个问题还需要进一步研究。
