Sánchez-Palomino Paulino, Sánchez-Cobo Paulino, Rodriguez-Archilla Alberto, González-Jaranay Maximino, Moreu Gerardo, Calvo-Guirado José-Luis, Peñarrocha-Diago Miguel, Gómez-Moreno Gerardo
Department of Special Care in Dentistry, Master of Periodontology and Implant Dentistry, and Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Colegio Máximo s/n, E18071 Granada, Spain,
Med Oral Patol Oral Cir Bucal. 2015 Sep 1;20(5):e616-20. doi: 10.4317/medoral.20510.
Dual antiplatelet therapy consists of administering antiplatelet (antiaggregant) drugs (clopidogrel and aspirin) to prevent thrombotic processes, as a preventative measure in patients with acute coronary disease, or in patients subjected to percutaneous coronary intervention.
The purpose of this study was to evaluate the efficacy of a protocol for performing dental extraction in patients receiving dual antiplatelet therapy.
Thirty-two patients undergoing dental extractions were included in the study. The variables evaluated were: collagen-epinephrine fraction, collagen- adenosine diphosphate fraction, surgical surface, post-surgical measures, and adverse effects. Alveolar sutures and gauzes impregnated with an antifibrinolytic agent (tranexamic acid), which the patient pressed in place for 30 minutes, were applied to all patients as post-surgical measures. Descriptive statistics were calculated and analyzed with Student's t-test to compare pairs of quantitative variables; simple regression analysis was performed using Pearson's correlation coefficient. Statistical significance was set at p<0.05.
Collagen/epinephrine fraction was 264.53±55.624 seconds with a range of 135 to 300 seconds, and collagen/ADP fraction was 119.41±44.216 seconds, both values being higher than normal. As a result of the post-surgical measures taken, no patients presented post-operative bleeding, hematoma or infection.
Dental extraction was safe for patients receiving dual anti-platelet therapy when using sutures and gauze impregnated with tranexamic acid, which the patient pressed in place for 30 minutes.
双重抗血小板治疗是指使用抗血小板(抗聚集)药物(氯吡格雷和阿司匹林)来预防血栓形成过程,作为急性冠状动脉疾病患者或接受经皮冠状动脉介入治疗患者的预防措施。
本研究的目的是评估在接受双重抗血小板治疗的患者中进行拔牙的方案的疗效。
32例接受拔牙的患者纳入本研究。评估的变量包括:胶原-肾上腺素部分、胶原-二磷酸腺苷部分、手术创面、术后措施及不良反应。作为术后措施,所有患者均采用牙槽缝合及浸渍抗纤维蛋白溶解剂(氨甲环酸)的纱布,患者按压30分钟。计算描述性统计量并用学生t检验分析以比较定量变量对;使用Pearson相关系数进行简单回归分析。设定统计学显著性为p<0.05。
胶原/肾上腺素部分为264.53±55.624秒,范围为135至300秒,胶原/二磷酸腺苷部分为119.41±44.216秒,两者均高于正常。由于采取了术后措施,无患者出现术后出血、血肿或感染。
对于接受双重抗血小板治疗的患者,使用浸渍氨甲环酸的缝线和纱布并由患者按压30分钟进行拔牙是安全的。