Campos Flavio Halak de Oliveira, Ferreira Lorraine Braga, Romano Marcelo Munhoes, Moreira Maria Stella, Eduardo Carlos de Paula, Ramalho Karen Müller
Universidade Ibirapuera - UNIB, School of Dentistry, São Paulo, SP, Brazil.
Universidade de São Paulo - USP, School of Dentistry, Department of Biomaterials, São Paulo, SP, Brazil.
Braz Oral Res. 2018 Jun 7;32:e56. doi: 10.1590/1807-3107bor-2018.vol32.0056.
Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.
鉴于持续使用抗凝剂的医学指征呈增长趋势，服用这些药物的患者数量持续上升。对于需要进行口腔外科手术的口服抗凝剂患者的管理引发了诸多争议。抗凝方案的改变与血栓栓塞风险增加相关。然而，如果手术能够在不改变抗凝治疗的情况下进行，这似乎对患者的健康既合理又有益。在牙科领域，高功率激光在这方面的研究还很少。高功率激光的止血特性可能有助于抗凝患者的口腔软组织手术。本研究的目的是比较用手术刀或二极管激光进行舌系带切除术后抗凝大鼠的出血时间与健康动物的出血时间。将24只雄性Wistar大鼠分为四组（n = 6）：（CS）对照组 - 手术刀手术；（AS）抗凝组 - 手术刀手术；（CL）对照组 - 激光（810 nm/1.5 W二极管激光）手术；（AL）抗凝组 - 激光手术（810 nm/1.5 W二极管激光）。使用华法林诱导抗凝。每隔30秒用滤纸吸干血液，直到出血停止以核实出血时间。两名盲法研究人员进行手术并收集出血时间数据。二极管激光手术在舌系带切除术期间和术后导致大鼠完全止血。在抗凝大鼠的手术期间和二极管激光手术后评估为零出血。激光诱导的止血为抗凝治疗患者术中及术后出血控制这一有争议的问题提供了一种替代解决方案。
