Special Care in Dentistry and Gerodontology Unit, Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain.
Int J Environ Res Public Health. 2021 Feb 8;18(4):1609. doi: 10.3390/ijerph18041609.
Bleeding complications in patients undergoing antiplatelet and/or anticoagulant therapy have been one of the main concerns in dental practice. Upon the introduction of new antiplatelet and anticoagulant drugs, there is a search for new protocols that respond to a secure treatment. The aim of the present study was to evaluate bleeding complications in anticoagulated and antiplatelet-treated patients after performing simple dental extractions, in a period of 4 years.
147 clinical records of anticoagulated and/or antiplatelet-treated patients undergoing a simple dental extraction over a period of 4 years (October 2015 to September 2019) were studied. Within the sample, 63 patients were antiplatelet-treated, 83 were anticoagulated, and 1 patient was under both therapies. Within the anticoagulated patients, 70 took classic anticoagulants and 14 new oral anticoagulants (NOACs). Quantitative data were studied with arithmetic mean and standard deviation (SD). The chi-square test was used for the qualitative variables. ANOVA tests were used to compare age and anticoagulated or antiplatelet-treated patients. Statistical significance was determined when < 0.05.
From the 418 dental extractions performed, five severe bleeding complications took place in three patients (2.11%). From the five events, four were in patients treated with NOACs (1.68%) and one occurred in a patient anticoagulated with acenocoumarol (0.42%; = 0.003).
Considering the results of this retrospective clinical study, we can conclude that bleeding complications in anticoagulated and/or antiplatelet-treated patients after tooth extractions were low, with a higher incidence recorded in patients treated with NOACs, followed by classic anticoagulants, and there were no complications in antiplatelet-treated patients.
在抗血小板和/或抗凝治疗的患者中,出血并发症一直是口腔实践中的主要关注点之一。随着新型抗血小板和抗凝药物的引入,人们一直在寻找能够安全治疗的新方案。本研究旨在评估 4 年内接受简单拔牙术的抗凝和/或抗血小板治疗患者的出血并发症。
研究了 4 年内(2015 年 10 月至 2019 年 9 月)接受简单拔牙术的抗凝和/或抗血小板治疗的 147 例临床病历。在样本中,63 例患者接受抗血小板治疗,83 例患者接受抗凝治疗,1 例患者同时接受两种治疗。在抗凝患者中,70 例患者服用经典抗凝剂,14 例患者服用新型口服抗凝剂(NOAC)。定量数据采用均数和标准差(SD)表示。定性变量采用卡方检验。方差分析用于比较年龄和抗凝或抗血小板治疗患者。当 P<0.05 时,认为差异具有统计学意义。
在 418 例拔牙术中,有 3 例患者发生 5 例严重出血并发症(2.11%)。在这 5 例事件中,有 4 例发生在服用 NOAC 的患者中(1.68%),1 例发生在服用 acenocoumarol 的患者中(0.42%; P=0.003)。
考虑到这项回顾性临床研究的结果,我们可以得出结论,抗凝和/或抗血小板治疗患者拔牙后出血并发症发生率较低,服用 NOAC 的患者发生率较高,其次是服用经典抗凝剂的患者,服用抗血小板药物的患者无并发症。