Larionova Elena Vladimirovna, Diachkova Ekaterina Yurievna, Morozova Elena Anatolievna, Davtyan Albert Artemovich, Tarasenko Svetlana Viktorovna
Department of Oral Surgery of E.V. Borovskiy Institute of Dentistry of I.M. Sechenov First Moscow State Medical University (Sechenov University), Russia.
Biomedicine (Taipei). 2021 Jun 1;11(2):47-54. doi: 10.37796/2211-8039.1072. eCollection 2021.
The provision of efficient dental care to patients with hemostatic disorders is tied to difficulties and problems, such as prolonged bleeding after or during surgical manipulation.
was to increase the efficiency of oral surgery in patients with thrombocytopenia with the use of erbium laser on different stages of tooth extraction.
Patients (n = 96) were selected for tooth extraction on an outpatient basis: patients with confirmed thrombocytopenia (age 44 ± 15.4, 19-74) were included in the 1 group, and patients without impaired hemostasis (age 47.6 ± 15.3, 19-81) were included in the 2 group (p > 0.05). In the 1st group, operation with the use of erbium laser with with a wavelength of 2490 nm in a noncontact mode was performed in two stages: separation of a circular tooth ligament and curettage of the socket after tooth extraction. In the 2 group (control), the treatment was provided according to a traditional algorithm. Before the operation, the lab blood tests for thrombocytes were performed in both groups; moreover, for the 1st group, the duration of bleeding and total coagulation were evaluated. In the postoperative period, pain and edema of soft tissues and hemostasis duration were assessed in both groups.
According to the results of our research, the use of erbium laser in the 1 group allowed us to decrease hemostasis duration compared with the control group of patients (80.9 ± 35.9 and 175 ± 67.5 sec, p < 0.01) and reach the similar probability of postoperative bleeding after tooth extraction (p < 0.5). Pain and edema of soft tissues in dynamics after operation were less in the 1 group (p < 0.001).
Application of erbium laser is an up-to-date method that can be successfully used in surgical treatment in patients with hemostasis failure for bleeding and other postoperative complications prevention and stimulation of the alveolar epithelialization after tooth extraction.
为患有止血障碍的患者提供有效的牙科护理存在诸多困难和问题，例如手术操作期间或之后出血时间延长。
旨在通过在拔牙的不同阶段使用铒激光来提高血小板减少症患者口腔手术的效率。
门诊选择患者（n = 96）进行拔牙：确诊为血小板减少症的患者（年龄44±15.4，19 - 74岁）纳入第1组，止血功能未受损的患者（年龄47.6±15.3，19 - 81岁）纳入第2组（p>0.05）。在第1组中，使用波长为2490 nm的铒激光以非接触模式分两个阶段进行手术：分离圆形牙周韧带和拔牙后牙槽窝刮治。在第2组（对照组）中，按照传统算法进行治疗。两组术前均进行实验室血小板血液检查；此外，对第1组评估出血持续时间和总凝血时间。术后评估两组软组织的疼痛、水肿和止血持续时间。
根据我们的研究结果，与对照组患者相比，第1组使用铒激光可缩短止血持续时间（80.9±35.9秒和175±67.5秒，p<0.01），并使拔牙后术后出血概率相似（p<0.5）。术后第1组软组织的疼痛和水肿动态变化较小（p<0.001）。
铒激光的应用是一种最新方法，可成功用于止血功能障碍患者的手术治疗，以预防出血和其他术后并发症，并促进拔牙后牙槽上皮化。
