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抗血栓治疗对简单拔牙后创口愈合的影响:一项随机临床试验。

Influence of the Antithrombotic Therapy in the Healing of Simple Post-Extraction Sockets: A Randomized Clinical Trial.

作者信息

Sammartino Gilberto, Gasparro Roberta, Spagnuolo Gianrico, Miniello Alessandra, Blasi Andrea, Marenzi Gaetano

机构信息

Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy.

出版信息

J Clin Med. 2022 Jun 24;11(13):3654. doi: 10.3390/jcm11133654.

Abstract

Background: An adequate blood supply plays a leading role in the healing process of the post-extractive socket; its coagulation leads to fibrin clot formation, which acts as a physical barrier able to prevent postoperative bleeding and microbial infection. The purpose of this study was to evaluate the effectiveness of antiaggregant drugs in healing post-extraction sockets compared to natural wound healing. Methods: This was a single-center prospective clinical trial. Extraction sockets allocated in healthy patients and in patients assuming antiplatelet drugs were considered. Thirty consecutive patients under (treated with/in treatment with) oral antiplatelet treatment were enrolled in the test group. In order to provide a control group, 30 consecutive patients meeting all the exclusion and inclusion criteria were enrolled. The extraction of the mono-radicular tooth was atraumatically performed without gingivoplasty or osteotomy procedures that could influence the healing process. Photographs were obtained before and immediately after surgery and at 3-, 7-, 14- and 28-days follow-up. Results: All patients assumed the prescribed therapy and their post-operative recovery was uneventful without any kind of post-extractive complications. The results of inter-group comparison show that on the third and seventh days of follow-up, the antiplatelet group expressed a statistically significant higher level of healing compared to the control group (p < 0.05), while no statistically significant differences were recorded at 14- and 28-days follow-up. Conclusions: Patients treated with antiplatelet agents seemed to show that this therapy can positively affect the healing process after tooth extractions.

摘要

背景

充足的血液供应在拔牙后牙槽窝的愈合过程中起主导作用;其凝血导致纤维蛋白凝块形成,该凝块作为一种物理屏障,能够防止术后出血和微生物感染。本研究的目的是评估抗血小板药物在拔牙后牙槽窝愈合方面相对于自然伤口愈合的有效性。方法:这是一项单中心前瞻性临床试验。研究纳入了健康患者以及正在服用抗血小板药物的患者的拔牙牙槽窝。试验组纳入了连续30例接受口服抗血小板治疗的患者。为了设立对照组,纳入了连续30例符合所有排除和纳入标准的患者。单根牙的拔除在无创伤的情况下进行,未进行可能影响愈合过程的牙龈成形术或截骨术。在手术前、手术后即刻以及术后3天、7天、14天和28天进行随访时拍摄照片。结果:所有患者均接受了规定的治疗,术后恢复顺利,未出现任何拔牙后并发症。组间比较结果显示,在随访的第3天和第7天,抗血小板组的愈合水平在统计学上显著高于对照组(p < 0.05),而在随访14天和28天时未记录到统计学上的显著差异。结论:接受抗血小板药物治疗的患者似乎表明这种治疗可以对拔牙后的愈合过程产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6e/9267478/e56ce8495629/jcm-11-03654-g001.jpg

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