Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Cardiovascular Center, University Hospital and Health Services, Trieste, Italy.
Clin Oral Investig. 2023 Jun;27(6):2865-2874. doi: 10.1007/s00784-023-04880-z. Epub 2023 Jan 28.
The aim of this clinical observational study was to assess the efficacy of L-PRF as a hemostatic agent in patients under treatment with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs).
Patients under oral anticoagulant therapy (VKA or DOACs) who needed a single simple tooth extraction were enrolled. L-PRF plug was positioned inside the alveolus and secured with non-absorbable sutures. Surgical time, pain-VAS, paracetamol intake, intra-operative, post-operative biological complications, and bleeding events have been registered.
A total of 112 patients (59 patients for DOAC and 53 for VKA group) were enrolled. Post-operative bleeding was recorded in nine patients (17%) for VKA group and nine patients (15.3%) for DOACs group. None of the patients needed a medical support for managing of bleeding. Seven days after surgery, no cases of post-extractive complications occurred.
The use of L-PRF resulted in limited mild late post-operative bleedings without the need of medical intervention.
The use of L-PRF can be adopted for an uneventful post-operative curse in anticoagulated patients without chasing their therapy for single tooth extraction.
本临床观察性研究旨在评估富血小板纤维蛋白（L-PRF）作为止血剂在接受维生素 K 拮抗剂（VKA）或直接口服抗凝剂（DOAC）治疗的患者中的疗效。
招募接受口服抗凝治疗（VKA 或 DOAC）且需要单次简单拔牙的患者。将 L-PRF 塞置于牙槽内并用不可吸收缝线固定。记录手术时间、疼痛视觉模拟评分（VAS）、扑热息痛摄入量、术中、术后生物并发症和出血事件。
共纳入 112 例患者（DOAC 组 59 例，VKA 组 53 例）。VKA 组有 9 例（17%）和 DOAC 组有 9 例（15.3%）患者发生术后出血。两组均无患者需要医疗支持来处理出血。术后 7 天，无拔牙后并发症发生。
L-PRF 的使用导致有限的轻度迟发性术后出血，无需医疗干预。
在不改变抗凝治疗的情况下，使用 L-PRF 可使接受抗凝治疗的患者在术后获得平稳的恢复，无需担心术后并发症。
