Seo Mi Hyun
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
Department of One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, South Korea.
J Dent Sci. 2025 Jul;20(3):1506-1512. doi: 10.1016/j.jds.2024.12.029. Epub 2025 Jan 9.
BACKGROUND/PURPOSE: With the growing elderly population and their increasing prevalence of systemic diseases, the use of antithrombotic medications is on the rise. These medications are essential for preventing thromboembolic events in patients with cardiovascular, cerebrovascular diseases. However, their use poses challenges in dental surgeries, where the risk of postoperative bleeding needs to be carefully balanced against the risks of discontinuing antithrombotic therapy. This study aimed to assess whether continuing antithrombotic therapy increases the risk of postoperative bleeding during dental procedures.
Retrospective analysis was conducted on 118 patients who underwent oral surgeries, including extractions and dental implants. Patients were categorized based on whether they continued or discontinued antithrombotic therapy before the procedure. Data on age, sex, type of antithrombotic agent, and occurrence of delayed bleeding were collected. Multiple regression analysis was used to identify potential risk factors for postoperative bleeding.
Of the 118 patients, 78 continued antithrombotic therapy, while 40 discontinued it. Delayed postoperative bleeding occurred in 10 patients (8.47 %), with no statistically significant difference between those who continued and those who discontinued their medication. The type of antithrombotic agent, interaction between drug cessation and procedure, preoperative platelet count, prothrombin time, and partial thromboplastin time did not significantly affect the incidence of bleeding.
Continuing antithrombotic therapy does not significantly increase the risk of postoperative bleeding in patients undergoing oral surgeries. Dental practitioners can consider maintaining antithrombotic therapy during certain procedures, emphasizing the importance of balancing bleeding risks with the potential for thromboembolic events.
背景/目的:随着老年人口的增加以及他们全身疾病患病率的上升,抗血栓药物的使用正在增加。这些药物对于预防心血管、脑血管疾病患者的血栓栓塞事件至关重要。然而,在牙科手术中使用这些药物存在挑战,因为术后出血风险需要与停止抗血栓治疗的风险仔细权衡。本研究旨在评估继续抗血栓治疗是否会增加牙科手术期间术后出血的风险。
对118例行口腔手术(包括拔牙和牙种植)的患者进行回顾性分析。根据患者在手术前是否继续或停止抗血栓治疗进行分类。收集患者的年龄、性别、抗血栓药物类型和延迟出血的发生情况。采用多元回归分析确定术后出血的潜在危险因素。
118例患者中,78例继续抗血栓治疗,40例停止治疗。10例患者(8.47%)发生术后延迟出血,继续用药组和停药组之间无统计学显著差异。抗血栓药物类型、停药与手术的相互作用、术前血小板计数、凝血酶原时间和活化部分凝血活酶时间对出血发生率无显著影响。
继续抗血栓治疗不会显著增加接受口腔手术患者的术后出血风险。牙科医生在某些手术过程中可以考虑维持抗血栓治疗,强调平衡出血风险与血栓栓塞事件可能性的重要性。