[논문]Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

Cho, Yong-Wook; Kim, Euiseong

doi:10.5395/rde.2013.38.3.113

Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery? 원문보기

RDE : Restorative dentistry & endodontics, v.38 no.3, 2013년, pp.113 - 118

Cho, Yong-Wook (Department of Conservative Dentistry, Yonsei University College of Dentistry) , Kim, Euiseong (Microscope Center, Department of Conservative Dentistry, Yonsei University College of Dentistry)

Abstract ▼ AI-Helper

Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

주제어

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문제 정의

The purpose of this paper is to review the literatures about evidence that supports either changing/ discontinuing or continuing the OAT for minor dental surgery and endodontic surgery, and to suggest the strategies for patients taking the OAT.

가설 설정

Furthermore, 7 patients died due to thromboembolism.¹⁸ In this study, the author said that if anyone stops the OAT, he or she will soon encounter the risk of thromboembolic event regardless of the period of discontinuation. Furthermore, there is no method to select the low-risk patient, so OAT should be continued for the patient’s whole life.

제안 방법

The dentist must consult with the physician and verify that the patient’s systemic status is acceptable for the minor surgical procedure. The purpose of the consultation is first, the confirmation of INR value within therapeutic range for dental surgical procedures. Second, it is to let the physician know that the patient will be taken some kind of dental minor surgery.

성능/효과

In conclusion, even if the INR value is in therapeutic range (2 - 4), post-operative hemorrhage can not be so serious and can be well controlled in a dental minor surgery, especially when the local hemostatic methods are used appropriately.

후속연구

In patients who are continuing the anticoagulation therapy, post-operative bleeding can be well controlled with the local hemostatic measures. In the endodontic surgery, further research is necessary to find out whether intra-operative bleeding control can be achieved well only with local hemostatic measures in patients who continue the anticoagulation therapy.

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Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery? 원문보기

Abstract ▼ AI-Helper

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Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery? 원문보기

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