.: ORİJİNAL ARAŞTIRMA
Should Antiplatelet Drugs Stopped Before Dental Extraction?
Antiplatelet İlaçlar Diş Çekiminden Önce Kesilmeli midir?
Turkiye Klinikleri J Cardiovasc Sci. 2019;31(2):93-9
doi: 10.5336/cardiosci.2018-63266
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The aim of this study was to evaluate the incidence of postoperative bleeding after dental extraction in patients without interruption of single or dual antiplatelet therapy. Material and Methods: The study comprised a total of 195 consecutive subjects who underwent dental extractions performed by the same qualified dentist in Baskent University Department of Oral and Maxillofacial Surgery between the date of February and May 2016. Patients were divided into three groups (n=65 in each group): dual antiplatelet therapy (acetylsalicylic acid and clopidogrel), first control (no antiplatelet or anticoagulant therapy) and second control group (antiplatelet therapy ceased for 3-10 days prior to dental extraction). Results: There was no significant difference in sex distribution, mean age, or in the types or number of teeth extracted between the groups. The incidence of postoperative bleeding was higher in the study group than in the control groups, but the difference was not significant. In the study group, the incidence of postoperative bleeding was higher in patients on dual therapy than in those on acetylsalicylic acid alone or clopidogrel alone; however, the differences were not significant. Conclusion: The findings of the present study suggest that there is no need to stop single or dual antiplatelet therapy prior to dental extraction.
Keywords: Bleeding; dental extraction; antiplatelet drugs; hemorrhage
Objective: The aim of this study was to evaluate the incidence of postoperative bleeding after dental extraction in patients without interruption of single or dual antiplatelet therapy. Material and Methods: The study comprised a total of 195 consecutive subjects who underwent dental extractions performed by the same qualified dentist in Baskent University Department of Oral and Maxillofacial Surgery between the date of February and May 2016. Patients were divided into three groups (n=65 in each group): dual antiplatelet therapy (acetylsalicylic acid and clopidogrel), first control (no antiplatelet or anticoagulant therapy) and second control group (antiplatelet therapy ceased for 3-10 days prior to dental extraction). Results: There was no significant difference in sex distribution, mean age, or in the types or number of teeth extracted between the groups. The incidence of postoperative bleeding was higher in the study group than in the control groups, but the difference was not significant. In the study group, the incidence of postoperative bleeding was higher in patients on dual therapy than in those on acetylsalicylic acid alone or clopidogrel alone; however, the differences were not significant. Conclusion: The findings of the present study suggest that there is no need to stop single or dual antiplatelet therapy prior to dental extraction.
Keywords: Bleeding; dental extraction; antiplatelet drugs; hemorrhage
ÖZET
Amaç: Bu çalışmanın amacı antiplatelet ilaç tedavisinin kesilmediği durumlarda diş çekimi sonrası postoperative kanama insidansının değerlendirilmesidir. Gereç ve Yöntemler: Bu klinik çalışmaya, Şubat-Mayıs 2016 tarihleri arasında Başkent Üniversitesi Ağız Diş Çene Cerrahisi Anabilim Dalı'nda aynı nitelikli dişhekimi tarafından diş çekimi uygulanan toplam 195 kişi dahil edilmiştir. Hastalar herbir grupta 65 kişi olacak şekilde üç gruba ayrılmıştır. Kombine ilaç tedavisi (asetil salisilik asit ve klopidogrel), ilk kontrol grubu (antiplatelet tedavi görmeyen bireyler) ve ikinci kontrol grubu (antiplatelet tedaviye diş çekilmesinden 3-10 gün önce ara veren hastalar). Bulgular: Gruplar arasında cinsiyet dağılımı, yaş ortalaması, dişlerin çekim tipleri veya sayısı açısından anlamlı bir fark yoktu. Postoperatif kanama insidansı çalışma grubunda kontrol grubuna göre daha yüksekti, ancak fark anlamlı değildi. Çalışma grubunda, postoperatif kanama insidansı, ikili ilaç tedavisi alan hastalarda tek başına asetil salisilik asit veya klopidogrel kullanan hastalara göre daha yüksekti. Ancak farklılıklar istatistiksel olarak anlamlı değildi. Sonuç: Bu çalışmanın bulguları, diş çekimi öncesinde antiplatelet (dual veya tek) tedaviyi durdurmaya gerek olmadığını düşündürmektedir.
Anahtar Kelimeler: Kanama; diş çekimi; antiplatelet ilaç; hemoraji
Amaç: Bu çalışmanın amacı antiplatelet ilaç tedavisinin kesilmediği durumlarda diş çekimi sonrası postoperative kanama insidansının değerlendirilmesidir. Gereç ve Yöntemler: Bu klinik çalışmaya, Şubat-Mayıs 2016 tarihleri arasında Başkent Üniversitesi Ağız Diş Çene Cerrahisi Anabilim Dalı'nda aynı nitelikli dişhekimi tarafından diş çekimi uygulanan toplam 195 kişi dahil edilmiştir. Hastalar herbir grupta 65 kişi olacak şekilde üç gruba ayrılmıştır. Kombine ilaç tedavisi (asetil salisilik asit ve klopidogrel), ilk kontrol grubu (antiplatelet tedavi görmeyen bireyler) ve ikinci kontrol grubu (antiplatelet tedaviye diş çekilmesinden 3-10 gün önce ara veren hastalar). Bulgular: Gruplar arasında cinsiyet dağılımı, yaş ortalaması, dişlerin çekim tipleri veya sayısı açısından anlamlı bir fark yoktu. Postoperatif kanama insidansı çalışma grubunda kontrol grubuna göre daha yüksekti, ancak fark anlamlı değildi. Çalışma grubunda, postoperatif kanama insidansı, ikili ilaç tedavisi alan hastalarda tek başına asetil salisilik asit veya klopidogrel kullanan hastalara göre daha yüksekti. Ancak farklılıklar istatistiksel olarak anlamlı değildi. Sonuç: Bu çalışmanın bulguları, diş çekimi öncesinde antiplatelet (dual veya tek) tedaviyi durdurmaya gerek olmadığını düşündürmektedir.
Anahtar Kelimeler: Kanama; diş çekimi; antiplatelet ilaç; hemoraji
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