항혈소판 및 항응고제 복용하는 환자의 치과시술 후의 출혈 경향에 대한 후향적 평가

Abstract

Patients with cardiovascular disease who take antiplatelets and anticoagulants are known to have an increased risk of bleeding from open dental surgery. This study is aimed at aiding the analysis of the tendency toward bleeding among patients taking antiplatelets and those taking anticoagulants and to develop guidelines related to drug management during their actual clinical dental care. A total of 413 patients over 65 years of age who visited the Oral and Maxillofacial Surgery Clinic at our hospital from January through December 2018, and underwent extraction and implant surgery participated. This included patients diagnosed with cardio-cerebral vascular disease who were prescribed antiplatelet and anticoagulant drugs. The medical histories of these patients were analyzed to evaluate the tendency toward bleeding depending on the type of drug, whether or not the drug was discontinued, and type of surgery (tooth extraction, implant). In the case of antiplatelet drugs, a total of 113 patients were included, and none of them returned to the hospital due to bleeding, even though the drug was discontinued. A total of 42 patients on anticoagulants were included, of which 2 (4.8%) returned to the hospital with bleeding but the bleeding was controlled through the appropriate hemostatic procedures. Statistically, the type of drug, the presence or absence of drug discontinuation, type of surgery, and occurrence of bleeding after dental surgery were not significant. Therefore, the risk of bleeding during tooth extraction and implant surgery is not significant, based on the findings of this investigation. Therefore, the drug should not be necessarily discontinued if discontinuation of antithrombotic agents increases the patient’s systemic risk, such as for the recurrence of cardiovascular blood clots.