Abstract
The opportunity to carry out oral surgery in patients under anticoagulant therapy has been increasing, although a dilemma exists between the hemostasis in the dental procedures and the contineous anticoagulant management.
It is our purpose to know the safety of oral surgery among the patients using anticoagulant.
The present study was based on forty one oral surgery in 19 patients treated Nagoya University Hospital during 1973 to 1978. All cases had been managed by anticoagulant therapy with Warfarin for the replaced prosthetic valve, or for the management of mitral or aortic disease, etc.. The oral procedures consisted of 30 dental extractions, 5 scaling, two resections of torus mandibularis, two cases of alveoloplasty, removal of an apical cyst and biopsy in each case.
The mean value of thrombotest with the therapeutic dose of Warf arin was 24.3±11.8%. And the value on the data of dental extraction was found to be 49.9±21.2%. Postoperative bleeding, only for one or two days, was observed in 10 cases with dental extraction. A comparison of the value between cases of the bleeding and non-bleeding after dental extraction revealed no significant difference, of which the group with bleeding and non-bleeding were 56.6±23.6% and 46.6±20.2%, respectively.
The present results may indicate that the bleeding at oral surgery is not related to the anticoagulant therapy and that it is not necessary to discontinue the therapy for oral surgery. However, further detailed studies are necessary to establish a comprehensive policy.
