歯科薬物療法
Online ISSN : 1884-4928
Print ISSN : 0288-1012
ISSN-L : 0288-1012
抗凝固・抗血小板療法施行患者における抜歯手術に関する臨床的検討
岩崎 昭憲三宅 実目黒 敬一郎岡本 雅之小川 尊明大林 由美子長畠 駿一郎
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2008 年 27 巻 1 号 p. 17-24

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We clinically evaluated extraction of tooth in patients undergoing antithrombotic therapy. The subjects consisted of 47 patients undergoing antithrombotic therapy, aged from 33 to 91 years old. Fifteen patients received warfarin therapy, including 6 who also received antiplatelet medication. The other 32 patients received antiplatelet medication alone. The mean of PT-INR (International Normalized Ratio) in patients who received warfarin therapy was 2.00 ± 0.57.
Seventy-two extractions of 129 teeth, including one impacted tooth, were performed on 47 patients. Sixteen of the 72 cases took more than 10 minutes to stop bleeding after surgical treatment (22%) . However, local hemostasis in each of the 16 cases was successfully controlled by local measures, such as application of pressure by biting on gauze, suturing, and the application of atelocollagen. Thirteen of the 72 cases showed postoperative hemorrhage (18%) . However, in all of those cases hemorrhage had stopped by the time of re-examination on the day following surgical treatment, and so no special treatments were required. Except for two cases of small subcutaneous hematoma, there was no fatal problematic complication such as serious embolic complication. In conclusion, extraction of tooth should be performed under antithrombotic therapy by local hemostasis measures.
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