scholarly journals Application of thrombin powder after tooth extraction in patients receiving anticoagulant therapy

2002 ◽  
Vol 59 (4) ◽  
pp. 389-392 ◽  
Author(s):  
Marjan Marjanovic
Keyword(s):  
Anticoagulant Therapy ◽  
Tooth Extraction ◽  
Oral Surgery ◽  
Risk Group ◽  
Oral Environment ◽  
Before And After

Patients with extreme hypocoagulation, which occurs either as an effect of some diseases with coagulation deficiency or because of the anticoagulant therapy (ACT), are a risk group for oral surgery. In the last decades decision to change or interrupt ACT before and after the procedure was abandoned and more often local hemostasis was being achieved by combining chemical and biological substances. The success of the surgical hemostasis and thrombin powder combination was tested on the group of 20 patients with ACT. The results were satisfactory despite thrombin powder solubility in the moist oral environment.

REGENERAÇÃO ÓSSEA GUIADA DE ALVÉOLOS DE EXTRAÇÃO DENTÁRIO- UMA REVISÃO

2016 ◽  
Vol 1 (45) ◽  
Author(s):  
Bruno Pires Miranda
Keyword(s):  
Bone Regeneration ◽  
Tooth Extraction ◽  
Oral Surgery ◽  
Guided Bone Regeneration ◽  
The Body ◽  
Synthetic Material ◽  
Dynamic Changes ◽  
Tooth Socket ◽  
Ability To Regenerate ◽  
Implant Dentistry

Resumo O osso é um tecido conjuntivo especializado, vascularizado e dinâmico que se modifica ao longo do organismo. Quando lesado, possui uma capacidade única de regeneração e reparação sem a presença de cicatrizes, mas em algumas situações devido tamanho do defeito ósseo não se regenera por completo. Assim, se faz necessária a realização de procedimentos de regeneração óssea guiada. Para isso, o implantodontista deve conhecer as bases biológicas da regeneração óssea guiada alveolar e suas indicações. Nesta revisão foram abordadas indicações, vantagens e tipos de biomateriais utilizados para preenchimento do alvéolo dentário imediatamente após a extração dentária sempre que o objetivo for à reabilitação através da instalação de implantes. Mesmo este, biomateriais, apresentando inúmeras qualidades, estudos ainda devem ser feitos a fim de obter a cada dia, um material sintético compatível com o tecido ósseo perdido em quantidades adequadas sem necessitar de cirurgias extra-bucais.ABSTRACT Bone is a specialized vascularized connective tissue that dynamic changes throughout the body. When injured, it has a unique ability to regenerate and repair without the presence of scars, but in some situations due to size of the bone defect does not regenerate completely. Thus, it is necessary to perform guided bone regeneration procedures. For this, the implant dentistry must know the biological bases of alveolar guided bone regeneration and its indications. In this review were addressed indications, advantages and types of biomaterials used for filling the tooth socket immediately after the tooth extraction whenever the goal is rehabilitation through implants installation. Even this, biomaterials, having several qualities, further studies must be done to obtain each day, a synthetic material compatible with the bone tissue lost in proper amounts without the need of extra-oral surgery.

scholarly journals Associated characteristics and treatment outcomes of medication-related osteonecrosis of the jaw in patients receiving denosumab or zoledronic acid for bone metastases

2021 ◽  
Author(s):  
Hiroaki Ikesue ◽  
Moe Mouri ◽  
Hideaki Tomita ◽  
Masaki Hirabatake ◽  
Mai Ikemura ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Bone Metastases ◽  
Tooth Extraction ◽  
Proportional Hazards ◽  
Osteonecrosis Of The Jaw ◽  
Cox Proportional Hazards ◽  
Patients With Cancer ◽  
Proportional Hazards Regression ◽  
Before And After ◽  
Denosumab Treatment

Abstract Purpose This study aimed to evaluate the association between clinical characteristics and development of medication-related osteonecrosis of the jaw (MRONJ) in patients who underwent dental examinations before the initiation of treatment with denosumab or zoledronic acid, which are bone-modifying agents (BMAs), for bone metastases. Additionally, the clinical outcomes of patients who developed MRONJ were evaluated along with the time to resolution of MRONJ. Methods The medical charts of patients with cancer who received denosumab or zoledronic acid for bone metastases between January 2012 and September 2016 were retrospectively reviewed. Patients were excluded if they did not undergo a dental examination at baseline. Results Among the 374 included patients, 34 (9.1%) developed MRONJ. The incidence of MRONJ was significantly higher in the denosumab group than in the zoledronic acid (27/215 [12.6%] vs 7/159 [4.4%], P = 0.006) group. Multivariate Cox proportional hazards regression analysis revealed that denosumab treatment, older age, and tooth extraction before and after starting BMA treatments were significantly associated with developing MRONJ. The time to resolution of MRONJ was significantly shorter for patients who received denosumab (median 26.8 months) than for those who received zoledronic acid (median not reached; P = 0.024). Conclusion The results of this study suggest that treatment with denosumab, age > 65 years, and tooth extraction before and after starting BMA treatments are significantly associated with developing MRONJ in patients undergoing treatment for bone metastases. However, MRONJ caused by denosumab resolves faster than that caused by zoledronic acid.

scholarly journals Effects of pre-extraction intermittent PTH administration on extraction socket healing in bisphosphonate administered ovariectomized rats

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Hyo-Won Jang ◽  
Jung-In Kim ◽  
In-Ho Cha
Keyword(s):  
Tooth Extraction ◽  
Bisphosphonate Therapy ◽  
Ovariectomized Rats ◽  
Control Group ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Extraction Socket ◽  
Before And After ◽  
Socket Healing ◽  
Positive Effect

AbstractThe purpose of this study was to investigate the effect of administering intermittent parathyroid hormone (iPTH) before tooth extraction versus after tooth extraction on the risk of developing MRONJ in experimental animal model. Twenty-five ovariectomized rats received 6 weeks of bisphosphonate therapy. They were classified into 3 groups, based on the timing of the medication, as Control, Pre-PTH and Post-PTH groups. For Control group, normal saline was administered before and after tooth extraction. iPTH was administered during 4 weeks before tooth extraction for Pre-PTH group and after tooth extraction for Post-PTH group. The animals were euthanized 8 weeks after tooth extraction. Macroscopic, histological, micro-computed tomography (micro-CT), and histomorphometric examinations were conducted. The incidences of impaired healing were 11.11% both in Pre-PTH and Post-PTH groups, which was lower than the Control group (42.86%). Bone healing in the extraction socket, based on micro-CT and histomorphometry evaluations, was best in Post-PTH and worst in Control group. The Pre-PTH group showed moderate healing pattern. Despite of limitations in this study, the authors identified Pre-PTH group seems to have positive effect on extraction socket healing. With regard to timing, administering iPTH after tooth extraction was superior to applying it before tooth extraction.

scholarly journals Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Kusumoto ◽  
Atsushi Uda ◽  
Takeshi Kimura ◽  
Shungo Furudoi ◽  
Ryosuke Yoshii ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Antibiotic Use ◽  
Oral And Maxillofacial Surgery ◽  
Third Generation ◽  
Oral Antibiotics ◽  
Appropriate Use ◽  
Before And After ◽  
Third Generation Cephalosporins

Abstract Background In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital. Methods The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018. Results After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466). Conclusions This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.

scholarly journals CIRURGIAS ORAIS EM PACIENTES EM USO DE VARFARINA: REVISÃO DE LITERATURA

2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Marlus Da Silva Pedrosa ◽  
Jézlia Chris Da Silva Galdino ◽  
Flávia Ennes Dourado Ferro ◽  
José Guilherme Férrer Pompeu ◽  
Marcia Socorro da Costa Borba
Keyword(s):  
Drug Therapy ◽  
Anticoagulant Therapy ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Thromboembolic Events ◽  
Risk Of Bleeding ◽  
Dental Procedures ◽  
Therapy Interruption ◽  
Anticoagulant Drug ◽  
Dental Offices

Introduction: Dental treatment performed in patients on anticoagulant drug therapy is becoming increasingly common in dental offices. Thus, questions concerning thromboembolic and bleeding risks relative to invasive dental procedures, are frequently raised. Aim: To review the scientific evidences regarding anticoagulant therapy interruption in patients taking warfarin undergoing oral surgeries. Methods: It was carried out a literature review in the electronic SciELO, PubMed, Lilacs and Oviatt Library databases from January to March of 2016, using as descriptors: Anticoagulants, Warfarin, Oral Surgery, and Oral Hemorrhage. Results and Discussion: Anticoagulant therapy is extremely important in patients at high risk for development of thromboembolic events. Most studies show that the risk of bleeding oral surgery in patients taking warfarin is relatively insignificant and it can be controlled by simple measures such as hemostasis. Conclusion: It is highly recommended to not interrupt anticoagulant in minor oral surgeries.

scholarly journals Dental anxiety in patients undergoing oral surgery and its effects on blood pressure and heart rate

2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Waiting Room ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Before And After ◽  
Evaluation Anxiety

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.

scholarly journals Evaluation of Preventive Treatment Protocols for Patients under Antiresorptive Therapy Undergoing Tooth Extraction at a Swiss University Clinic

2021 ◽  
Vol 18 (18) ◽  
pp. 9924
Author(s):  
Ellen Pick ◽  
Nicolas Leuenberger ◽  
Irina Kuster ◽  
Nicole Selina Stutzmann ◽  
Bernd Stadlinger ◽  
...  
Keyword(s):  
Tooth Extraction ◽  
Wound Closure ◽  
Oral Surgery ◽  
Preventive Treatment ◽  
Osteonecrosis Of The Jaw ◽  
Antiresorptive Therapy ◽  
Related Factors ◽  
Treatment Protocols ◽  
Primary Wound Closure ◽  
Mucoperiosteal Flap

Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a dreaded complication in patients with compromised bone metabolism. The purpose of the present study was to examine the occurrence of ARONJ and its related factors among patients with a history of antiresorptive therapy undergoing tooth extraction using preventive protocols at a Swiss university clinic. Data were retrospectively pooled from health records of patients having received a surgical tooth extraction between January 2015 and April 2020 in the Clinic of Cranio-Maxillofacial and Oral surgery, University of Zurich. A total of 970 patients received an extraction with flap elevation or wound closure during this period. A total of 104 patients could be included in the study. Furthermore, variables including age, gender, smoking, risk profile, choice, indication and duration of antiresorptive therapy, number of extractions, extraction site, surgical technique, choice and duration of antibiotics as well as the presence of postoperative inflammatory complications were assessed. Overall, 4 patients developed ARONJ (incidence of 3.8%) after tooth extraction at the same location, without previous signs of osteonecrosis. Preventive methods included predominantly primary wound closure using a full thickness mucoperiosteal flap and prolonged perioperative antibiotic prophylaxis. In accordance with current literature, the applied protocol showed a reliable outcome in preventing ARONJ when a tooth extraction is required.

Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy

2015 ◽  
Vol 20 (6) ◽  
pp. 1279-1282 ◽  
Author(s):  
Henning Hanken ◽  
Alexander Gröbe ◽  
Max Heiland ◽  
Ralf Smeets ◽  
Lan Kluwe ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Surgery ◽  
Postoperative Bleeding ◽  
Bleeding Risk

Megan’s Law 20 Years Later: An Empirical Analysis and Policy Review

2018 ◽  
Vol 45 (7) ◽  
pp. 1028-1046 ◽  
Author(s):  
Kristen M. Zgoba ◽  
Wesley G. Jennings ◽  
Laura M. Salerno
Keyword(s):  
Sex Offenders ◽  
Sex Offender ◽  
Risk Group ◽  
High Risk Group ◽  
Regression Equations ◽  
Megan's Law ◽  
Multivariate Logistic Regression ◽  
Recidivism Rates ◽  
Before And After ◽  
General Recidivism

This present study examines the sexual and general recidivism rates of 547 convicted sex offenders released before and after the enactment of Megan’s Law in New Jersey. Presenting the longest Megan’s Law evaluation, participants were followed for an average of 15 years after release (range = 10-29 years). Bivariate and multivariate logistic regression equations were estimated to identify covariates significantly associated with both sexual and general recidivism. Group-based trajectories of general recidivism within the 10 years post–prison release were also estimated and compared according to pre–Megan’s Law and post–Megan’s Law release status. No differences in recidivism rates were noted between the cohorts, but differences emerged in the offending trajectories of the high-risk group of offenders within 10 years of release. These results highlight the lack of impact that sex offender registration and notification (SORN) laws have on sexual and general reoffending rates postrelease.

Abstract 19763: Role of HAS-BLED Score on Major Bleeding in Atrial Fibrillation Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoshitaka Ito ◽  
Kazuhiro Naito ◽  
Katsuhisa Waseda ◽  
Hiroaki Takashima ◽  
Akiyoshi Kurita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Stent Implantation ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk

Background: While anticoagulant therapy is standard management for atrial fibrillation (Af), dual antiplatelet therapy (DAPT) is needed after stent implantation for coronary artery disease. HAS-BLED score estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in Af care. However, it is little known about usefulness of HAS-BLED score in Af patient treated with coronary stents requiring DAPT or DAPT plus warfarin (triple therapy: TT). The aim of this study was to evaluate the role of HAS-BLED score on major bleeding in Af patients undergoing DAPT or TT. Methods: A total of 837 consecutive patients were received PCI in our hospital from Jan. 2007 to Dec. 2010, and 66 patients had Af or paroxysmal Af at the time of PCI. Clinical events including major bleeding (cerebral or gastrointestinal bleeding) were investigated up to 3 years. Patients were divided into 2 groups based on HAS-BLED score (High-risk group: HAS-BLED score≥4, n=19 and Low-risk group: HAS-BLED score<4, n=47). DAPT therapy was required for a minimum 12 months after stent implantation and warfarin was prescribed based on physicians’ discretion. Management/change of antiplatelet and anticoagulant therapy during follow-up periods were also up to physicians’ discretion. Results: Baseline characteristics were not different between High-risk and Low-risk group except for age. Overall incidence of major bleeding was observed in 8 cases (12.1%) at 3 years follow-up. Major bleeding event was significantly higher in High-risk group compared with Low-risk group (31.6% vs. 4.3%, p=0.002). However, management of DAPT and TT was not different between the 2 groups. Among component of HAS-BLED score, renal dysfunction and bleeding contributed with increased number of the score. Conclusion: High-risk group was more frequently observed major bleeding events compared with Low-risk group in patients with Af following DES implantation regardless of antiplatelet/anticoagulant therapy.

Sign in / Sign up

Export Citation Format

Share Document