目的:这项工作旨在评估接受植入手术的口服抗凝治疗(OAT)患者“非保守”治疗方案的血栓栓塞和出血风险。
方法:我们决定采取手术“非保守”方案,在美学区域插入四个植入物,不使用无翼手术和手术模板。根据血液学家的说法,INR值降低,华法林被低分子量肝素替代,有一个更好的凝血控制。
结果:现代指南对OAT患者实施保守治疗方案,微创手术,无翼,和使用手术模板,以减少不受控制的出血风险。这个,多亏了牙医和血液学家之间的团队合作,多亏了INR的仔细调整和当地止血剂的使用,没有遇到任何出血或手术内或术后的问题。
结论:对于口腔外科医生来说,OAT患者的手术治疗是一个真正的问题,每次与血液学家联合治疗。应用这种外科手术,不同于今天的指导方针,根据我们的经验,没有发生术后并发症(出血或出血);骨整合未受损,假体康复成功完成.
OBJECTIVE: This work aims to assess the risks both thromboembolic that bleeding of a management protocol \"non-conservative\" in patients on oral anticoagulant therapy (
OAT) to be undergoing implant surgery.
METHODS: We decided to take a surgical \"non-conservative\" protocol, to insert four implants in the aesthetic zone, without using flapless surgery and the surgical template. In accordance with the hematologist, the value of INR is lowered and warfarin was replaced with heparin low molecular weight, to have a better coagulation\'s control.
RESULTS: The modern guidelines impose a protocol of conservative management in patients with
OAT, with minimally invasive surgery, flapless, and use of surgical template to reduce the risk of uncontrolled bleeding. This, thanks to the team-work between dentist and hematologist, thanks to careful adjustment of INR and the use of local haemostatic agents, were not encountered any problems with bleeding or intra or postoperative.
CONCLUSIONS: Surgical treatment of patients with
OAT is a real problem for the oral surgeon, to treat every time in association with the hematologist. Applying this type of surgical procedure, different from today\'s guidelines, in our experience there were no post-operative complications (bleeding or bleeding); osseointegration has not been compromised and the prosthetic rehabilitation was completed successfully.