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Risk of rebleeding after dentoalveolar surgery in patients on anticoagulant therapy compared to patients without anticoagulant therapy
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21st ICOMS 2013—Abstracts: Oral Papers
Key words: submental intubation; panfacial fractures; airway management http://dx.doi.org/10.1016/j.ijom.2013.07.231
T8.OR002 Risk of rebleeding after dentoalveolar surgery in patients on anticoagulant therapy compared to patients without anticoagulant therapy
T7.OR070
F. Broekema ∗ , B. van Minnen, J. Jansma, R. Bos
A single 2.0 mm mandible locking plate fixation as tension band for mandibular angle fracture
University Medical Center Groningen, Netherlands
L. Zhang ∗ , L. Lu, M.L. Yang, Q. Liu, X.K. Wang
Objectives: Continuation of anticoagulant therapy in patients undergoing dentoalveolar surgery is recommended because of the risk for thromboembolic events. Little information is available about the incidence of rebleeding in these patients. The objective of this study was to evaluate the incidence of rebleeding after dentoalveolar surgery in patients receiving anticoagulant therapy and compare this to patients without anticoagulant therapy. Materials and methods: 206 patients were included from which 103 were on anticoagulant therapy and 103 received no anticoagulant therapy. From the patients on anticoagulant therapy 71 used thrombocyte aggregation inhibitors and 32 used coumarin derivatives. The surgery consisted of dental extraction, apicoectomy or implant placement. The patients received standard postoperative care and the wounds were closed with absorbable sutures. Tranexamic acid mouthwash was used postoperatively by the patients receiving coumarin derivatives. Results: From the 103 patients on anticoagulant therapy, seven suffered from a mild rebleeding after dentoalveolar surgery (6.8%). The patients that used coumarin derivatives had a mean INR of 2.6 (1.9–3.4). In this group three mild rebleedings occurred (9.4%). In the group that used thrombocyte aggregation inhibitors four mild rebleedings were reported (5.6%). In the control group without anticoagulant therapy two patients suffered from a mild rebleeding (1.9%). All bleedings were controlled by the patients themselves with a compressive gauze. In none of the patients a severe rebleeding requiring medical intervention was seen. Conclusion: These results show that continuation of anticoagulant therapy during dentoalveolar surgery leads to a higher percentage of mild rebleedings. However, no severe rebleedings were reported and therefore we conclude that it is safe to perform dentoalveolar surgery in patients receiving anticoagulant therapy.
Department of Oral and Maxillofacial Surgery, School of Stomatology, Liaoning Institute of Dental Research, China Medical University, China Objective: To evaluate the clinical effects of a single 2.0 mm mandible locking palate fixation as tension band for mandibular angle fracture. Methods: All 58 cases use a single 2.0 mm mandible locking palate fixation as tension band for mandibular angle fracture. 3D CT of the mandible was taken for evaluation of bone healing. Results: All 58 cases had bone healing. 2 cases (3.54%) had infection and second stage wound healing, 3 cases (5.17%) had malocclusion but recover to normal occlusion with the elastic fixation. All cases had no pain at 8 weeks after operation, and there were no recurrence fracture after removing the palate and screws. Conclusion: The treatment with a single 2.0 mm mandible locking palateon the tension band fixation is a stable and reliable method for mandibular angle fracture. http://dx.doi.org/10.1016/j.ijom.2013.07.232 T8. Dental Alveolar Surgery T8.OR001 Patient’s informed consent prior to extraction of impacted third molars A. Alharbi ∗ , M. Alkindi, Y. Alali College of Dentistry, King Saud University, Saudi Arabia Aim: The aim of this study was to look at the current practice of obtaining verbal or written consent for extraction of impacted third molars by general practitioners and oral and maxillofacial surgeons in Riyadh, Saudi Arabia. Materials and methods: Cross sectional study based on questionnaire designed by authors were submitted to general practitioners and oral and maxillofacial surgeons in Riyadh, Saudi Arabia. The questionnaire was to review the title of clinicians, occupations, year of experiences and the method used for consenting the patients. SPSS software used for statistical analysis. Results: Among the submitted questionnaire, the response rate was 83%, 65 males and 18 females (77.4% and 21.4%, respectively). Almost 80% of the clinicians consented their patients prior to extraction of impacted 3rd molars. Verbal consent was the most method used for consenting the patients (52.4%). Swelling, trismus and soft tissue injury were the most three complications they consent the patients about it (94%, 73.8% and 64.3% respectively). Conclusions: The verbal consent was the most method used by clinicians in term of consenting the patients. And among the complications for consenting, we found that swelling was the most, while fracture of maxillary tuberosity the least. http://dx.doi.org/10.1016/j.ijom.2013.07.233
http://dx.doi.org/10.1016/j.ijom.2013.07.234 T8.OR003 Comparison of lokal anaesthetic efficacy of lidocaine and mepivacaine in sedated pediatric patients undergoing exodontia: randomized, prospective clinical study A. C ¸ aliþ 1,∗ , E. C ¸ aðy´ ran 2 , C. Efeoðlu 1 , H. Koca 1 1 Ege University Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Turkey 2 Ege University Medical Faculty, Department of Anesthesiology and Reanimation, Turkey
Background and objectives: Generally in the case of minor oral surgical procedures and exodontia co-operation of the patients and their families with the dentist will lead to superior treatment outcomes. Midazolam gives potent sedation, loss of memory and anxiolysis. The aim of this randomised prospective clinical study is to compare the local anaesthetic and haemodynamic effects of 2% lidocaine and 3% mepivacaine in sedated pediatric patients undergoing deciduous tooth extraction. Patients and methods: The study was approved by the local Ethics Committee, and 60 pediatric patients undergoing sedation
21st ICOMS 2013—Abstracts: Oral Papers
Key words: submental intubation; panfacial fractures; airway management http://dx.doi.org/10.1016/j.ijom.2013.07.231
T8.OR002 Risk of rebleeding after dentoalveolar surgery in patients on anticoagulant therapy compared to patients without anticoagulant therapy
T7.OR070
F. Broekema ∗ , B. van Minnen, J. Jansma, R. Bos
A single 2.0 mm mandible locking plate fixation as tension band for mandibular angle fracture
University Medical Center Groningen, Netherlands
L. Zhang ∗ , L. Lu, M.L. Yang, Q. Liu, X.K. Wang
Objectives: Continuation of anticoagulant therapy in patients undergoing dentoalveolar surgery is recommended because of the risk for thromboembolic events. Little information is available about the incidence of rebleeding in these patients. The objective of this study was to evaluate the incidence of rebleeding after dentoalveolar surgery in patients receiving anticoagulant therapy and compare this to patients without anticoagulant therapy. Materials and methods: 206 patients were included from which 103 were on anticoagulant therapy and 103 received no anticoagulant therapy. From the patients on anticoagulant therapy 71 used thrombocyte aggregation inhibitors and 32 used coumarin derivatives. The surgery consisted of dental extraction, apicoectomy or implant placement. The patients received standard postoperative care and the wounds were closed with absorbable sutures. Tranexamic acid mouthwash was used postoperatively by the patients receiving coumarin derivatives. Results: From the 103 patients on anticoagulant therapy, seven suffered from a mild rebleeding after dentoalveolar surgery (6.8%). The patients that used coumarin derivatives had a mean INR of 2.6 (1.9–3.4). In this group three mild rebleedings occurred (9.4%). In the group that used thrombocyte aggregation inhibitors four mild rebleedings were reported (5.6%). In the control group without anticoagulant therapy two patients suffered from a mild rebleeding (1.9%). All bleedings were controlled by the patients themselves with a compressive gauze. In none of the patients a severe rebleeding requiring medical intervention was seen. Conclusion: These results show that continuation of anticoagulant therapy during dentoalveolar surgery leads to a higher percentage of mild rebleedings. However, no severe rebleedings were reported and therefore we conclude that it is safe to perform dentoalveolar surgery in patients receiving anticoagulant therapy.
Department of Oral and Maxillofacial Surgery, School of Stomatology, Liaoning Institute of Dental Research, China Medical University, China Objective: To evaluate the clinical effects of a single 2.0 mm mandible locking palate fixation as tension band for mandibular angle fracture. Methods: All 58 cases use a single 2.0 mm mandible locking palate fixation as tension band for mandibular angle fracture. 3D CT of the mandible was taken for evaluation of bone healing. Results: All 58 cases had bone healing. 2 cases (3.54%) had infection and second stage wound healing, 3 cases (5.17%) had malocclusion but recover to normal occlusion with the elastic fixation. All cases had no pain at 8 weeks after operation, and there were no recurrence fracture after removing the palate and screws. Conclusion: The treatment with a single 2.0 mm mandible locking palateon the tension band fixation is a stable and reliable method for mandibular angle fracture. http://dx.doi.org/10.1016/j.ijom.2013.07.232 T8. Dental Alveolar Surgery T8.OR001 Patient’s informed consent prior to extraction of impacted third molars A. Alharbi ∗ , M. Alkindi, Y. Alali College of Dentistry, King Saud University, Saudi Arabia Aim: The aim of this study was to look at the current practice of obtaining verbal or written consent for extraction of impacted third molars by general practitioners and oral and maxillofacial surgeons in Riyadh, Saudi Arabia. Materials and methods: Cross sectional study based on questionnaire designed by authors were submitted to general practitioners and oral and maxillofacial surgeons in Riyadh, Saudi Arabia. The questionnaire was to review the title of clinicians, occupations, year of experiences and the method used for consenting the patients. SPSS software used for statistical analysis. Results: Among the submitted questionnaire, the response rate was 83%, 65 males and 18 females (77.4% and 21.4%, respectively). Almost 80% of the clinicians consented their patients prior to extraction of impacted 3rd molars. Verbal consent was the most method used for consenting the patients (52.4%). Swelling, trismus and soft tissue injury were the most three complications they consent the patients about it (94%, 73.8% and 64.3% respectively). Conclusions: The verbal consent was the most method used by clinicians in term of consenting the patients. And among the complications for consenting, we found that swelling was the most, while fracture of maxillary tuberosity the least. http://dx.doi.org/10.1016/j.ijom.2013.07.233
http://dx.doi.org/10.1016/j.ijom.2013.07.234 T8.OR003 Comparison of lokal anaesthetic efficacy of lidocaine and mepivacaine in sedated pediatric patients undergoing exodontia: randomized, prospective clinical study A. C ¸ aliþ 1,∗ , E. C ¸ aðy´ ran 2 , C. Efeoðlu 1 , H. Koca 1 1 Ege University Dentistry Faculty, Department of Oral and Maxillofacial Surgery, Turkey 2 Ege University Medical Faculty, Department of Anesthesiology and Reanimation, Turkey
Background and objectives: Generally in the case of minor oral surgical procedures and exodontia co-operation of the patients and their families with the dentist will lead to superior treatment outcomes. Midazolam gives potent sedation, loss of memory and anxiolysis. The aim of this randomised prospective clinical study is to compare the local anaesthetic and haemodynamic effects of 2% lidocaine and 3% mepivacaine in sedated pediatric patients undergoing deciduous tooth extraction. Patients and methods: The study was approved by the local Ethics Committee, and 60 pediatric patients undergoing sedation