open access
메뉴ISSN : 0376-4672
Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.
1. Ferro A, Garcial DA, Antiplatelet and anticoagulation therapy. Springer. New York, NY, USA, 2013
2. Leon MB, Baim DS, Popma JJ, Gordon PC, Cutlip DE, Ho KK, Giambartolomei A, Diver DJ, Lasorda DM, Williams DO, Pocock SJ, Kuntz RE. A clinical trial comparing three antithrombotic drug regimens after coronary artery stenting. Stent anticoagulation restenosis study investigators. 1998; 339:1665-71
3. Ghantous AE, Ferneini EM. Aspirin, Plavix, and other antiplaetlet medications. What the oral and maxillofacial surgeon needs to know. Oral Maxillofac Surg Clin N Am 2016; 28:497,506
4. Artang R, Dieter R. Analysis of 36 reported cases of late thrombosis in drug eluting stents placed in coronary arteries. Am J Cardiol 2007; 99:1039-43
5. Oh SK. Management of perioperative antiplatelet therapy. Korean J Med 2013:85; 22-8
6. Lee JK. Dental management of patients on anti-thormbotic agents. J Korean Assoc Oral Maxillofac Surg 2018; 44:143-50
7. Dezsi CA, Dezsi BB, Dezsi AD. Management of denatl patients receiving antiplatelet therapy or chronic oral anticoagulation: A review of the latest evidence. Euro J Gen Surg. 2017; 23:196-201
8. Zabojszcz M1, Malinowski KP2, Janion-Sadowska A1, Lillis T3, Ziakas A4, Sławska A5, Janion M1, Siudak Z1. Saefty of dental extractions in patients on dual antiplaetlet therapy - a meta-analysis. Postepy Kardiol Interwencyjnej. 2019; 15(1):68-73
9. Cervino G, Fiorillo L, Monte IP, De Stefano R, Laino L, Crimi S, Bianchi A, Herford AS, Biondi A, Cicci? M. Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies. Materials (Basel). 2019; 9:9; 12 pii: E1524
10. Hao Q, Tampi M, O'Donnell M, Foroutan F, Siemieniuk RA, Guyatt G. Clopidogrel plus aspirin versus aspirin alone for acute minor ischaemic stroke or high risk transient ischaemic attack: systematic review and meta-analysis. BMJ. 2018; 363:k5108.
11. Borges JMDM, de Carvalho FO, Gomes IA, Rosa MB, Sousa ACS. Antiplatelet agents in perioperative noncardiac surgeries: to maintain or to suspend? Ther Clin Risk Manag. 2018; 14:1887-95
12. Cattaneo M. Response variability to clopidogrel: is tailored treatment, based on laboratory testing, the right solution? J Thormb Haemost 2012; 10:327-36
13. Chassot PG, Delabays A, Spahn DR. Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction. Br J Anaesth 2007; 99:316-28
14. Abualsaud AO, Eisenberg MJ. Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3:131-42
15. Eisenberg MJ, Richard PR, Libersan D, et al. Safety of short term discontinuation of antiplatelet therapy in patients with drug eluting stents. Circulation 2009; 119:1634-42
16. Scottish Dental Clinical Effectiveness Programme(SDCEP). 2015. Management of dental patients taking anticoagulants or antiplatelet drugs. Dental Clinical Guidance. Available from: http://www.sdcep.org.uk/wp-content/uploads/2015/09/SDCEPanticoagulants-Guidance.pdf
17. Burger W, Chemnitius JM, Kneissl GD, Rucker G. Low-dose aspirin for secondary cardiovascular prevention-cardiovascular risk after its perioperative withdrawal versus bleeding risks with its continuation-review and meta-analysis. J Intern Med 2005; 257:399-414
18. P ayne DA, Hayes PD, Jones CI, Belham P, Nayolr AR, Goodal AH. Combined therapy with clopidogrel and aspirin significantly increases the bleeding time through a synergistic antiplatelet action. J Vasc Surg 2002; 35:1204-9