Objective: The present study explores bleeding manifestations in routine dental surgical procedures, evaluates the influence of antithrombotic drugs upon bleeding risk, and validates the efficiency of a clinical method for the measurement of bleeding. Material and method: A prospective observational study was made involving a cohort of 99 patients in the setting of normal clinical practice, with the added conduction of prior hematological tests including baseline hemostasis and platelet function, based on a new method (Multiplate System®). For evaluation of the bleeding manifestations, a clinical method was selected that evaluates bleeding on the basis of its duration and the hemostatic measures needed to resolve the problem. Results: Almost one-third of the patients (27.3%) were receiving treatment with oral antiplatelet drugs, while 19.2% received oral anticoagulants and 9% received combined therapy with acetylsalicylic acid plus clopidogrel. In turn, an 8% incidence of moderate bleeding episodes was detected correlated to the ASPI platelet function test and to advanced patient age. Conclusion: The incorporation of platelet function tests increases the safety of oral surgery in elderly patients subjected to antiplatelet treatment, particularly with acetylsalicylic acid and clopidogrel.
The mesio-distal gap reduction is higher during the first month following the extraction and continues in time, but to a lesser extent. When the inter-dental contacts were absent, the mesio-distal gap reduction is lower. When a molar tooth is extracted or the distal tooth to the edentulous space does not occlude with an antagonist, the mesio-distal gap reduction is larger. The consideration of mesio-distal gap dimension changes can help improve dental treatment planning.
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