Abstract
Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.
Highlights
The need to deal with anticoagulated patients during dental care has become increasingly frequent
The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or high-power diode laser with bleeding time in healthy animals
As the animals were kept in individual cages, the volume of water consumed was recorded as follows: Initial volume in the bottle - Final volume in the bottle = Consumed volume
Summary
The need to deal with anticoagulated patients during dental care has become increasingly frequent. In 1957, Ziffer et al.[3] reported serious postoperative bleeding after oral surgery in anticoagulated patients. The management of patients on oral anticoagulants requiring oral surgical procedures has been riven by controversy.[4] some patients have stopped taking antithrombotic medications before dental surgery without developing serious side effects,[5] others have suffered complications, such as thrombosis and embolism.[4,6] Several incidents have been reported in the literature, including deaths after anticoagulation therapy discontinuation.[6,7,8,9]
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