ワルファリン至適治療域での抜歯に関する検討

概要

論文の詳細を見る
The purpose of this study was to clarify whether tooth extraction in accordance with the JCS2004 guidelines has any problems. A total of 213 patients (429 teeth) who were receiving anticoagulant therapy with warfarin and required tooth extraction were examined between 2000 and 2008. The study group comprised 123 men and 90 women. The average age of the patients was 66.8 years, and a total of 429 teeth were extracted. The mean International Normalized Ratio (INR) of the patients and was 1.85 before publication of the JCS2004 guidelines and 2.15 after publication. This difference in the INR was significant (p < 0.01). Before 2004, 37 of 55 patients underwent tooth extraction after stopping warfarin, and 3 had postoperative hemorrhage. After 2004, 144 of 158 patients underwent tooth extraction while continuing warfarin. The mean INR value at the time of extraction was 2.03, significantly higher than the value of 1.48 before 2004. There was no increase in postoperative hemorrhage.Bleeding complications in association with the continuation of warfarin also did not occur. The JCS2004 guidelines recommend maintaining the INR at 1.6 to 3.0, while excluding some patients. Our results suggest that tooth extraction can be done safely in association with the continuation of warfarin therapy if the patients INR is controlled under optimal anticoagulation conditions.
Japanese Society of Oral and Maxillofacial Surgeonsの論文