ABSTRACT
BACKGROUND AND OBJECTIVE: A considerable number of patients consulting a dental surgeon are on antiplatelet therapy, and an interruption of these agents for 3 to 7 days has been practised by majority of them prior to dental surgical intervention fearing excessive bleeding, risking the patient for the occurrence of adverse thrombotic events. The dental and medical literature shows a very low risk of excessive bleeding associated on the continuation of antiplatelet therapy. The objective of this study is to compare the bleeding following single-firm molar tooth extraction in patients who interrupt and those who continue antiplatelet therapy perioperatively. METHODOLOGY: This is a prospective descriptive study on 170 patients on long-term low-dose antiplatelet therapy with 2 groups, each containing 85 patients-Group 1 with patients who interrupted antiplatelet therapy for 5 days before extraction and Group 2, patients who continued it perioperatively. A single molar tooth extraction was done under local anaesthesia with a vasoconstrictor. Gauze pressure pack was placed for 60 min. Socket was observed every 15 min for 1 h to look for excessive post-extraction bleeding. RESULTS: No statistically significant differences were found in post-extraction bleeding between the patients who stopped antiplatelet therapy and those who continued it. CONCLUSION: The bleeding risk when continuing long-term low-dose antiplatelet therapy following a single molar tooth extraction is minimal. Bleeding, if excessive, can be easily controlled by gauze pressure pack or other local haemostatic agents. Thus, dental extractions can be performed on these patients without interrupting the antiplatelet drug pre-operatively provided a thorough medical history, physician's consent and coagulation profile have been obtained prior to the procedure.
ABSTRACT
OBJECTIVE: To assess the changes in alar base width in patients who underwent Lefort 1 osteotomy with anterior maxillary osteotomy (AMO), where conventional alar cinch suturing was done to control the alar base widening. MATERIALS AND METHODS: This study was conducted on pre-operative and post-operative photographs of 100 female patients aged between 18 and 30 years who underwent Lefort 1 osteotomy with AMO. The derived values were then compared and analysed using t test. RESULTS: The mean alar base width pre-operatively was 14.11 mm and post-operatively was 15.28 mm. The mean increase in alar base width was 1.176 mm. The result indicated a definitive change between pre-operative and post-operative alar base widths with mean increase in width of 1.176 mm (P = 0.000), which is clinically not very significant. CONCLUSION: The effect of Lefort 1 osteotomy on the alar base can be well controlled by the conventional alar cinch suturing without any additional anchorage on the ANS with predictable results.