PubMed:31116189 JSONTXT

{"project":"yangbin123xm_800_3","denotations":[{"id":"T1","span":{"begin":127,"end":156},"obj":"CI"},{"id":"T2","span":{"begin":512,"end":541},"obj":"CI"},{"id":"T3","span":{"begin":945,"end":974},"obj":"CI"},{"id":"T4","span":{"begin":158,"end":164},"obj":"CI"},{"id":"T5","span":{"begin":543,"end":549},"obj":"CI"},{"id":"T6","span":{"begin":976,"end":982},"obj":"CI"},{"id":"T7","span":{"begin":1616,"end":1622},"obj":"CI"},{"id":"T8","span":{"begin":1748,"end":1754},"obj":"CI"},{"id":"T9","span":{"begin":1871,"end":1877},"obj":"CI"},{"id":"T10","span":{"begin":2230,"end":2236},"obj":"CI"},{"id":"T11","span":{"begin":2474,"end":2480},"obj":"CI"},{"id":"T12","span":{"begin":2677,"end":2683},"obj":"CI"},{"id":"T13","span":{"begin":2830,"end":2836},"obj":"CI"},{"id":"T14","span":{"begin":2959,"end":2965},"obj":"CI"},{"id":"T15","span":{"begin":3111,"end":3117},"obj":"CI"},{"id":"T16","span":{"begin":3264,"end":3270},"obj":"CI"},{"id":"T17","span":{"begin":3721,"end":3727},"obj":"CI"},{"id":"T18","span":{"begin":173,"end":208},"obj":"CI"},{"id":"T19","span":{"begin":575,"end":610},"obj":"CI"},{"id":"T20","span":{"begin":1008,"end":1043},"obj":"CI"},{"id":"T21","span":{"begin":210,"end":215},"obj":"CI"},{"id":"T22","span":{"begin":612,"end":617},"obj":"CI"},{"id":"T23","span":{"begin":1045,"end":1050},"obj":"CI"},{"id":"T24","span":{"begin":1648,"end":1653},"obj":"CI"},{"id":"T25","span":{"begin":1758,"end":1763},"obj":"CI"},{"id":"T26","span":{"begin":1882,"end":1887},"obj":"CI"},{"id":"T27","span":{"begin":2257,"end":2262},"obj":"CI"},{"id":"T28","span":{"begin":2501,"end":2506},"obj":"CI"},{"id":"T29","span":{"begin":2690,"end":2695},"obj":"CI"},{"id":"T30","span":{"begin":2854,"end":2859},"obj":"CI"},{"id":"T31","span":{"begin":2973,"end":2978},"obj":"CI"},{"id":"T32","span":{"begin":3135,"end":3140},"obj":"CI"},{"id":"T33","span":{"begin":3275,"end":3280},"obj":"CI"}],"text":"Dental extractions for patients on oral antiplatelet: a within-person randomised controlled trial comparing haemostatic plugs, advanced-platelet-rich fibrin (A-PRF+) plugs, leukocyte- and platelet-rich fibrin (L-PRF) plugs and suturing alone.\nPURPOSE: To compare the outcome of tooth extractions in patients taking oral antithrombotic without reducing their dose. Four different interventions were compared within the same patient: suturing alone (control group), suturing plus a haemostatic plug, suturing plus advanced-platelet-rich fibrin (A-PRF+) plug, and suturing plus leukocyte- and platelet-rich fibrin (L-PRF) plug into the socket.\nMATERIALS AND METHODS: Forty patients, taking oral antiplatelet agents, requiring the extraction of at least four non-adjacent teeth were selected for the study. After extractions the sockets were randomly allocated to suturing alone (control group), suturing plus haemostatic plug (HAEM), suturing plus advanced-platelet-rich fibrin (A-PRF+) plug, and suturing plus leukocyte- and platelet-rich fibrin (L-PRF) plug into the socket without reducing the dose of oral antiplatelets according to a split-mouth design. Outcome measures were complications, time to complete each procedure, postoperative bleeding, costs of the materials, patient preference and a wound healing index recorded 1 and 2 weeks postextraction by blinded assessors.\nRESULTS: Two weeks after extraction no patient dropped out and no complication was reported. The average time to complete suturing after tooth extractions was: 1.0 ± 0.00 minutes at control sites, 1.5 ± 0.41 at HAEM sites, 2.8 ± 0.61 at A-PRF+ sites, and 2.8 ± 0.56 at L-PRF sites, the difference being statistically significant between each pairwise comparison except A-PRF+ vs L-PRF. Postoperative bleeding 30 minutes after extractions was present at 8, 5, 1 and 2 sites for control, HAEM, A-PRF+ and L-PRF sites, respectively. A-PRF showed statistically significantly less bleeding compared to the control group (odds ratio = 0.1 (95% CI [0.01;0.86]; P \u003c 0.0361). In all cases bleeding was moderate in nature and not severe. One week after extractions the mean wound healing index was 1.05 ± 0.60 for control, 1.18 ± 0.59 for HAEM, 1.00 ± 0.68 for A-PRF+ and 0.95 ± 0.50 for L-PRF sites. No statistically significant difference was detected across groups (P = 0.633). Two weeks after extractions the mean wound healing index was 0.33 ± 0.53 for control, 0.43 ± 0.50 for HAEM, 0.25 ± 0.49 for A-PRF+ and 0.15 ± 0.36 for L-PRF sites. No statistically significant difference across groups was detected (P = 0.255). One week after extractions, nine patients preferred control sites, eight HAEM, ten A-PRF+, four L-PRF and nine had no preference. No statistically significant differences were detected for control sites (P = 0.6779), HAEM (P = 1.0000), A-PRF+ (P = 0.4055) and L-PRF (P = 0.1472). Two weeks after extractions five patients preferred control sites, three HAEM, eight A-PRF+, eight L-PRF and 16 had no preference. No statistically significant differences were detected for control sites (P = 0.8147), HAEM (P = 0.2363), A-PRF+ (P = 0.3488) and L-PRF (P = 0.3488). Costs without counting sutures and blood centrifuges were 0.00, 14.49, 2.44 and 2.44 Euro for control, HAEM, A-PRF+ and L-PRF sites, respectively.\nCONCLUSIONS: It may not be necessary to discontinue the use of oral antiplatelets in patients undergoing dental extractions and, when present, the minor statistically significant differences between procedures were not clinically relevant; therefore clinicians can use any of the tested interventions according to their preference, keeping in mind that simple suturing is sufficient and is faster and cheaper, and that A-PRF+ was associated with less postoperative bleeding when compared to suturing alone."}

{"project":"chenxin_473849_800_3","denotations":[{"id":"T1","span":{"begin":127,"end":156},"obj":"CI"},{"id":"T2","span":{"begin":512,"end":541},"obj":"CI"},{"id":"T3","span":{"begin":945,"end":974},"obj":"CI"},{"id":"T4","span":{"begin":158,"end":164},"obj":"CI"},{"id":"T5","span":{"begin":543,"end":549},"obj":"CI"},{"id":"T6","span":{"begin":976,"end":982},"obj":"CI"},{"id":"T7","span":{"begin":1616,"end":1622},"obj":"CI"},{"id":"T8","span":{"begin":1748,"end":1754},"obj":"CI"},{"id":"T9","span":{"begin":1871,"end":1877},"obj":"CI"},{"id":"T10","span":{"begin":2230,"end":2236},"obj":"CI"},{"id":"T11","span":{"begin":2474,"end":2480},"obj":"CI"},{"id":"T12","span":{"begin":2677,"end":2683},"obj":"CI"},{"id":"T13","span":{"begin":2830,"end":2836},"obj":"CI"},{"id":"T14","span":{"begin":2959,"end":2965},"obj":"CI"},{"id":"T15","span":{"begin":3111,"end":3117},"obj":"CI"},{"id":"T16","span":{"begin":3264,"end":3270},"obj":"CI"},{"id":"T17","span":{"begin":3721,"end":3727},"obj":"CI"},{"id":"T18","span":{"begin":173,"end":208},"obj":"CI"},{"id":"T19","span":{"begin":575,"end":610},"obj":"CI"},{"id":"T20","span":{"begin":1008,"end":1043},"obj":"CI"},{"id":"T21","span":{"begin":210,"end":215},"obj":"CI"},{"id":"T22","span":{"begin":612,"end":617},"obj":"CI"},{"id":"T23","span":{"begin":1045,"end":1050},"obj":"CI"},{"id":"T24","span":{"begin":1648,"end":1653},"obj":"CI"},{"id":"T25","span":{"begin":1758,"end":1763},"obj":"CI"},{"id":"T26","span":{"begin":1882,"end":1887},"obj":"CI"},{"id":"T27","span":{"begin":2257,"end":2262},"obj":"CI"},{"id":"T28","span":{"begin":2501,"end":2506},"obj":"CI"},{"id":"T29","span":{"begin":2690,"end":2695},"obj":"CI"},{"id":"T30","span":{"begin":2854,"end":2859},"obj":"CI"},{"id":"T31","span":{"begin":2973,"end":2978},"obj":"CI"},{"id":"T32","span":{"begin":3135,"end":3140},"obj":"CI"},{"id":"T33","span":{"begin":3275,"end":3280},"obj":"CI"}],"text":"Dental extractions for patients on oral antiplatelet: a within-person randomised controlled trial comparing haemostatic plugs, advanced-platelet-rich fibrin (A-PRF+) plugs, leukocyte- and platelet-rich fibrin (L-PRF) plugs and suturing alone.\nPURPOSE: To compare the outcome of tooth extractions in patients taking oral antithrombotic without reducing their dose. Four different interventions were compared within the same patient: suturing alone (control group), suturing plus a haemostatic plug, suturing plus advanced-platelet-rich fibrin (A-PRF+) plug, and suturing plus leukocyte- and platelet-rich fibrin (L-PRF) plug into the socket.\nMATERIALS AND METHODS: Forty patients, taking oral antiplatelet agents, requiring the extraction of at least four non-adjacent teeth were selected for the study. After extractions the sockets were randomly allocated to suturing alone (control group), suturing plus haemostatic plug (HAEM), suturing plus advanced-platelet-rich fibrin (A-PRF+) plug, and suturing plus leukocyte- and platelet-rich fibrin (L-PRF) plug into the socket without reducing the dose of oral antiplatelets according to a split-mouth design. Outcome measures were complications, time to complete each procedure, postoperative bleeding, costs of the materials, patient preference and a wound healing index recorded 1 and 2 weeks postextraction by blinded assessors.\nRESULTS: Two weeks after extraction no patient dropped out and no complication was reported. The average time to complete suturing after tooth extractions was: 1.0 ± 0.00 minutes at control sites, 1.5 ± 0.41 at HAEM sites, 2.8 ± 0.61 at A-PRF+ sites, and 2.8 ± 0.56 at L-PRF sites, the difference being statistically significant between each pairwise comparison except A-PRF+ vs L-PRF. Postoperative bleeding 30 minutes after extractions was present at 8, 5, 1 and 2 sites for control, HAEM, A-PRF+ and L-PRF sites, respectively. A-PRF showed statistically significantly less bleeding compared to the control group (odds ratio = 0.1 (95% CI [0.01;0.86]; P \u003c 0.0361). In all cases bleeding was moderate in nature and not severe. One week after extractions the mean wound healing index was 1.05 ± 0.60 for control, 1.18 ± 0.59 for HAEM, 1.00 ± 0.68 for A-PRF+ and 0.95 ± 0.50 for L-PRF sites. No statistically significant difference was detected across groups (P = 0.633). Two weeks after extractions the mean wound healing index was 0.33 ± 0.53 for control, 0.43 ± 0.50 for HAEM, 0.25 ± 0.49 for A-PRF+ and 0.15 ± 0.36 for L-PRF sites. No statistically significant difference across groups was detected (P = 0.255). One week after extractions, nine patients preferred control sites, eight HAEM, ten A-PRF+, four L-PRF and nine had no preference. No statistically significant differences were detected for control sites (P = 0.6779), HAEM (P = 1.0000), A-PRF+ (P = 0.4055) and L-PRF (P = 0.1472). Two weeks after extractions five patients preferred control sites, three HAEM, eight A-PRF+, eight L-PRF and 16 had no preference. No statistically significant differences were detected for control sites (P = 0.8147), HAEM (P = 0.2363), A-PRF+ (P = 0.3488) and L-PRF (P = 0.3488). Costs without counting sutures and blood centrifuges were 0.00, 14.49, 2.44 and 2.44 Euro for control, HAEM, A-PRF+ and L-PRF sites, respectively.\nCONCLUSIONS: It may not be necessary to discontinue the use of oral antiplatelets in patients undergoing dental extractions and, when present, the minor statistically significant differences between procedures were not clinically relevant; therefore clinicians can use any of the tested interventions according to their preference, keeping in mind that simple suturing is sufficient and is faster and cheaper, and that A-PRF+ was associated with less postoperative bleeding when compared to suturing alone."}