Laser-assisted tooth extraction in patients with impaired hemostasis

Introduction: The provision of efficient dental care to patients with hemostatic disorders is tied to difficulties and problems, such as prolonged bleeding after or during surgical manipulation. Aim: was to increase the efficiency of oral surgery in patients with thrombocytopenia with the use of erbium laser on different stages of tooth extraction. Methods: Patients (n = 96) were selected for tooth extraction on an outpatient basis: patients with confirmed thrombocytopenia (age 44 +/- 15.4, 19-74) were included in the 1st group, and patients without impaired hemostasis (age 47.6 +/- 15.3, 19-81) were included in the 2nd group (p > 0.05). In the 1st group, operation with the use of erbium laser with with a wavelength of 2490 nm in a noncontact mode was performed in two stages: separation of a circular tooth ligament and curettage of the socket after tooth extraction. In the 2nd group (control), the treatment was provided according to a traditional algorithm. Before the operation, the lab blood tests for thrombocytes were performed in both groups; moreover, for the 1st group, the duration of bleeding and total coagulation were evaluated. In the postoperative period, pain and edema of soft tissues and hemostasis duration were assessed in both groups. Results: According to the results of our research, the use of erbium laser in the 1st group allowed us to decrease hemostasis duration compared with the control group of patients (80.9 +/- 35.9 and 175 +/- 67.5 sec, p < 0.01) and reach the similar probability of postoperative bleeding after tooth extraction (p < 0.5). Pain and edema of soft tissues in dynamics after operation were less in the 1st group (p < 0.001). Conclusion: Application of erbium laser is an up-to-date method that can be successfully used in surgical treatment in patients with hemostasis failure for bleeding and other postoperative complications prevention and stimulation of the alveolar epithelialization after tooth extraction.