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Abstract

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: This study aims 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 1st group, operation with the use of erbium laser with a wavelength of 2940 nm in a noncontact mode was performed on several stages. In the 2nd group (control), the treatment was carried out according to the traditional algorithm. Before the operation, the lab blood tests for thrombocytes were performed in both groups; additionally, for the 1st group, we evaluated the duration of bleeding and total coagulation. In the postoperative period, pain and edema of soft tissues and hemostasis duration were assessed in both groups.

Results: The results revealed that the use of erbium laser in the 1st group allowed us to decrease hemostasis duration compared with the control group (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 epithelization after

Article1_Fig1.JPG (100 kB)
Figure 1. Separation of a circular tooth ligament using radiation of the IRE-Polus diode laser with the power of 2.4 Watts in the area of the tooth 1.5 root

Article1_Fig2.JPG (125 kB)
Figure 2. Curettage of the socket of the extracted tooth 1.5 root using an IRE-Polus diode laser with the power of 2.4 Watts.

Article1_Fig3.JPG (87 kB)
The socket of the extracted tooth 1.5 root.

Article_Fig4.tiff (14112 kB)
The socket of the extracted tooth 1.5 root on the 3rd day after surgery

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