title: [Correlation between platelet aggregation rates of aspirin users and intra-socket clotting after extraction of a maxillary tooth with periodontitis].
abstract: OBJECTIVE
  To explore the optimal platelet aggregation rates (PAgTs) of aspirin users, which can ensure normal intra-socket clotting after extraction of a maxillary tooth with serious periodontitis, and to determine the reasonable time of pre-extraction aspirin suspension.
  
  
  METHODS
  Ninety aspirin users (100mg/d) requiring extraction of a maxillary tooth with serious periodontitis were enrolled and divided into anterior tooth group (group A), premolar group (group B) and molar group (group C). Each group contained 10 cases with aspirin continuation, 10 cases with aspirin withdrawal 3 days pre-extraction and 10 cases with 5-day of aspirin withdrawal. After preoperative light transmission aggregometry (LTA) using arachidonic acid (AA) as the inducer to each case, the extractions were preformed. According to the intra-socket clotting classification table (class I indicated normal clotting, class II-III indicated successively increasing bleeding amount), the evaluation for each case was implemented and the analysis of the impacts caused by pre-extraction aspirin continuation and suspension on intra-socket clotting was conducted. The research on the best cut-off value of AA-induced PAgT to predict normal post-extraction clotting was also carried out by using receiver operating characteristic curve (ROC curve, SPSS11.6).
  
  
  RESULTS
  (1)There were 4 cases of Class II in group A (3 without aspirin cessation and 1 with 3-day suspension), 8 in group B (5 without aspirin cessation, 2 with 3-day suspension and 1 with 5-day suspension) and 11 in group C (6 without aspirin cessation, 4 with 3-day suspension and 1 with 5-day suspension). The other cases in 3 groups were Class I. (2) The best cut-off value of AA induced PAgT was 10.15%, 13.25%, 16.5% for group A, B, C, respectively.
  
  
  CONCLUSIONS
  For aspirin users (100mg/d) who will accept extraction of a maxillary tooth with serious periodontitis, a detection of pre-extraction LTA-AA is profitable, AA induced PAgT≥10.15% for an anterior tooth extraction, PAgT≥13.25% for a premolar extraction and PAgT≥16.5% for a molar extraction indicate normal postoperative intra-socket clotting, so aspirin continuation is feasible under such conditions. Otherwise, post-extraction bleeding amount can increase and preoperative aspirin cessation should be considered. The reasonable time of aspirin suspension is 3 days for an anterior tooth extraction and 5 days for a premolar or molar extraction. Additionally, hemostatic measures on the surgical site should be strengthened.
authors.affiliation: Department of Oral Surgery, Shanghai Stomatology Disease Centre. Shanghai 200001; China.E-mail:lumengmeng428@126.com.
authors.forename: Meng-meng
authors.initials: MM
authors.lastname: Lu
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Zhuang
authors.forename: Yi-ming
authors.initials: YM
authors.lastname: Gao
mesh_terms: D001241:Aspirin; D001641:Bicuspid; D006801:Humans; D008963:Molar; D010518:Periodontitis; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors; D014070:Tooth; D014081:Tooth Extraction
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin