Bleeding incidence after oral surgery with continued oral anticoagulation

Abstract

The results suggest that oral surgical procedures can be performed safely without alteration of the oral anticoagulant treatment. CINICAL RELEVANCE: Local hemostasis with collagen fleece, local flap, and acrylic splint seems to be sufficient to prevent postoperative bleeding.

Risk factors for bleeding after oral surgery in patients who continued using oral anticoagulant therapy

“…Results from several studies have shown that minor dentoalveolar surgery can be performed safely without interruption of OAT in patients who are therapeutically anticoagulated. [5][6][7][8][9][10][11][12][13][14][15][16] However, there is a lack of evidence concerning the safety of high-risk dentoalveolar surgery in patients who continued using OAT, as well as about the safety of dentoalveolar surgery in patients who are highly anticoagulated. 15 van Diermen and colleagues 21 recommended discussion with the patient's physician if the patient's INR is higher than 3.5 and if more complicated or invasive surgical procedures are planned (level of evidence A, recommendation class I).…”

“…5 Results from numerous reports show that dental extractions can be performed safely in patients receiving OAT if INR values are in the therapeutic range (< 4.0), providing that efficient local hemostatic measures are used. [5][6][7][8][9][10][11][12][13][14][15][16] The most commonly used local hemostatic agents are absorbable gelatin or collagen sponges, oxidized regenerated cellulose, fibrin glue, and antifibrinolytics applied directly into the wound or in the form of a solution as a mouthwash.…”

Management of anticoagulated patients in implant therapy: a clinical comparative study

“…Most of the studies published in the current literature primarily focused on tooth extraction. Data about extended oral surgical procedures such as implant dentistry and augmentation procedures (Bacci et al 2011;Gomez-Moreno et al 2015), cystic excisions (Sacco et al 2007), mucoperiosteal flaps (Campbell et al 2000), osteotomies and abscess incisions (Bublitz et al 2000;Eichhorn et al 2012;Kammerer et al 2015) are rare. For clinical practice, it would be useful to categorize dental surgical procedures by their invasiveness and assess the related risk of a postoperative bleeding to give treatment-based recommendations.…”

Étude rétrospective évaluant les risques hémorragiques et thromboemboliques lors d’avulsions dentaires chez 93 patients habituellement traités par AVK et/ou AAP

“…Les analyses multivariées ont été réalisées à l'aide de régression logistique. [11,14]. En réalité, il semble qu'une interruption brève du traitement par le patient ne s'accompagne que rarement d'événements thromboemboliques [18].…”