Impact of Post-Exodontia Bleeding in Cardiovascular Patients: A New Classification Proposal

Lillis, Theodoros; Didagelos, Matthaios; Lillis, Leonidas; Theodoridis, Charis; Karvounis, Haralambos; Ziakas, Antonios

doi:10.2174/1874192401711010102

Cited by 9 publications

(8 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-exodontia bleeding is also evaluated in the study of Lillis et al, 2017, with the aim of understanding the behavior of clinicians [37]. Behavior in clinical practice that often tends to not reflect international protocols, as previously mentioned in this article, is unfortunately highly variable.…”

Section: Discussionmentioning

confidence: 99%

“…The dentist, even in patients undergoing therapy, can perform routine extraction without risk without interrupting or modifying the latter. Patients do not have a greater risk of bleeding, even if they have been in antiplatelet therapy for a long time but, in some cases, as some authors mention in a refined way, the therapy must be personalized for each patient [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42] Pototski et al in 2007, stated in their work that patients can be treated without risk if their INR is lower than 4.0 [48]. However, other studies assess that the risk of bleeding can be controlled by post-extraction hemostasis maneuvers [49].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

et al. 2019

View full text Add to dashboard Cite

Background: Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient’s different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist’s approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. Methods: This review paper considered different published papers in literature through quoted scientific channels, going in search of “ancient” works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. Results: Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. Conclusion: Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient’s situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Sutures were removed after 7 days. According to Lockhart & Lillis, 2003,[ 12 13 ] clinically significant bleeding can be classified as (1) continues beyond 12 h; (2) causes the patient to call or return to the dental practitioner or to the accident and emergency department; (3) results in the development of a large hematoma or ecchymosis within the oral soft tissues; or (4) requires a blood transfusion. Statistical analysis was performed with SPSS 23.0 (IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

Evaluating the Need of Continuing the Antiplatelet Drug Therapy in Patients Undergoing Minor Oral Surgical Procedures

Kumar¹,

Rao²,

Nimkar³

et al. 2021

Journal of Pharmacy and Bioallied Sciences

View full text Add to dashboard Cite

Background: Dental treatment in patients on antiplatelet drug therapy is a long standing debate. Discontinuation of medication increases the risk of thrombotic complications, whereas continuation leads to increased postoperative bleeding. Aim: We conducted this prospective cross-sectional study to assess risk of bleeding in patients continuing antiplatelet medication while performing minor oral surgical procedures such as single or multiple teeth extraction, transalveolar extraction of third molar, biopsy, and alveoloplasty. Materials and Methods: We calibrated the steps taken to achieve hemostasis, time taken to arrest bleeding, and correlated time taken to achieve hemostasis in patients under antiplatelet drug therapy (Group A [n = 64] - aspirin, Group B [n = 36] - aspirin and clopidogrel) and in patients without any drug therapy (Group C [n = 100] healthy patients). Results: Out of 200 patients, Level 1 hemostatic measures were required for 129 (64.5%) patients, Level 2 hemostatic measures were taken for 68 (34.0%) patients, and Level 3 hemostatic measures were taken for 3 (1.5%) patients. Chi-square test conducted to compare the local hemostatic measures taken for minor oral surgical procedure for all groups was statistically significant ( P ≤ 0.001). Conclusion: Overall, there was no postoperative bleeding within 24 h of extraction in any patient group. In conclusion, surgical procedures can be safely accomplished in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken.

show abstract

“…If the "liver clot" is ruptured, the socket restarts aggressively oozing blood until a replacement one is made, and so on. Repetition of this situation and ingestion of large amounts of blood or clots may cause nausea and vomiting [17].…”

Section: Post-extraction Bleedingmentioning

confidence: 99%

Medical Emergencies in Dental Office: An Overview

Vaish¹,

Priyadarshini²,

David³

2020

Act Scie Dental

View full text Add to dashboard Cite

Impact of Post-Exodontia Bleeding in Cardiovascular Patients: A New Classification Proposal

Cited by 9 publications

References 34 publications

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

Evaluating the Need of Continuing the Antiplatelet Drug Therapy in Patients Undergoing Minor Oral Surgical Procedures

Medical Emergencies in Dental Office: An Overview

Contact Info

Product

Resources

About