Tooth extraction without discontinuation of oral antithrombotic treatment: A prospective study

Abstract

Objective: To identify which variable, among those related to surgeries, to patients, or to antithrombotic treatments, could be considered as a bleeding indicator, and to analyze effectiveness of the local hemostatic protocols used, incidence of bleeding and healing index, depending on the number of extracted teeth, and patient antithrombotic treatment.Methods: Patients who underwent tooth extractions without interruption or reduction of antithrombotic treatment were prospectively followed. The exact two-tailed Fisher test was used to investigate the relationship between presence/absence of bleeding and type of hemostatic material. The effect of variables on the probability of bleeding and healing index was assessed by means of a multivariate logistic regression.Results: Two hundred and fifty-four procedures were analyzed. The incidence of bleeding was 15.75%. Severe bleeding occurred in only 6 patients (2.34%). The number of involved dental quadrants and pre-surgical antibiotic treatments were found to be positively related with bleeding. The use of vasoconstrictors during surgery resulted in a reduction of healing index scores. Conclusions:Tooth extractions in patients on antithrombotic treatment were found to be free from significant bleeding although the involvement of more than 1 quadrant in the same procedure should be avoided.

The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis

“…Several studies have investigated the outcome of dental extraction without stopping or modifying the antithrombotic treatment. Their results revealed that, when obtaining sufficient hemostasis upon the completion of this procedure, tooth extraction could be done safely without any adjustment to the patients' antithrombotic therapy [8][9][10][11] . Consequently, this step is not justified and has become less popular.Although tooth extraction has been shown to be safe in patients with higher bleeding risk, postoperative bleeding events have still been reported 12 .…”