Management of patients on anticoagulant therapy undergoing dental extractions: a systematic review

Authors

  • Patricio Oliva-Mella Universidad del Desarrollo
  • Maria Francisca Ruiz-Gutiérrez Universidad del Desarrollo

DOI:

https://doi.org/10.17533/udea.rfo.v27n2a8

Keywords:

Anticoagulants, Extraction, Hemorrhages

Abstract

Introduction: the management of patients who have undergone dental surgeries and are on antithrombotic therapy is debatable. The goal of this study was to establish the management of patients on anticoagulant therapy prior to dental extractions. Methods: this was a systematic review based on the search for scientific randomized controlled studies (clinical trials). Articles were searched in databases such as Embase, Pubmed, or Ebsco, selecting the articles that met the inclusion criteria and correlated dental extractions to the use of anticoagulant therapy. Results: 5 studies were found with a total of 548 patients, 282 of which had their anticoagulant therapy modified and the remaining 266 kept their therapy prior to extractions. The number of events (hemorrhages) was measured in both groups, observing that most events occurred in the group of patients whose therapy was modified (35 events) while there were 18 cases in patients who kept their therapy. Heterogeneity in this study was null (I² = 0%, p = 0.99). Conclusion: there are no significant differences in the hemorrhage levels of patients who maintain anticoagulant therapy compared with those who had their therapy modified prior to dental extractions. It is then recommended to keep the treatment.

|Abstract
= 1061 veces | PDF (ESPAÑOL (ESPAÑA))
= 584 veces|

Downloads

Download data is not yet available.

Author Biographies

Patricio Oliva-Mella, Universidad del Desarrollo

PhD in Biomedical Research, M.Sc. in Clinical Epidemiology. Research Coordinator, School of Dentistry, Universidad del Desarrollo. Concepción, Chile

Maria Francisca Ruiz-Gutiérrez, Universidad del Desarrollo

DMD, Guest Researcher, Research Department, School of Dentistry, Universidad del Desarrollo. Concepción, Chile.

References

Benito M, Benito M, Morón A, Bernardoni C, Pereira S, Bracho M et al. Manejo odontológico de pacientes con enfermedades hemorrágicas y terapia anticoagulante: revisión bibliográfica. Acta Odontol Venez 2004; 42(2): 1-7.

López P, Gordillo F, Rocca A. Controversias en torno al control de la anticoagulación oral en atención primaria. Aten Prim 1998; 21(4): 190-192.

Sánchez P. Manejo odontológico de pacientes con alteraciones de la hemostasia. Tesis de Maestría, Granada, España: Universidad de Granada; 2009.

Pedemonte C, Montini C, Castellón L. Manejo de pacientes en tratamiento con anticoagulantes orales previo a cirugía oral. Rev Dent Chile 2005; 96(2): 18-23.

Assayag D. Complicaciones en cirugía oral menor en pacientes bajo medicación anticoagulante. Tesis de Maestría. Lima, Perú: Universidad Nacional Mayor de San Marcos; 2008.

Al-Mubarak S, Al-Ali N, Abou-Rass M, Al-Sohail A, Robert A, Al-Zoman K et al. Evaluation of dental extractions, suturing and INR on postoperative bleeding of patients maintained on oral anticoagulant therapy. Br Dent J 2007; 203(7): E15; 410-411.

Chocarro L, Venturini C. Procedimientos y cuidados en enfermería médico-quirúrgica. 1a ed. Madrid: Elsevier; 2006.

Sacco R, Sacco M, Carpenedo M, Mannucci P. Oral surgery in patients on oral anticoagulant therapy: a randomized comparison of different intensity targets. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(1): e18-21.

Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a literature review and meta-analysis. J Can Dent Assoc 2009; 75(1): 41.

Furundanera J, Torán L, Plou P, Vivanco G, Izagirre A, Martínez M et al. Manejo de los pacientes en tratamiento anticoagulante o antiagregante que van a ser sometidos a procedimientos quirúrgicos. Donostia: Hospital Donostia, 2011.

Karsli E, Erdogan Ö, Esen E, Acartürk E. Comparison of the effects of warfarin and heparin on bleeding caused by dental extraction: a clinical study. J Oral Maxillofac Surg 2011; 69(10): 2500-2507.

Souto JC, Oliver A, Zuazu-Jausoro I, Vives A, Fontcuberta J. Oral surgery in anticoagulated patients without reducing the dose of oral anticoagulant: a prospective randomized study. J Oral Maxillofac Surg 1996; 54(1): 27-32.

Bajkin B, Popovic S, Selakovic S. Randomized, prospective trial comparing bridging therapy using low-molecular-weight heparin with maintenance of oral anticoagulation during extraction of teeth. J Oral Maxillofac Surg 2009; 67(5): 990-995.

Cannon PD, Dharmar VT. Minor oral surgical procedures in patients on oral anticoagulants: a controlled study. Aust Dent J 2003; 48(2): 115-118.

Evans IL, Sayers MS, Gibbons AJ, Price G, Snooks H, Sugar AW. Can warfarin be continued during dental extraction? Results of a randomized controlled trial. Br J Oral Maxillofac Surg 2002; 40(3): 248-252.

Pértega S, Fernández S. Revisiones sistemáticas y metaanálisis [Internet]. Cuadernos Aten Prim 2005; 2: 209-112. Disponible en: http://www.agamfec.com/wp/wp-content/uploads/2015/07/14_Invest_N12_2.pdf

Higgins P, Green S (editores). Cochrane handbook for systematic reviews of interventions, version 5.1.0 updated March 2011 [Internet]. Londres: Cochrane; 2011. [Consultado el 6 de junio de 2013]. Disponible en: http://handbook.cochrane.org/

L’abbé KA, Detsky AS, O’Rourke K. El metaanálisis en la investigación clínica. Bol of Sanit Panam 1994; 116(3): 226-244.

Ramström G, Sindet-Pedersen S, Hall S, Blombäck M, Alander U. Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg 1993; 51(11): 1211-1216.

Linnebur SA, Ellis SL, Astroth JD. Educational practices regarding anticoagulation and dental procedures in U.S. dental schools. J Dent Educ 2007; 71(2): 296-303.

Blinder D, Manor Y, Martinowitz U, Taicher S. Dental extractions in patients maintained on oral anticoagulant therapy: comparison of INR value with occurrence of postoperative bleeding. Int J Oral Maxillofac Surg 2001; 30(6): 518-521.

Wahl MJ. Myths of dental surgery in patients receiving anticoagulant therapy. J Am Dent Assoc 2000; 131(1): 77-81.

Published

2016-06-30

How to Cite

Oliva-Mella, P., & Ruiz-Gutiérrez, M. F. (2016). Management of patients on anticoagulant therapy undergoing dental extractions: a systematic review. Revista Facultad De Odontología Universidad De Antioquia, 27(2), 389–403. https://doi.org/10.17533/udea.rfo.v27n2a8