Elsevier

Dental Abstracts

Volume 60, Issue 1, January–February 2015, Pages 55-56
Dental Abstracts

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Anticoagulants and dentoalveolar surgery

https://doi.org/10.1016/j.denabs.2014.05.049Get rights and content

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Background

Oral anticoagulation therapy successfully prevents many thromboembolic events. Thrombocyte aggregation inhibitors such as acetylsalicylic acid and clopidogrel and vitamin K antagonists such as warfarin, acenocoumarol, and fenprocoumon are the most commonly prescribed agents. With an aging population, more patients are keeping their teeth longer and require dentoalveolar surgery, but they are also taking anticoagulants, which pose an increased risk for postoperative bleeding. The practice of

Methods

A prospective study of 206 patients (mean age 59 years; range 21 to 86 years) was undertaken, with half of the patients taking anticoagulants and half not taking them. Thrombocyte aggregation inhibitors were prescribed for 71 of the group taking anticoagulants; the others were receiving vitamin K antagonists. In all cases the guidelines prepared by ACTA were followed. Procedures included surgical extraction with the surgeon incising the gingiva before extraction, nonsurgical extraction,

Results

The most common procedures performed were surgical and nonsurgical extractions. All episodes of bleeding occurred in patients having these procedures. Patients taking anticoagulants and having surgical extractions were the most likely to develop bleeding, but the incidence did not differ significantly from that of patients who had nonsurgical extractions while taking anticoagulants. One episode of postoperative bleeding occurred among the patients not taking anticoagulants who had surgical

Discussion

Patients at high risk for experiencing thromboembolic events, such as those who have mechanical heart valve prostheses and those with recurrent or recent events of this sort, must consider the continuation of anticoagulant medication as an important part of their life. The possible consequences of bleeding after dentoalveolar surgery must be weighed against those related to a thromboembolic event. None of the patients studied developed severe postoperative bleeding, even within the first week

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Broekema FI, van Minnen B, Jansma J, et al: Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants. Br J Oral Maxillofac Surg 52:e15-e19, 2014

Reprints available from FI Broekema, Dept of Oral and Maxillofacial Surgery, Univ Medical Ctr Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands; fax: +31 50 3611136; e-mail: [email protected]

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