Management of anticoagulated patients in dentoalveolar surgery: a clinical comparative study

Schmitt C, Rusche B, Clemm R, Neukam FW, Buchbender M (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Clinical Oral Investigations Springer Verlag (Germany)

Abstract

Objectives: This prospective, comparative, clinical study analyzed the postoperative bleeding risk of patients on anticoagulation therapy (AT) who were undergoing tooth extractions and osteotomies. Materials and methods: Patients with the following ATs were included (test groups): (1.) platelet aggregation inhibitors (PAIs), (2.) vitamin K inhibitors, (3.) low molecular weight heparin (LMWH), and (4.) direct oral anticoagulants (DOACs). Patients in the control group were not on any AT (non-AT group). Patients were subdivided into the following treatment groups: (1.) single tooth extraction, (2.) serial extraction (≥ 2 adjacent teeth), and (3.) tooth osteotomy. Pre-, intra-, and postoperative data concerning the treatment, extent of the surgery, and bleeding were recorded and statistically evaluated. Results: There were 15 postoperative bleeding events in 838 patients (1.7%): four (0.7%) in the non-AT group (n = 603 patients) and 11 (4.7%) in the AT group (n = 235 patients). The surgical procedure had no statistically significant effect on postoperative bleeding frequencies. Patients taking vitamin K inhibitors had a significantly higher risk of postoperative bleeding compared with patients without AT (p < 0.00001). Four patients were hospitalized due to the severity of the bleeding (vitamin K inhibitor group). Postoperative bleeding events were all controlled with local hemostatic measures. Conclusions: The postoperative bleeding risk after tooth extractions and osteotomies in patients continuing AT is low, and bleeding can be controlled with local hemostatic measures. Clinical relevance: AT should be continued in patients undergoing tooth removal procedures under the provision that local hemostatic measures are applied.

Authors with CRIS profile

Christopher Schmitt Department of Anaesthesiology Birgit Rusche Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie Raphael Clemm Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie Friedrich Wilhelm Neukam Medizinische Fakultät Mayte Buchbender Department of Oral and Cranio-Maxillofacial Surgery

How to cite

APA:

Schmitt, C., Rusche, B., Clemm, R., Neukam, F.W., & Buchbender, M. (2019). Management of anticoagulated patients in dentoalveolar surgery: a clinical comparative study. Clinical Oral Investigations. https://doi.org/10.1007/s00784-019-03124-3

MLA:

Schmitt, Christopher, et al. "Management of anticoagulated patients in dentoalveolar surgery: a clinical comparative study." Clinical Oral Investigations (2019).

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