MANAGEMENT OF DENTAL EXTRACTION IN PATIENTS UNDER ANTICOAGULANT THERAPY: A LITERATURE REVIEW
DOI:
https://doi.org/10.31984/oactiva.v6i2.566Keywords:
Warfarin, Anticoagulants, Direct oral anticoagulant, Dental extraction, Oral surgeryAbstract
In recent years the teeth extraction in patients who consume anticoagulants has increased, and with it also the need for new studies that allow us to know how to address such cases. Oral anticoagulant therapy is used to prevent thromboembolic type diseases. Among anticoagulants we have Vitamin K Antagonists and direct oral anticoagulants. The objective of this study is to analyze the type of management that an anticoagulated patient needs, in addition to the limitations, indications, and hemostatic measures for dental extraction in these patients. A search was made in the digital databases of Pubmed, Science Direct, Cochrane and SciELO, obtaining a total of 2176 articles that after the implementation of inclusion and exclusion criteria resulted in 59 articles for this literature review. The management in these patients should be done with extreme caution taking into account their systemic state, the extraction will be done safely without suspension or modification of the drug, when the surgical intervention has been planned with an atraumatic technique of one to three pieces and the INR is ≤3.5. It is essential for the dentist to have updated knowledge of the treatment of anticoagulated patients and their bleeding complications.
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References
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26. Lu SY, Lin LH, Hsue SS. Management of dental extractions in patients on warfarin and antiplatelet therapy. Journal of the Formosan Medical Association. 2018;117(11):979–986.
27. Cabbar F, Cabbar AT, Coşansu K, Çekirdekçi Eİ. Effects of Direct Oral Anticoagulants on Quality of Life During Periprocedural Management for Dental Extractions. Journal of Oral and Maxillofacial Surgery. mayo de 2019;77(5):904–911.
28. Lee J-S, Kim M-K, Kang S-H. Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction. JKAOMS. 31 de agosto de 2020;46(4):228-34.
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37. Caliskan M, Tükel HC, Benlidayi ME, Deniz A. Is it necessary to alter anticoagulation therapy for tooth extraction in patients taking direct oral anticoagulants? Medicina Oral, Patologia Oral y Cirugia Bucal. noviembre de 2017;22(6):e767–e773.
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42. Cocero N, Basso M, Grosso S, Carossa S. Direct Oral Anticoagulants and Medical Comorbidities in Patients Needing Dental Extractions: Management of the Risk of Bleeding. Journal of Oral and Maxillofacial Surgery. 2019;77(3):463–470.
43. Yoshikawa H, Yoshida M, Yasaka M, Yoshida H, Murasato Y, Fukunaga D, et al. Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study. Int J Oral Maxillofac Surg. agosto de 2019;48(8):1102-8.
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2. Ahmed I, Younis M, Shah AA. Extraction in Patients on Oral Anticoagulant Therapy With and without Stopping the Drug: A Comparative Study. Journal of Maxillofacial and Oral Surgery. 2019;18(4):555–558.
3. Motta RHL, Bergamaschi CDC, De Andrade NK, Guimaraes CC, Ramacciato JC, Araújo JDO, et al. Bleeding risk in patients using oral anticoagulants submitted to surgical procedures in dentistry: A systematic review protocol. BMJ Open [Internet]. diciembre de 2017;7(12). Disponible en: https://pubmed.ncbi.nlm.nih.gov/29259064/
4. Berton F, Costantinides F, Rizzo R, Franco A, Contarin J, Stacchi C, et al. Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study. Clinical Oral Investigations. agosto de 2019;23(8):3183–3192.
5. Rubino RT, Dawson DR, Kryscio RJ, Al-Sabbagh M, Miller CS. Postoperative bleeding associated with antiplatelet and anticoagulant drugs: A retrospective study. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. septiembre de 2019;128(3):243-9.
6. Shi Q, Xu J, Zhang T, Zhang B, Liu H. Postoperative Bleeding Risk in Dental Surgery for Patients on Oral Anticoagulant Therapy: A Meta-analysis of Observational Studies. Frontiers in Pharmacology. febrero de 2017;08(FEB):58.
7. Bensi C, Belli S, Paradiso D, Lomurno G. Postoperative bleeding risk of direct oral anticoagulants after oral surgery procedures: a systematic review and meta-analysis. International Journal of Oral and Maxillofacial Surgery. 1 de julio de 2018;47(7):923-32.
8. Manfredi M, Dave B, Percudani D, Christoforou J, Karasneh J, Diz Dios P, et al. World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis. Oral Diseases. junio de 2019;25(S1):157–173.
9. ichi Yamada S, Hasegawa T, Soutome S, Yoshimura H, Miyakoshi M, Ueda N, et al. Prevalence of and risk factors for postoperative hemorrhage after lower third molar extraction on warfarin therapy: a multicenter retrospective study in Japan. Odontology. 2020;108(3):462–469.
10. Molina Castaño D, Campos Quesada M, Núñez Guerrero A. Historia de los anticoagulantes y su uso clínico en el presente. Rev.méd.sinerg. 1 de febrero de 2020;5(2):e365.
11. Lombardi N, Varoni EM, Sorrentino D, Lodi G. International normalized ratio (INR) values in patients receiving oral vitamin K antagonists and undergoing oral surgery: A clinical audit. Spec Care Dentist. julio de 2020;40(4):374-81.
12. Nieves Bel Peña. Guía para el seguimiento Farmacológico Individualizado en Personas con Tratamiento de Anticoagulación Oral (v.2).
13. Hanken H, Gröbe A, Heiland M, Smeets R, Kluwe L, Wikner J, et al. Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy. Clin Oral Investig. julio de 2016;20(6):1279-82.
14. Yang S, Shi Q, Liu J, Li J, Xu J. Should oral anticoagulant therapy be continued during dental extraction? A meta-analysis. BMC Oral Health. 2016;16(1):1–9.
15. Ruiz Gutiérrez MF, Oliva Mella P, Universidad del Desarrollo, Universidad del Desarrollo. Manejo de pacientes con terapia anticoagulante sometidos a extracciones dentales: una revisión sistemática. Rev Fac Odontol Univ Antioq [Internet]. febrero de 2016 [citado 18 de septiembre de 2020];27(2). Disponible en: https://revistas.udea.edu.co/index.php/odont/article/view/16368
16. Inokoshi M, Kubota K, Yamaga E, Ueda K, Minakuchi S. Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy. Clin Oral Invest [Internet]. 1 de septiembre de 2020 [citado 19 de septiembre de 2020]; Disponible en: http://link.springer.com/10.1007/s00784-020-03559-z
17. Morimoto Y, Yokoe C, Imai Y, Sugihara M, Futatsuki T. Tooth extraction in patients taking nonvitamin K antagonist oral anticoagulants. Journal of Dental Sciences. 2016;11(1):59–64.
18. Rai S, Rattan V. Efficacy of Feracrylum as Topical Hemostatic Agent in Therapeutically Anticoagulated Patients Undergoing Dental Extraction: A Comparative Study. Journal of Maxillofacial and Oral Surgery. 2019;18(4):579–583.
19. Lukacs D, Staczer N, Vajta L, Olasz L, Joob-Fancsaly A, Szalma J. Dental and Oral Surgical Treatment of Medication-Induced Bleeding Patients: Audit of the National Guideline in Hungary. Orvosi Hetilap. octubre de 2016;157(43):1722–1728.
20. Schmitt C, Rusche B, Clemm R, Neukam F, Buchbender M. Management of anticoagulated patients in dentoalveolar surgery: a clinical comparative study. Clinical Oral Investigations. noviembre de 2019;1–10.
21. Yagyuu T, Kawakami M, Ueyama Y, Imada M, Kurihara M, Matsusue Y, et al. Risks of postextraction bleeding after receiving direct oral anticoagulants or warfarin: A retrospective cohort study. BMJ Open. 2017;7(8):1–8.
22. Rocha AL, Oliveira SR, Souza AF, Travassos DV, Abreu LG, Ribeiro DD, et al. Bleeding assessment in oral surgery: A cohort study comparing individuals on anticoagulant therapy and a non-anticoagulated group. Journal of Cranio-Maxillofacial Surgery. 1 de mayo de 2019;47(5):798-804.
23. Hakata K, Okubo M, Hasegawa T, Izumi S, Komiyama Y, Uchida D, et al. Alterations of serum vitamin K levels and prothrombin time-international normalized ratio during tooth extractions among patients receiving warfarin. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. noviembre de 2018;30(6):550–553.
24. Clark NP, Douketis JD, Hasselblad V, Schulman S, Kindzelski AL, Ortel TL. Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: Analysis of the BRIDGE trial. American Heart Journal. enero de 2018;195:108-14.
25. Erden İ, Erden EÇ, Aksu T, Gölcük ŞE, Turan B, Erkol A, et al. Comparison of uninterrupted warfarin and bridging therapy using low-molecular weight heparin with respect to the severity of bleeding after dental extractions in patients with prosthetic valves. Anatolian Journal of Cardiology. 2016;16(7):467–473.
26. Lu SY, Lin LH, Hsue SS. Management of dental extractions in patients on warfarin and antiplatelet therapy. Journal of the Formosan Medical Association. 2018;117(11):979–986.
27. Cabbar F, Cabbar AT, Coşansu K, Çekirdekçi Eİ. Effects of Direct Oral Anticoagulants on Quality of Life During Periprocedural Management for Dental Extractions. Journal of Oral and Maxillofacial Surgery. mayo de 2019;77(5):904–911.
28. Lee J-S, Kim M-K, Kang S-H. Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction. JKAOMS. 31 de agosto de 2020;46(4):228-34.
29. Daroit NB, Festugatto FL, Beltrame LF, Maciel JCC, Rados PV. Analysis of profiles of patients on oral anticoagulants undergoing dental extraction - A retrospective study. JORDI - Journal of Oral Diagnosis. 2017;2(1):1–5.
30. Biedermann JS, Rademacher WMH, Hazendonk HCAM, van Diermen DE, Leebeek FWG, Rozema FR, et al. Predictors of oral cavity bleeding and clinical outcome after dental procedures in patients on vitamin K antagonists. A cohort study. Thromb Haemost. 27 de 2017;117(7):1432-9.
31. Febbo A, Cheng A, Stein B, Goss A, Sambrook P. Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin. Journal of Oral and Maxillofacial Surgery. agosto de 2016;74(8):1518–1523.
32. Kataoka T, Hoshi K, Ando T. Is the HAS-BLED score useful in predicting post-extraction bleeding in patients taking warfarin? A retrospective cohort study. BMJ Open. 2016;6(3).
33. Miclotte I, Vanhaverbeke M, Agbaje JO, Legrand P, Vanassche T, Verhamme P, et al. Pragmatic approach to manage new oral anticoagulants in patients undergoing dental extractions: a prospective case-control study. Clin Oral Investig. septiembre de 2017;21(7):2183-8.
34. Patel JP, Woolcombe SA, Patel RK, Obisesan O, Roberts LN, Bryant C, et al. Managing direct oral anticoagulants in patients undergoing dentoalveolar surgery. British Dental Journal. febrero de 2017;222(4):245–249.
35. Lanau N, Mareque J, Giner L, Zabalza M. Direct oral anticoagulants and its implications in dentistry. A review of literature. J Clin Exp Dent. 2017;0-0.
36. Müller M, Schlittler F, Schaller B, Nagler M, Exadaktylos AK, Sauter TC. Characteristics, treatment and outcome of bleeding after tooth extraction in patients on DOAC and phenprocoumon compared to non-anticoagulated patients—a retrospective study of emergency department consultations. Clinical Oral Investigations. mayo de 2019;23(5):2273–2278.
37. Caliskan M, Tükel HC, Benlidayi ME, Deniz A. Is it necessary to alter anticoagulation therapy for tooth extraction in patients taking direct oral anticoagulants? Medicina Oral, Patologia Oral y Cirugia Bucal. noviembre de 2017;22(6):e767–e773.
38. Mauprivez C, Khonsari RH, Razouk O, Goudot P, Lesclous P, Descroix V. Management of dental extraction in patients undergoing anticoagulant oral direct treatment: a pilot study. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. noviembre de 2016;122(5):e146–e155.
39. Kwak EJ, Nam S, mee Park K, yul Kim S, Huh J, Park W. Bleeding related to dental treatment in patients taking novel oral anticoagulants (NOACs): a retrospective study. Clinical Oral Investigations. enero de 2019;23(1):477–484.
40. Brennan Y, Gu Y, Schifter M, Crowther H, Favaloro EJ, Curnow J. Dental extractions on direct oral anticoagulants vs. warfarin: The DENTST study. Research and Practice in Thrombosis and Haemostasis. febrero de 2020;4(2):278–284.
41. Lababidi E, Breik O, Savage J, Engelbrecht H, Kumar R, Crossley CW. Assessing an oral surgery specific protocol for patients on direct oral anticoagulants: a retrospective controlled cohort study. Int J Oral Maxillofac Surg. julio de 2018;47(7):940-6.
42. Cocero N, Basso M, Grosso S, Carossa S. Direct Oral Anticoagulants and Medical Comorbidities in Patients Needing Dental Extractions: Management of the Risk of Bleeding. Journal of Oral and Maxillofacial Surgery. 2019;77(3):463–470.
43. Yoshikawa H, Yoshida M, Yasaka M, Yoshida H, Murasato Y, Fukunaga D, et al. Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study. Int J Oral Maxillofac Surg. agosto de 2019;48(8):1102-8.
44. Hasegawa T, Yanamoto S, Tachibana A, Kojima Y, Koyama Y, Maeda M, et al. The risk factors associated with postoperative hemorrhage after tooth extraction: a multi-center retrospective study of patients receiving oral antithrombotic therapy. Oral and Maxillofacial Surgery. 2017;21(4):397–404.
45. Ehrhard S, Burkhard JP, Exadaktylos AK, Sauter TC. Severe Enoral Bleeding with a Direct Oral Anticoagulant after Tooth Extraction and Heparin Bridging Treatment. Case Reports in Emergency Medicine. 2019;2019:1–5.
46. Andrade MVS, Andrade LAP, Bispo AF, Freitas L de A, Andrade MQS, Feitosa GS, et al. Evaluation of the bleeding intensity of patients anticoagulated with warfarin or dabigatran undergoing dental procedures. Arquivos Brasileiros de Cardiologia. 2018;111(3):394–399.
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2021-05-12
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Yamunaque Vire, J. M. (2021). MANAGEMENT OF DENTAL EXTRACTION IN PATIENTS UNDER ANTICOAGULANT THERAPY: A LITERATURE REVIEW. Odontología Activa Revista Científica, 6(2), 27–36. https://doi.org/10.31984/oactiva.v6i2.566
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