Analysis of profiles of patients on oral anticoagulants undergoing dental extraction - A retrospective study
DOI:
https://doi.org/10.5935/2525-5711.20170018Keywords:
Oral Surgical Procedures, Anticoagulants, WarfarinAbstract
Introduction: Many oral surgeons, in clinical practice, face the challenge of management of patients under anticoagulants treatment. The main reason for this concern is the post- operative problems. Objective: The objective is to demonstrate the profiles of patients on oral anticoagulants, who underwent exodontia and did not have complications. Material and Methods: This review was performed using the records of all cases of Special Care Dental Ambulatory during a period of two years. Results: Records of a total of 60 patients, 82 procedures, and 145 extracted teeth were found. The anticoagulant utilized for the sample was warfarin, the mean INR was 2.47 (SD ± 0.53), the majority of teeth extracted was monoradicular was extracted one/time. Conclusion: Can be inferred that is safe to perform dento-alveolar surgeries in anticoagulants patients since additional care measures such as INR monitoring, minimally traumatic technique, and local hemostasis are adopted. This research clarifies some aspects related to routinely surgical procedures in patients under oral anticoagulant therapy.
References
Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al.; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:480-6.
Labuz-Roszak B, Pierzchala K, Skrzypek M, Swiech M, Machowska-Majchrzak A. Oral anticoagulant and antiplatelet drugs used in prevention of cardiovascular events in elderly people in Poland. BMC Cardiovasc Disord. 2012;12:98.
Kelly JG, O'Malley K. Clinical pharmacokinetics of oral anticoagulants. Clin Pharmacokinet. 1979;4:1-15.
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;16:81.
WHO; World Heart Federation; World Stroke Organization, eds. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva: World Health Organization; 2011.
Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part II: the aging heart in health: links to heart disease. Circulation. 2003;107:346-54.
World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.
Ouirke W, Cahill M, Perera K, Sargent J, Conway J. Warfarin prevalence, indications for use and haemorrhagic events. Irish Med J. 2007;100:402-4.
Wahl MJ, Pinto A, Kilham J, Lalla RV. Dental surgery in anticoagulated patients - stop the interruption. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119:136-57.
Iwabuchi H, Imai Y, Asanami S, Shirakawa M, Yamane GY, Ogiuchi H, et al. Evaluation of postextraction bleeding incidence to compare patients receiving and not receiving warfarin therapy: a cross-sectional, multicentre, observational study. BMJ Open. 2014;4:e005777.
European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31:2369-429.
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:e010471.
Dudek D, Marchionni S, Gabriele M, Iurlaro A, Helewski K, Toti P, et al. Bleeding Rate after Tooth Extraction in Patients under Oral Anticoagulant Therapy. J Craniofac Surg. 2016;27:1228-33.
Bacci C, Maglione M, Favero L, Perini A, Di Lenarda R, Berengo M, et al. Management of dental extraction in patients undergoing anticoagulant treatment. Results from a large, multicenter, prospective, case-control study. Thromb Haemost. 2010;104:972-5.
Febbo A, Cheng A, Stein B, Goss A, Sambrook P. Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin. J Oral Maxillofac Surg. 2016;74:1518-23.
Perry DJ, Noakes TJ, Helliwell PS; British Dental Society. Guidelines for the management of patients on oral anticoagulants requiring dental surgery. Br Dental J. 2007;203:389-93.
Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M, et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165:1095-106.
Curto A, Albaladejo A, Alvarado A. Dental management of patients taking novel oral anticoagulants (NOAs): Dabigatran. J Clin Exp Dent. 2017;9:e289-e293.
Firriolo FJ, Hupp WS. Beyond warfarin: the new generation of oral anticoagulants and their implications for the management of dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:431-41.
