Perioperative Management of Antithrombotic Therapy in Patients Who Undergo Dental Procedures: A Systematic Review of the Literature and Network Meta-Analysis

Int J Environ Res Public Health. 2023 Mar 28;20(7):5293. doi: 10.3390/ijerph20075293.

Abstract

Background: The surgical dental treatment of subjects admitted for anticoagulants therapy represents a consistent risk for peri-operative bleeding. The aim of the present study was to investigate the clinical findings of dental surgery operative management of the patients under anticoagulants drugs protocol.

Methods: The literature screening was performed using Pubmed/Medline, EMBASE and Cochrane library, considering only randomized clinical trials (RCTs) papers. No limitations about the publication's period, follow-up time or clinical parameters were considered.

Results: A total of eight RCTs were included for the qualitative synthesis. No thromboembolic complications were reported in any studies. Several bleeding episodes associated with anticoagulant drugs in dental surgery were mild and generally happened on the first day after the treatment.

Conclusions: The use of local haemostatic measures is generally effective for bleeding control with no further pharmacological drug management or suspension.

Keywords: anticoagulants; antiplatelet therapy; antithrombotic therapy; atrial fibrillation and oral surgery; haemostasis; oral haemorrhage; oral surgery; tooth extraction.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Anticoagulants
  • Fibrinolytic Agents* / therapeutic use
  • Hemorrhage
  • Humans
  • Network Meta-Analysis
  • Thromboembolism*

Substances

  • Fibrinolytic Agents
  • Anticoagulants

Grants and funding

This research received no external funding.