PMID- 24485810
OWN - NLM
STAT- MEDLINE
DCOM- 20141205
LR  - 20220318
IS  - 1532-1940 (Electronic)
IS  - 0266-4356 (Linking)
VI  - 52
IP  - 3
DP  - 2014 Mar
TI  - Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants.
PG  - e15-9
LID - S0266-4356(14)00023-0 [pii]
LID - 10.1016/j.bjoms.2014.01.006 [doi]
AB  - To avoid increasing the risk of thromboembolic events, it is recommended that 
      treatment with anticoagulants should be continued during dentoalveolar 
      operations. We have evaluated the incidence of bleeding after dentoalveolar 
      operations in a prospective study of 206 patients, 103 who were, and 103 who were 
      not, taking anticoagulants. Seventy-one were taking thrombocyte aggregation 
      inhibitors and 32 vitamin K antagonists. Patients were treated according to 
      guidelines developed at the Academic Centre for Dentistry Amsterdam (ACTA), The 
      Netherlands. The operations studied included surgical extraction (when the 
      surgeon had to incise the gingiva before extraction), non-surgical extraction, 
      apicectomy, and placement of implants. Patients were given standard postoperative 
      care and those taking vitamin K antagonists used tranexamic acid mouthwash 
      postoperatively. No patient developed a severe bleed that required intervention. 
      Seven patients (7%) taking anticoagulants developed mild postoperative bleeds. 
      Patients taking vitamin K antagonists reported 3 episodes (9%) compared with 4 
      (6%) in the group taking thrombocyte aggregation inhibitors. Among patients not 
      taking anticoagulants, two (2%) developed mild bleeding. The differences between 
      the groups were not significant. All bleeding was controlled by the patients 
      themselves with compression with gauze. We conclude that dentoalveolar surgery is 
      safe in patients being treated with anticoagulants provided that the conditions 
      described in the ACTA guidelines are met.
CI  - Copyright (c) 2014 The British Association of Oral and Maxillofacial Surgeons. 
      Published by Elsevier Ltd. All rights reserved.
FAU - Broekema, Ferdinand I
AU  - Broekema FI
AD  - Department of Oral and Maxillofacial Surgery, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands. Electronic 
      address: f.i.broekema@umcg.nl.
FAU - van Minnen, Baucke
AU  - van Minnen B
AD  - Department of Oral and Maxillofacial Surgery, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
FAU - Jansma, Johan
AU  - Jansma J
AD  - Department of Oral and Maxillofacial Surgery, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
FAU - Bos, Rudolf R M
AU  - Bos RR
AD  - Department of Oral and Maxillofacial Surgery, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20140130
PL  - Scotland
TA  - Br J Oral Maxillofac Surg
JT  - The British journal of oral & maxillofacial surgery
JID - 8405235
RN  - 0 (Anticoagulants)
RN  - 0 (Antifibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 12001-79-5 (Vitamin K)
RN  - 6T84R30KC1 (Tranexamic Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*therapeutic use
MH  - Antifibrinolytic Agents/therapeutic use
MH  - Apicoectomy/methods
MH  - Dental Implantation, Endosseous/methods
MH  - Female
MH  - Gingiva/surgery
MH  - Hemostatic Techniques
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oral Hemorrhage/*etiology
MH  - Oral Surgical Procedures/*methods
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Postoperative Hemorrhage/etiology
MH  - Practice Guidelines as Topic
MH  - Prospective Studies
MH  - Risk Factors
MH  - Self Care
MH  - Tooth Extraction/methods
MH  - Tranexamic Acid/therapeutic use
MH  - Vitamin K/antagonists & inhibitors
MH  - Young Adult
OTO - NOTNLM
OT  - Acenocoumarol
OT  - Apicectomy
OT  - Aspirin
OT  - Dental implantation
OT  - Haemorrhage
OT  - Tooth extraction
EDAT- 2014/02/04 06:00
MHDA- 2014/12/15 06:00
CRDT- 2014/02/04 06:00
PHST- 2013/08/26 00:00 [received]
PHST- 2014/01/08 00:00 [accepted]
PHST- 2014/02/04 06:00 [entrez]
PHST- 2014/02/04 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - S0266-4356(14)00023-0 [pii]
AID - 10.1016/j.bjoms.2014.01.006 [doi]
PST - ppublish
SO  - Br J Oral Maxillofac Surg. 2014 Mar;52(3):e15-9. doi: 
      10.1016/j.bjoms.2014.01.006. Epub 2014 Jan 30.