Tags

Type your tag names separated by a space and hit enter

Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy-a prospective study.
Clin Oral Investig. 2020 Jun 22 [Online ahead of print]CO

Abstract

BACKGROUND

Dental surgeons consider patients on antiplatelet therapy (APT) to be at a risk for perioperative bleeding during dental extraction. This fear often prompts them to consider a temporary withdrawal of the medication for a few days before extraction. Such withdrawal can have serious consequences, especially in patients on dual antiplatelet therapy (DAPT).

OBJECTIVES

The purpose of this study was to analyze if patients on uninterrupted DAPT undergoing dental extractions had an increased risk of bleeding complications when compared with patients on no antiplatelet therapy.

METHODS

This prospective study included 120 DAPT patients and an equal number of age- and gender-matched non-APT patients undergoing dental extractions. Immediate and delayed bleeding complications in both groups were recorded. Interventions required to control the post-extraction hemorrhage were also analyzed.

RESULTS

Duration of DAPT medication ranged from 6 months to 13 years. Post-percutaneous coronary intervention was the most common cause for DAPT. A vast majority of patients in both groups underwent extraction of one or two teeth. Patients on DAPT had a 7-fold increased risk of immediate bleeding complications when compared with control group. All bleeding episodes were controlled with local hemostatic measures. Transalveolar extractions and localized periodontitis had a significant relationship to bleeding complications.

CONCLUSION

This study observed an increase in the risk of prolonged bleeding in uninterrupted DAPT patients undergoing dental extractions. Bleeding episodes were amenable to local hemostatic measures with favorable outcomes.

CLINICAL RELEVANCE

Dental extractions in patients on uninterrupted DAPT can be done safely. Resorting to temporary withdrawal of DAPT due to a fear of excessive bleeding is unnecessary.

Authors+Show Affiliations

Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India. krishident@yahoo.co.uk.Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India.Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India.Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India.Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India.Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 74, 4th cross, ThanthaiPeriyar Nagar, Pondicherry, 605005, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32572638

Citation

Krishnan, B, et al. "Post-extraction Bleeding Complications in Patients On Uninterrupted Dual Antiplatelet Therapy-a Prospective Study." Clinical Oral Investigations, 2020.
Krishnan B, Prasad GA, Madhan B, et al. Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy-a prospective study. Clin Oral Investig. 2020.
Krishnan, B., Prasad, G. A., Madhan, B., Saravanan, R., Mote, N. P., & Akilesh, R. (2020). Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy-a prospective study. Clinical Oral Investigations. https://doi.org/10.1007/s00784-020-03410-5
Krishnan B, et al. Post-extraction Bleeding Complications in Patients On Uninterrupted Dual Antiplatelet Therapy-a Prospective Study. Clin Oral Investig. 2020 Jun 22; PubMed PMID: 32572638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy-a prospective study. AU - Krishnan,B, AU - Prasad,G Arun, AU - Madhan,B, AU - Saravanan,R, AU - Mote,Nirmal Pratap, AU - Akilesh,R, Y1 - 2020/06/22/ PY - 2020/04/09/received PY - 2020/06/10/accepted PY - 2020/6/24/entrez KW - Antiplatelet KW - Aspirin KW - Bleeding KW - Clopidogrel KW - Dentoalveolar KW - Dual antiplatelet KW - Exodontia KW - Extraction KW - Hemorrhage KW - Oral surgery JF - Clinical oral investigations JO - Clin Oral Investig N2 - BACKGROUND: Dental surgeons consider patients on antiplatelet therapy (APT) to be at a risk for perioperative bleeding during dental extraction. This fear often prompts them to consider a temporary withdrawal of the medication for a few days before extraction. Such withdrawal can have serious consequences, especially in patients on dual antiplatelet therapy (DAPT). OBJECTIVES: The purpose of this study was to analyze if patients on uninterrupted DAPT undergoing dental extractions had an increased risk of bleeding complications when compared with patients on no antiplatelet therapy. METHODS: This prospective study included 120 DAPT patients and an equal number of age- and gender-matched non-APT patients undergoing dental extractions. Immediate and delayed bleeding complications in both groups were recorded. Interventions required to control the post-extraction hemorrhage were also analyzed. RESULTS: Duration of DAPT medication ranged from 6 months to 13 years. Post-percutaneous coronary intervention was the most common cause for DAPT. A vast majority of patients in both groups underwent extraction of one or two teeth. Patients on DAPT had a 7-fold increased risk of immediate bleeding complications when compared with control group. All bleeding episodes were controlled with local hemostatic measures. Transalveolar extractions and localized periodontitis had a significant relationship to bleeding complications. CONCLUSION: This study observed an increase in the risk of prolonged bleeding in uninterrupted DAPT patients undergoing dental extractions. Bleeding episodes were amenable to local hemostatic measures with favorable outcomes. CLINICAL RELEVANCE: Dental extractions in patients on uninterrupted DAPT can be done safely. Resorting to temporary withdrawal of DAPT due to a fear of excessive bleeding is unnecessary. SN - 1436-3771 UR - https://www.unboundmedicine.com/medline/citation/32572638/Post-extraction_bleeding_complications_in_patients_on_uninterrupted_dual_antiplatelet_therapy-a_prospective_study L2 - https://dx.doi.org/10.1007/s00784-020-03410-5 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.