9/24/2023 0 Comments Inr normal range extraction![]() ![]() Because most of these dental operations can be invasive and hemorrhagic, concern over the safety and efficacy of the OAT and the accompanying bleeding risks related to these invasive dental procedures is unavoidable ( Pototski and Amenabar, 2007 Kosyfaki et al., 2011 Jimson et al., 2015). However, although oral anticoagulant treatment (OAT) with vitamin K antagonists is effective for prophylaxis of potentially life-threatening thromboembolic events, the risk of post-operative bleeding has been a concern in the medical treatment of patients undergoing OAT compared with non-anticoagulated subjects ( Rodríguez-Cabrera et al., 2011 Rowley et al., 2013 Philip et al., 2014).Īccording to previous reports ( Cannon and Dharmar, 2003 Kämmerer et al., 2015), minor dental surgery, which is the common procedure in dental health care and routine outpatient treatment, including tooth extractions, dental implant surgery, mucoperiosteal flaps, periodontal surgical procedures, alveoloplasties, limited oral soft tissue surgery, and augmentation procedures (e.g., elevation of the maxillary sinus). Because of the aging populations and high rates of cardiovascular disease in most countries, a large number of patients will be undergoing oral anticoagulant treatment ( Madrid and Sanz, 2009 Nocini et al., 2013). In recent years, new oral anticoagulants (NOACs) have emerged and been used in clinical practice ( Ning et al., 2016). Most of these drugs act as vitamin K antagonists, and their mechanism of action is through inhibition of vitamin K dependent clotting factors (II, VII, IX, X) ( Mackman, 2008 Andras et al., 2012). Oral anticoagulants (OAs) are commonly used in patients with artificial heart valves, deep vein thrombosis, and pulmonary embolisms to prevent thromboembolic events ( Key and Kasthuri, 2010 Andras et al., 2012 Akin et al., 2015). However, more well-designed studies are required for future research. Besides, The NOACs might be safer than the vitamin K antagonists in dental implant surgery. For the dental implant surgeries and dental extractions, our study failed to demonstrate a higher risk of bleeding in the OAT patients compared with the non-OAT patients. As for the different oral anticoagulants, the pooled RR in the subgroup of new oral anticoagulants (NOACs) was 1.603 (95% CI: 0.430–5.980, P = 0.482), while the pooled RR in the vitamin K antagonists subgroup was 3.067 (95% CI: 1.838–5.118, P = 0.000).Ĭonclusion: Under current evidence, OAT patients were under a higher post-operative bleeding risk than the non-OAT patients following minor dental surgery. A pooled analysis indicated that the post-operative bleeding risk in OAT patients is higher than that of non-OAT patients (RR: 2.794, 95% CI: 1.722–4.532, P = 0.000). Finally, 12 studies and a total of 2102 OAT patients and 2271 non-OAT patients were included. Results: Thirty two full text articles were assessed for eligibility and 20 studies were excluded according to the selection criteria. Subgroup analyses were used to identify the association between the bleeding rate and different dental surgeries or anticoagulants. Relative risk (RR) and 95% confidence interval (CI) were calculated. Methods: PubMed, Embase and the Cochrane Library were searched for eligible studies that compared the post-operative (following minor dental surgery) bleeding rates of OAT patients without interrupted or altered therapy with those of non-OAT patients. The aim of this meta-analysis is to evaluate this risk by comparing the post-operative bleeding rates of oral anticoagulation treatment (OAT) patients (without interrupted or altered anticoagulant intake) with non-OAT patients. Thus, in patients treated with anticoagulants, the bleeding risk related to these invasive procedures is concerning. Institute of Stomatology, Chinese PLA General Hospital, Beijing, Chinaīackground and Objective: Minor dental surgery is invasive and hemorrhagic.Quan Shi † Juan Xu † Tong Zhang Bin Zhang Hongchen Liu * ![]()
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