medigraphic.com
SPANISH

Revista Cubana de Estomatología

ISSN 1561-297X (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2022, Number 4

<< Back Next >>

Rev Cubana Estomatol 2022; 59 (4)

Bleeding after tooth extraction and measures for its control in patients treated with antiplatelet agents

Ciria GCB, Prado MAM, Salgado MMI, Espinosa GL, Marrero CA, Marrero CMC
Full text How to cite this article

Language: Spanish
References: 27
Page:
PDF size: 325.40 Kb.


Key words:

tooth extraction, aspirin, clopidogrel, oral surgery.

ABSTRACT

Introduction: The development of medical sciences brings with it an increase in life expectancy, together with the early detection of a large number of chronic diseases such as cerebrovascular and cardiovascular diseases, which are routinely treated with antiplatelet aggregation drugs. Knowledge on the treatment of these patients before stomatological surgical procedures constitutes a challenge in daily professional practice.
Objective: To determine the level of bleeding after tooth extraction in patients with cardiovascular and cerebrovascular disease, according to the type of antiplatelet agents and dental group, as well as the frequency of use of measures for their control.
Methods: An observational, descriptive, longitudinal and prospective study was carried out with a universe of 136 patients over 20 years of age, referred by their cardiologist, who needed dental extractions without modifying their treatment with antiplatelet agents. The variables studied were systemic disease, type of antiplatelet agent, level of bleeding, dental group treated and hemostatic method used.
Results: Half of the patients studied did not present bleeding after tooth extraction. In patients treated with aspirin or clopidogrel, 84.3% and 62.5%, respectively, had no bleeding. In those with double antiplatelet therapy, moderate bleeding prevailed with 46.3%. The incisor, canine and premolar tooth groups did not present bleeding episodes (64.1%, 51.6% and 53.3%, respectively). The most commonly used hemostatic method was cortical compression and cold thermotherapy (47.8%).
Conclusions: Half of the patients with cardiovascular and cerebrovascular diseases did not present bleeding after tooth extraction.


REFERENCES

  1. Rojanaworarit C, Limsawan S. Risk of hemorrhage attributed to underlyingchronic diseases and uninterrupted aspirin therapy of patientsundergoing minor oral surgical procedures: a retrospective cohort study.J Prev Med Public Health. 2017;50(3):165-76. DOI: 10.3961/jpmph.16.121

  2. Myszka A, Migut M, Czenczek-Lewandowska E, Brodowski R. Analyzingthe effectiveness of topical bleeding care following tooth extraction inpatients receiving dual antiplatelet therapy-retrospective observationalstudy BMC Oral Health. 2021;21:31. DOI: 10.1186/s12903-021-01391-9

  3. Malik A, Majeed S. Effect of antiplatelet therapy on minor dentalprocedures. Natl J Maxillofac Surg. 2020 Jan-Jun;11(1):64-6. DOI:10.4103/njms.NJMS_30_19

  4. Cervino G, Fiorillo L, Monte IP, De Stefano R, Laino L, Crimi S, BianchiA, Scott Herford A, Biondi A, Cicciù M. ,Advances in antiplatelet therapyfor dentofacial surgery patients: focus on past and present strategies.Materials (Basel). 2019 May;12(9):1524. DOI: 10.3390/ma12091524

  5. Ghantous AE, Ferneini EM. Aspirin, plavix, and other antiplateletmedications: what the oral and maxillofacial surgeon needs toknow Oral Maxillofac Surg Clin N Am. 2016;28:497-506. DOI: 10.1016/j.coms.2016.06.003

  6. American Dental Association. Department of Scientific Information,Evidence, Synthesis and Translation Research. Oral anticoagulant andantiplatelet medications and dental procedures. [acceso 02/09/2021].Disponible en: https://www.ada.org/en/member-center/oral-health-topics/oral-anticoagulant-and-antiplatelet-medications-and-dental-procedures

  7. Cuba. Ministerio de Salud Pública. Dirección Nacional de Registros Médicosy Estadísticas de Salud. Anuario Estadístico de Salud 2020. La Habana:Minsap; 2021 [acceso 02/09/2021]. Disponible en: https://files.sld.cu/bvscuba/files/2021/08/Anuario-Estadistico-Espa%c3%b1ol-2020-Definitivo.pdf

  8. Ciria González CB, Prado Mera AM, Castañer Roch ET, Espinosa GonzálezL, Basterrechea Millián M. Extracciones dentarias sin modificarla terapia anticoagulante en pacientes con enfermedad cardiovascular.Rev Cubana Cardiol Cir Cardiovasc. 2018 [acceso 21/10/2021];24(3). Disponibleen: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/796/pdf

  9. Committee on Management of Patients with Valvular Heart Disease.Guidelines for the management of patients with valvular heart disease.A report of the American College of Cardiology/American Heart Association.Task Force on practice guidelines. Circulation. 2006;114:e84–e231. DOI: 10.1161/CIRCULATIONAHA.106.176857

  10. Cañigral A, Silvestre FJ; Cañigral G, Alós M, García Herraiz A, PlazaA. Evaluation of bleeding risk and measurement methods in dental patients.Med Oral Patol Oral Cir Bucal. 2010;15(6):e863-8. DOI: 10.4317/medoral.15.e863

  11. Barrios Osuna I, Anido Escobar V, Morera Pérez M. Declaración deHelsinki:cambios y exégesis. Revista Cubana de Salud Pública. 2016 [acceso22/06/2020];42(1):132-42. Disponible en: https://www.medigraphic.com/pdfs/revcubsalpub/csp-2016/csp161n.pdf.

  12. Sáez Alcaide LM, Sola Martín C, Molinero Mourelle P, Paredes RodríguezV, Zarrias Caballero C, Hernández Vallejo G. Dental managementin patients with antiplatelet therapy: A systematic review. J Clin ExpDent. 2017;9(8):e1044-50. DOI: 10.4317/jced.54079

  13. Papanikolaou J, Platogiannis N, Gkekas D, Barmpatzas N, SpathoulasK, Platogiannis D. Discontinuation of prolonged dual antiplatelettherapy for a dental extraction: A nearly-fatal decision. Case Report.Interventional Cardiology. 2017 [acceso 28/09/2021];9(4):139-41. Disponibleen: https://www.openaccessjournals.com/articles/discontinuation-of-prolonged-dual-antiplatelet-therapy-for-a-dental-extraction-a-nearlyfatal-decision-12109.html

  14. Lewandowski B, Myszka A, Migut M, Czenczek Lewandowska E, BrodowskiR. Analysing the effectiveness of topical bleeding care followingtooth extraction in patients receiving dual antiplatelet therapy-retrospectiveobservational study. BMC Oral Health. 2021;21:31. DOI: 10.1186/s12903-021-01391-9

  15. Gupta R, Dugal A, Sane VD, Hiwarkar S, Khandelwal S, Iyengar A.Effect of low-dose aspirin on bleeding following exodontia: a prospectiveclinical study. J Maxillofac Oral Surg. 2018;17(3):350-5. DOI: 10.1007/s12663-017-1034-7

  16. Lu SY, Tsai CY, Lin LH, Lu SN. Dental extraction without stoppingsingle or dual antiplatelet therapy: results of a retrospective cohortstudy. Int J Oral Maxillofac Surg. 2016; 45:1293-8. DOI: 10.1016/j.ijom.2016.02.010

  17. Girotra C , Padhye M, Andlik G, Dabir A, Gite M, Dhonnar R, PandhiV, Vandekr M. Assessment of the risk of haemorrhage and its controlfollowing minor oral surgical procedure in patients on antiplatelet the rapy: a prospective study. Int J Oral Maxillofac Surg. 2014;43:99-106.DOI: 10.1016/j.ijom.2013.08.014

  18. Lillis T, Ziakas A, Koskinas K, Tsirlis A, Giannoglou G. Safety of dentalextractions during uninterrupted single or dual antiplatelet treatment.Am J Cardiol. 2011; 108(7):964-7. DOI: 10.1016/j.amjcard.2011.05.029

  19. Bajkin BV, Urosevic IM, Stankov KM, Petrovic BB, Bajkin IA. Dentalextractions and risk of bleeding in patients taking single and dual antiplatelettreatment. Br J Oral Maxillofac Surg. 2015;53(1):39-43. DOI:10.1016/j.bjoms.2014.09.009

  20. Chahine J, Khoudary MN, Nasr S. Anticoagulation Use prior toCommon Dental Procedures: A systematic review. Cardiol Res Pract.2019;2019:930863. DOI: 10.1155/2019/9308631

  21. Ardekian L, Gaspar R, Peled M, Brener B, Laufer D. Does low doseaspirin therapy complicate oral surgical procedures? J Am Dent Assoc.2000;131(3):331-5. DOI: 10.14219/jada.archive.2000.0176

  22. Madan GA, Madan SG, Madan G, Madan AD. Minor oral surgery withoutstopping daily low-dose aspirin therapy: A study of 51 patients.J Oral Maxillofac Surg. 2005;63:1262-5. DOI: 10.1016/j.joms.2005.05.164

  23. Krishnan B, Shenoy NA, Alexander M. Exodontia and antiplatelettherapy. J Oral Maxillofac Surg. 2008;66:2063-6. DOI: 10.1016/j.joms.2008.06.027

  24. Morimoto Y, Niwa H, Nakatani T. On the use of prothrombin complexconcentrate in patients with coagulopathy requiring tooth extraction.Oral Med Oral Pathol Oral Radiol Endod. 2010;110:e7–e10. DOI:10.1016/j.tripleo.2010.08.014

  25. Al-Belasy FA, Amer MZ. Hemostatic effect of n-butyl-2-cyanoacrylate(histoacryl) glue in warfarin-treated patients undergoing oralsurgery.J Oral Maxillofac Surg. 2003;61(12):1405-9. DOI: 10.1016/j.joms.2002.12.001

  26. Owattanapanich D, Ungprasert P, Owattanapanich W. Efficacy oflocal tranexamic acid treatment for prevention of bleeding after dentalprocedures: a systematic review and meta-analysis. J Dent Sci.2019;14:21-6. DOI: 10.1016/j.jds.2018.10.001

  27. Ferrieri GB, Castiglioni S, Carmagnola D, Cargnel M, StrohmengerL, Abati S. Oral surgery in patients on anticoagulant treatment withouttherapy interruption. J Oral Maxillofac Surg. 2007;65:1149-54.DOI: 10.1016/j.joms.2006.11.015




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Cubana Estomatol. 2022;59