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Articles prepublished February 08, 2012

Management of dental extraction in patients undergoing anticoagulant treatment

Journal:Thrombosis and Haemostasis
ISSN:0340-6245
DOI:http://dx.doi.org/10.1160/TH10-02-0139
Issue:2010: 104/5 (Nov) pp. 863-1082
Pages:972-975

Management of dental extraction in patients undergoing anticoagulant treatment

Results from a large, multicentre, prospective, case-control study

C. Bacci (1, 2), M. Maglione (3), L. Favero (1), A. Perini (3), R. Di Lenarda (3), M. Berengo (1), E. Zanon (4)

(1) Department of Medical and Surgical Science, Section of Clinical Dentistry, University of Padova, Padova, Italy; (2) Department of Dentistry, Unit of Dentistry and Stomatology, Provincial Health Service of Trento, Trento, Italy; (3) Department of Biomedicine, Unit of Dental Sciences and Biomaterials, University of Trieste, Trieste, Italy; (4) Department of Cardiac, Thoracic and Vascular Science, Second Chair of Internal Medicine, University of Padova, Padova, Italy

Summary

Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 – 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.

Keywords

multicenter study, Dental extraction, anticoagulated patients, warfarin therapy

DOI

http://dx.doi.org/10.1160/TH10-02-0139

You may also be interested in...

1.
Results of a multicenter study

H. Stergar (1), B. J. Krause (2), S. M. Eschmann (3), K. U. Juergens (4), H. Kuehl (5), A. C. Pfannenberg (6), J. Stollfuss (7), M. Weckesser (8), A. Bockisch (1)

Nuklearmedizin 2010 49 4: 129-137

http://dx.doi.org/10.3413/nukmed-0275


Articles prepublished January 25, 2012

Management of dental extraction in patients undergoing anticoagulant treatment

Journal:Thrombosis and Haemostasis
ISSN:0340-6245
DOI:http://dx.doi.org/10.1160/TH10-02-0139
Issue:2010: 104/5 (Nov) pp. 863-1082
Pages:972-975

Management of dental extraction in patients undergoing anticoagulant treatment

Results from a large, multicentre, prospective, case-control study

C. Bacci (1, 2), M. Maglione (3), L. Favero (1), A. Perini (3), R. Di Lenarda (3), M. Berengo (1), E. Zanon (4)

(1) Department of Medical and Surgical Science, Section of Clinical Dentistry, University of Padova, Padova, Italy; (2) Department of Dentistry, Unit of Dentistry and Stomatology, Provincial Health Service of Trento, Trento, Italy; (3) Department of Biomedicine, Unit of Dental Sciences and Biomaterials, University of Trieste, Trieste, Italy; (4) Department of Cardiac, Thoracic and Vascular Science, Second Chair of Internal Medicine, University of Padova, Padova, Italy

Summary

Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 – 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.

Keywords

multicenter study, Dental extraction, anticoagulated patients, warfarin therapy

DOI

http://dx.doi.org/10.1160/TH10-02-0139

You may also be interested in...

1.
Results of a multicenter study

H. Stergar (1), B. J. Krause (2), S. M. Eschmann (3), K. U. Juergens (4), H. Kuehl (5), A. C. Pfannenberg (6), J. Stollfuss (7), M. Weckesser (8), A. Bockisch (1)

Nuklearmedizin 2010 49 4: 129-137

http://dx.doi.org/10.3413/nukmed-0275


Articles prepublished January 11, 2012

Management of dental extraction in patients undergoing anticoagulant treatment

Journal:Thrombosis and Haemostasis
ISSN:0340-6245
DOI:http://dx.doi.org/10.1160/TH10-02-0139
Issue:2010: 104/5 (Nov) pp. 863-1082
Pages:972-975

Management of dental extraction in patients undergoing anticoagulant treatment

Results from a large, multicentre, prospective, case-control study

C. Bacci (1, 2), M. Maglione (3), L. Favero (1), A. Perini (3), R. Di Lenarda (3), M. Berengo (1), E. Zanon (4)

(1) Department of Medical and Surgical Science, Section of Clinical Dentistry, University of Padova, Padova, Italy; (2) Department of Dentistry, Unit of Dentistry and Stomatology, Provincial Health Service of Trento, Trento, Italy; (3) Department of Biomedicine, Unit of Dental Sciences and Biomaterials, University of Trieste, Trieste, Italy; (4) Department of Cardiac, Thoracic and Vascular Science, Second Chair of Internal Medicine, University of Padova, Padova, Italy

Summary

Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 – 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.

Keywords

multicenter study, Dental extraction, anticoagulated patients, warfarin therapy

DOI

http://dx.doi.org/10.1160/TH10-02-0139

You may also be interested in...

1.
Results of a multicenter study

H. Stergar (1), B. J. Krause (2), S. M. Eschmann (3), K. U. Juergens (4), H. Kuehl (5), A. C. Pfannenberg (6), J. Stollfuss (7), M. Weckesser (8), A. Bockisch (1)

Nuklearmedizin 2010 49 4: 129-137

http://dx.doi.org/10.3413/nukmed-0275


Articles prepublished December 21, 2011

Management of dental extraction in patients undergoing anticoagulant treatment

Journal:Thrombosis and Haemostasis
ISSN:0340-6245
DOI:http://dx.doi.org/10.1160/TH10-02-0139
Issue:2010: 104/5 (Nov) pp. 863-1082
Pages:972-975

Management of dental extraction in patients undergoing anticoagulant treatment

Results from a large, multicentre, prospective, case-control study

C. Bacci (1, 2), M. Maglione (3), L. Favero (1), A. Perini (3), R. Di Lenarda (3), M. Berengo (1), E. Zanon (4)

(1) Department of Medical and Surgical Science, Section of Clinical Dentistry, University of Padova, Padova, Italy; (2) Department of Dentistry, Unit of Dentistry and Stomatology, Provincial Health Service of Trento, Trento, Italy; (3) Department of Biomedicine, Unit of Dental Sciences and Biomaterials, University of Trieste, Trieste, Italy; (4) Department of Cardiac, Thoracic and Vascular Science, Second Chair of Internal Medicine, University of Padova, Padova, Italy

Summary

Following favourable results from a previous study, a large, multicentre, prospective, case-control study was performed to further assess the incidence of bleeding complications after dental extraction in patients taking oral anticoagulant therapy (OAT). Four hundred fifty-one patients being treated with warfarin who required dental extraction were compared with a control group of 449 non-anticoagulated subjects undergoing the same procedure. In the warfarin-treated group, the oral anticoagulant regimen was maintained unchanged, such that the patients had an International Normalised Ratio ranging between 1.8 and 4, and local haemostatic measures (i.e. fibrin sponges, silk sutures and gauzes saturated with tranexamic acid) were adopted. All the procedures were performed in an outpatient setting. Seven bleeding complications occurred in the OAT group and four in the control group; the difference in the number of bleeding events between the two groups was not statistically significant (OR=1.754; 95% CI 0.510 – 6.034; p=0.3727). No post-operative late bleeds requiring hospitalisation and/or blood transfusions were recorded, and the adjunctive local haemostatic measures were adequate to stop the bleeding. The results of our protocol applied in this large, multicenter study show that dental extractions can be performed easily and safely in anticoagulated outpatients without any modification of the ongoing anticoagulant therapy, thus minimising costs and reducing discomfort for patients.

Keywords

multicenter study, Dental extraction, anticoagulated patients, warfarin therapy

DOI

http://dx.doi.org/10.1160/TH10-02-0139

You may also be interested in...

1.
Results of a multicenter study

H. Stergar (1), B. J. Krause (2), S. M. Eschmann (3), K. U. Juergens (4), H. Kuehl (5), A. C. Pfannenberg (6), J. Stollfuss (7), M. Weckesser (8), A. Bockisch (1)

Nuklearmedizin 2010 49 4: 129-137

http://dx.doi.org/10.3413/nukmed-0275



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