Exodontia and Antiplatelet Therapy

Krishnan, Balasubramanian; Shenoy, Nithin A.; Alexander, Mohan

doi:10.1016/j.joms.2008.06.027

Cited by 66 publications

(39 citation statements)

References 18 publications

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“…Randomised control trials by Adrekian et al [1] and Krishnan et al [4] concluded that there was no post operative bleeding complications following dental extractions in patients on low-dose aspirin therapy in both groups (stopping and not stopping the regime). The present study concurred with these results.…”

Section: Discussionmentioning

confidence: 99%

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An Assessment of the Incidence of Prolonged Postoperative Bleeding After Dental Extraction Among Patients on Uninterrupted Low Dose Aspirin Therapy and to Evaluate the Need to Stop Such Medication Prior to Dental Extractions

Eapen

Baig

Avinash

2016

J. Maxillofac. Oral Surg.

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Purpose To propose that low dose aspirin therapy need not be withdrawn for routine dental extraction procedure. Aim This study was designed to evaluate the post operative bleeding in patients on low dose aspirin therapy by dividing them into two groups: one with withdrawing and the other without withdrawing the regime before dental extraction. Materials and Methods This study included 80 patients on low dose aspirin therapy. They were divided into two groups of 40 patients each; Group I (control group) included patients on who were asked to stop the medication 5 days prior to dental extraction; Group II (test group) included patients who were asked not to stop the medication prior to dental extraction. Strict atraumatic extractions were performed by a single surgeon. Data were analyzed using the independent ''t'' test @ 80 % power. Results The mean pre-operative bleeding time in the control group was 87.75 s and the test group was 95.75 s which was statistically significant (p \ 0.05). The mean pre-operative clotting time in the control group was 228.63 s and the test group was 246.25 s which was also statistically significant (p \ 0.05). No patients in either group had any episode of prolonged postoperative bleeding following extraction from the surgical site and no local haemostatic measures had to be used except for one patient in Group II. Conclusion Authors conclude from this study that dental extraction procedures in patients on low-dose therapy can be safely carried out without stopping the antiplatelet therapy.

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Section: Discussionmentioning

confidence: 99%

“…Few recent studies have shown differences in approach by maxillofacial surgeons on these patients [4]. These include:…”

Section: Introductionmentioning

confidence: 99%

An Assessment of the Incidence of Prolonged Postoperative Bleeding After Dental Extraction Among Patients on Uninterrupted Low Dose Aspirin Therapy and to Evaluate the Need to Stop Such Medication Prior to Dental Extractions

Eapen

Baig

Avinash

2016

J. Maxillofac. Oral Surg.

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“…Cette étude qui montre que le maintien des AAP en vue d'avulsions est rendu possible grâce à une hémostase renforcée avec l'utilisation d'un anesthésique avec vasoconstricteurs est en adéquation avec les recommandations émises pat la SFCO en 2015 [6]. Elle confirme par ailleurs les données de la littéra-ture [35][36][37].…”

Section: Surveillance Et Conseils Post-opératoiresunclassified

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

Baranes

Princ

Spaulding

et al. 2016

Med Buccale Chir Buccale

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Résumé -Introduction :Le clopidogrel est un agent antiplaquettaire (AAP) indiqué dans la prévention de l'athé-rothrombose et des thromboses de stents coronaires. Il augmente le risque hémorragique lors des actes chirurgicaux. Son arrêt, même transitoire, peut entraîner un accident thrombotique aigu potentiellement grave. Sujets et méthodes : Une étude prospective bicentrique était réalisée. L'objectif était d'évaluer le risque hémorragique postavulsionnel chez des patients des deux sexes, sans limite d'âge, sous clopidogrel en monothérapie ou bithérapie, bénéficiant d'une hémostase à base de colle chirurgicale. Les critères de non-inclusion étaient les patients ayant bénéficié d'un relais (héparine, flubiprofène) ou ayant arrêté leur traitement anti-agrégant. Quatre-vingt-neuf patients étaient inclus, 128 interventions réalisées, 284 dents extraites. Résultats : Douze épisodes hémorra-giques post-opératoires (9,5 %) étaient constatés dont 11 stoppés par le patient à domicile par compressions avec de l'acide tranexamique à 10 %. Deux tiers des hémorragies (8/12) concernaient des patients sous bithérapie antiagrégante. Un patient présentait une hémorragie persistante ayant nécessité une reprise de l'hémostase au fauteuil. Discussion : Cette étude confirme qu'un protocole d'hémostase locale adapté permet de réaliser les avulsions avec maintien du clopidogrel qu'il soit ou non associé à un autre AAP. En cas de bithérapie, les procédures d'hémos-tase doivent être renforcées. Conclusion : Ces résultats confirment les recommandations de la Société française de chirurgie orale (SFCO).Abstract -Dental avulsions in patients receiving clopidogrel: prospective bicentric study. Introduction: Clopidogrel is an antiplatelet drug used in the prevention of atherothrombosis and thrombosis after coronary stent implantation. It increases the risk of bleeding during surgical procedures. In 2015, the French Society of Oral Surgery (SFCO) published a practice guideline which clearly stated that "interruption of clopidogrel before a surgical procedure is not justified". However, there is limited data on tooth avulsions in patients receiving clopidogrel. Subjects and Methods: A prospective bicentric study was performed. The objective was to evaluate the risk of bleeding after tooth avulsion with an hemostatic procedure including surgical glue, in patients treated with clopidogrel alone or associated with aspirin. Patients under switch treatment (heparine, flurbiprofen) or who interrupted their treatment were not included in this study. 99 patients were included, 128 surgical procedures performed and 284 teeth extracted (2 ± 1 per intervention). Results: 12 post-surgical haemorrhages, 11 of which stopped by patient at home by compression with 10% tranexamic acid where noted. 2/3 of these haemorrhage concerned occurred in patients receiving dual antiplatelet therapy. Only one patient required a new local hemostasis procedure at hospital without transfusion or hospitalisation. Discussion: According to these results discontinuation of clopi...

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“…Pour l'ensemble de ces études cliniques [24,36,48,50,54,56,113,185,197,204,228,234,248,281], aucune complication hémorragique sévère non contrôlable par des mesures d'hémostase locale n'est rapportée. Deux études [212,237] ont évalué la perte sanguine après extraction dentaire chez des patients sous aspirine ou clopidogrel comparativement à des patients ne prenant pas d'aspirine ou ayant interrompu leur traitement par AAP 7 jours avant la procédure dentaire ou sous AINS.…”

Section: Arrêt Ou Maintien Du Traitement Par Agent Antiplaquettaire ?unclassified

“…Aframian, 2007 [1], Ardekian, 2000 [24], Bajkin, 2012 [35], Bajkin, 2015[36], Brennan,2008[49],Canigral,2008 [54]Cardona-Tortajada, 2009 [56], Garnier, 2007 [113], Iwabuchi, 2014 [173], Krishman, 2008 [185], Lillis, 2011 [197], Madan, 2010 [204],] Medeiros, 2011 [212], Moritomoto, 2008a [223], Morimoto, 2011 [225], Napenas, 2009 [227], Olmos-Carrasco, 2015 [234], Park, 2012 [239], Partridge, 2008 [237], Rai, 2013 [248], van Diermen, 2009 [278], Verma, 2013 [280], Verma, 2014 [281] Etape 3 «Antiplatelet» OU " «Aspirin» OU «Dipyridamol» OU «Ticlopidin»OU«Clopidogrel»OU«Prasugrel»OU«Ticagrelor» "ET" « Dental implant »…”

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confidence: 99%

Gestion péri-opératoire des patients traités par antithrombotiques en chirurgie orale. Argumentaire

2015

Med Buccale Chir Buccale

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Exodontia and Antiplatelet Therapy

Cited by 66 publications

References 18 publications

An Assessment of the Incidence of Prolonged Postoperative Bleeding After Dental Extraction Among Patients on Uninterrupted Low Dose Aspirin Therapy and to Evaluate the Need to Stop Such Medication Prior to Dental Extractions

An Assessment of the Incidence of Prolonged Postoperative Bleeding After Dental Extraction Among Patients on Uninterrupted Low Dose Aspirin Therapy and to Evaluate the Need to Stop Such Medication Prior to Dental Extractions

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

Gestion péri-opératoire des patients traités par antithrombotiques en chirurgie orale. Argumentaire

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