Warfarin anticoagulant therapy

Bailey, B M; Fordyce, April

doi:10.1038/sj.bdj.4805348

Cited by 6 publications

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“…), (ii) Suspending oral anticoagulants and administering heparin before dental treatment (Mehra et al. ; Johnson‐Leong & Rada ), (iii) Reducing (without suspending) the anticoagulant therapy (Bailey & Fordyce , ) and (iv) Maintaining unchanged the anticoagulant treatment and applying different local hemostatic measures at the site of the surgery (Martinowitz et al. ; Zanon et al.…”

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confidence: 99%

“…In the field of minor oral surgery (tooth extractions, osteotomies, periodontal surgical procedures) several approaches for patients under anticoagulation therapy (AT) have been suggested, including: (i). Suspending oral anticoagulant therapy for several days (Al-Mubarak et al 2006;Kammerer et al 2015), (ii) Suspending oral anticoagulants and administering heparin before dental treatment (Mehra et al 2000;Johnson-Leong & Rada 2002), (iii) Reducing (without suspending) the anticoagulant therapy (Bailey & Fordyce 1983, 1984 and (iv) Maintaining unchanged the anticoagulant treatment and applying different local hemostatic measures at the site of the surgery (Martinowitz et al 1990;Zanon et al 2003;Al-Mubarak et al 2006;Kammerer et al 2015).…”

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confidence: 99%

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Management of anticoagulated patients in implant therapy: a clinical comparative study

Clemm

Neukam

Rusche

et al. 2015

Clinical Oral Implants Res

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confidence: 99%

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Management of anticoagulated patients in implant therapy: a clinical comparative study

Clemm

Neukam

Rusche

et al. 2015

Clinical Oral Implants Res

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“…However, this interference in the continuous anticoagulant therapy may cause an unpredictable exponential decrease in INR (13, 15, 32, 37–39, 50, 73). The interval without functional anticoagulation may expose the patient to the thrombotic state for which anticoagulation was initially instituted (68, 93) and incur a high risk of adverse thromboembolic events including embolic stroke, myocardial ischaemia or even death (19, 20, 22, 56, 68–70, 73, 75, 77, 80, 86, 89, 91). Several studies with a relatively small sample of patients reported no case of thromboembolism following suspension of the oral anticoagulant (32, 37, 38, 45, 49, 50, 63, 65).…”

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confidence: 99%

The dental patient on oral anticoagulant medication: a literature review

Kosyfaki

Strub

2010

Journal of Oral Rehabilitation

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Specific diseases and medications may considerably influence the delivery of oral care and the course of dental therapy. The purpose of this literature review is to examine the relationship between oral anticoagulant medication and dental treatment. Electronic and manual searches were conducted for clinical studies in the English literature for the years 1988-2010. The review process provided a total of 110 pertinent literature references, out of which 38 studies dealt with oral anticoagulants and dental treatment. Different treatment strategies relative to dental periprocedural anticoagulation regimens have been identified, and their accompanying thromboembolic and bleeding risks are being presented and discussed. Regarding to what extent a safe and successful dental treatment in patients on anticoagulant medication is feasible, the level of evidence is lacking. Until high-level data are provided, an individualised treatment approach after consultation with the physician of the patient is highly recommended.

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“…direct oral anticoagulants), the coumarin derivative and vitamin K antagonist Phenprocomoun (Marcumar®), is still widely used for the prevention of thromboembolic events in atrial fibrillation or following heart valve replacement or pulmonary embolism. There are widely discussed approaches to the management of vitamin K antagonists prior to oral surgery: suspension for several days [ 2 , 5 ], temporary bridging with heparin [ 6 , 7 ], reducing the dosage without bridging [ 8 , 9 ] or unchanged dosages and hemostasis by local hemostatic measures [ 2 , 5 , 10 , 11 ]. Heparin offers the advantage of a good controllability due to its short half-life [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication

et al. 2021

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Background The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin. Methods A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/osteotomy/combined extraction and osteotomy) and the prothrombin time. Results In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG versus VG p = 0.004; CG versus BG p < 0.001, BG versus VG p < 0.001. A significant correlation of number of the extracted teeth in the BG (p = 0.014) and no significance in VG (p = 0.298) and CG (p = 0.210) and in the BG versus VG and CG with p < 0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time. Conclusions Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well-coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences.

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Warfarin anticoagulant therapy

Cited by 6 publications

References 0 publications

Management of anticoagulated patients in implant therapy: a clinical comparative study

Management of anticoagulated patients in implant therapy: a clinical comparative study

The dental patient on oral anticoagulant medication: a literature review

Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication

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