Postoperative bleeding risk of direct oral anticoagulants after oral surgery procedures: a systematic review and meta-analysis.

@article{Bensi2018PostoperativeBR,
  title={Postoperative bleeding risk of direct oral anticoagulants after oral surgery procedures: a systematic review and meta-analysis.},
  author={Caterina Bensi and Stefano Belli and Daniele Paradiso and Giuseppe Lomurno},
  journal={International journal of oral and maxillofacial surgery},
  year={2018},
  volume={47 7},
  pages={
          923-932
        }
}
World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta-analysis.
TLDR
Results from the included studies did not discern any important differences in postoperative bleeding events in patients who continued versus patients who discontinued DOACs, and the low quality of the studies must be considered.
Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study
TLDR
DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction, and non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions.
Tranexamic acid and bleeding in patients treated with non-vitamin K oral anticoagulants undergoing dental extraction: The EXTRACT-NOAC randomized clinical trial
TLDR
In patients on NOACs undergoing dental extraction, TXA does not seem to reduce the rate of periprocedural or early postoperative oral bleeding compared to placebo, and TXA appears to reduce delayed bleeds and postoperative Oral bleeding if multiple teeth are extracted.
Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy
TLDR
Clinicians should carefully consider postoperative bleeding after dental extraction in patients taking anticoagulant therapy, especially rivaroxaban, according to the likelihood of bleeding after surgery.
Increasing Use of Anticoagulants in Germany and Its Impact on Hospitalization for Tooth Extraction.
TLDR
It was showed that the large increase in OAC treatment rates in general from 2006 to 2017 had only a small impact on hospitalized TE cases with long-term use of OAC which flattens since 2014.
A retrospective analysis of dental implantation under anticoagulant treatment
TLDR
It can be concluded that patients under oral anticoagulant treatment can undergo dental implantation safely and bleeding events are rare and can be controlled by local hemostasis.
RETROSPECTIVE EVALUATION OF CORRELATION OF POST EXTRACTION HEMORRHAGE AND ANTI COAGULANT THERAPIES IN YOUNGER POPULATION: A PREVALENCE BASED CLINICAL STUDY
TLDR
It is concluded that anti coagulant therapies are significantly affecting post operative bleeding in extraction cases and the relative severity and prevalence of bleeding are also exaggerated by time period of anti coAGulant therapy.
A review of drugs that contribute to bleeding risk in general dental practice.
TLDR
Dentists are provided with an updated overview of the drugs commonly encountered in general dental practice that can contribute to a patient's post-operative bleeding risk.
Influence of Medical and Geriatric Factors on Implant Success: An Overview of Systematic Reviews.
TLDR
This review suggests that the risk assessment for an implant patient should not be based on age, but rather on the patient's specific risk factors, such as former and current diseases and medication.
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Post-operative Bleeding Risk in Dental Surgery for Patients on Oral Anticoagulant Therapy: A Meta-analysis of Observational Studies
TLDR
Oat patients were under a higher post-operative bleeding risk than the non-OAT patients following minor dental surgery, and the NOACs might be safer than the vitamin K antagonists in dental implant surgery.
Pragmatic approach to manage new oral anticoagulants in patients undergoing dental extractions: a prospective case-control study
TLDR
Skipping the morning dose of NOACs avoids excess bleeding during and early after the procedure, however, anticoagulated patients had an increased risk of delayed bleedings.
What influence do anticoagulants have on oral implant therapy? A systematic review.
TLDR
Evidence does not support that dental implant placement in patients on OAT is contraindicated and OAT discontinuation is not recommended for minor oral surgery, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope.
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TLDR
Among patients undergoing low-to-moderate risk dental procedures while receiving direct-acting oral anticoagulant (DOAC) therapy, bleeding rates were low regardless of whether the DOAC was held or continued surrounding the procedure.
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TLDR
Patients on novel anticoagulant therapy requiring dental surgery can be managed appropriately either without discontinuation of therapy or a delay in dose, for those patients at higher risks of postoperative bleeding complications.
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TLDR
Based on the results of the different studies, apixaban seems to be a good alternative to conventional anticoagulation and a reasonable treatment option, though its main and most common adverse effect is bleeding.
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TLDR
The data support not stopping DOACs prior to dental treatment, regardless of the complexity or the extent of the procedure, and Dosage adaptation is recommended in patients with a history of spontaneous hemorrhage.
Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy
TLDR
According to the data, continued anticoagulation therapy with rivaroxaban significantly increases postoperative bleeding risk for oral surgical procedures, although the bleeding events were manageable.
Dental management of patients taking novel oral anticoagulants (NOAs): Dabigatran
TLDR
It is necessary to develop clinical guidelines for the perioperative and postoperative management of these new oral anticoagulants in oral surgical procedures, and to carefully evaluate the bleeding risk of dental treatment, as well as the thrombotic risk of suppressing the new oral anti-cancerant.
Managing patients taking novel oral anticoagulants (NOAs) in dentistry: a discussion paper on clinical implications
TLDR
The clinician has to consider that the number of patients taking NOAs is rapidly increasing, and the dentist must use caution and attention when treating patients taking dabigatran, rivaroxaban and apixaban.
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