World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta-analysis.

  title={World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta-analysis.},
  author={Maddalena Manfredi and Bella Dave and Daniela Percudani and Janina Christoforou and Jumana Karasneh and Pedro Diz Dios and Michael Glick and Navdeep Kumar and Peter B. Lockhart and Lauren L. Patton},
  journal={Oral diseases},
  volume={25 Suppl 1},
OBJECTIVES This systematic review aimed to evaluate the current literature regarding the importance of discontinuing or not discontinuing direct oral anticoagulants (DOACs) before invasive oral procedures, and to establish the frequency and type of postoperative bleeding events in patients. MATERIAL AND METHODS We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library up until November 5, 2018. Selection of the studies, extraction of data, qualitative, and bias assessment… 
Managing direct oral anticoagulants in accordance with the Scottish Dental Clinical Effectiveness Programme guidance for patients undergoing dentoalveolar surgery
The SDCEP guidance is safe to follow, with no patients experiencing major haemorrhage and consulting a medical specialist for patients with heart failure of likely significance, based on the medical or drug history, in addition to those who report an advanced heart failure diagnosis and the frail/older person could reduce the incidence of post-operative bleeding.
Bleeding Complications in Anticoagulated and/or Antiplatelet-Treated Patients at the Dental Office: A Retrospective Study
It is concluded that bleeding complications in anticoagulated and/or antiplatelet-treated patients after tooth extractions were low, with a higher incidence recorded in patients treated with NOACs, followed by classic antICOagulants, and there were no complications in antiplatelets- treated patients.
Tooth extraction without discontinuation of oral antithrombotic treatment: a prospective study.
Tooth extractions in patients on antithrombotic treatment were found to be free from significant bleeding although the involvement of more than 1 quadrant in the same procedure should be avoided.
Influence of Medical and Geriatric Factors on Implant Success: An Overview of Systematic Reviews.
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.
The current studies has not yet defined a specific protocol for these cases, but it provides valuable information for clinical, surgical and pharmacological conduct in such these situations.
Bleeding and Clotting Disorders
Diseases of the Cardiovascular System
Literature Review for Office-Based Anesthesia.


Management of Direct-Acting Oral Anticoagulants Surrounding Dental Procedures With Low-to-Moderate Risk of Bleeding
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.
Direct oral anticoagulants: A retrospective study of bleeding, behavior, and documentation.
Bleeding was not observed with direct oral anticoagulation use in this oral surgery cohort, and drug discontinuation/continuation was not a factor in bleeding outcomes, and direct oral anti-coagulation interruption was variable and poorly documented.
A Study of the Management of Patients Taking Novel Oral Antiplatelet or Direct Oral Anticoagulant Medication Undergoing Dental Surgery in a Rural Setting
The approaches taken by dental surgeons in Orkney in the management of the NOAPs and DOACs varied and this is likely to be a reflection of the limited literature available.
Pragmatic approach to manage new oral anticoagulants in patients undergoing dental extractions: a prospective case-control study
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.
Post-operative Bleeding Risk in Dental Surgery for Patients on Oral Anticoagulant Therapy: A Meta-analysis of Observational Studies
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.
Four-year cross-sectional study of bleeding risk in dental patients on direct oral anticoagulants.
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.
Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study
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.
Is it necessary to alter anticoagulation therapy for tooth extraction in patients taking direct oral anticoagulants?
In patients taking direct oral anticoagulants simple tooth extractions can be safely carried out without altering the anticaogulant regimen with the use of local hemostatic agents.