Local haemostatic measures after tooth removal in patients on antithrombotic therapy: a systematic review

Clinical Oral Investigations
Anna OckermanReinhilde Jacobs

Abstract

The interruption of antithrombotics prior to tooth removal because of the fear of bleeding or following postoperative bleeding increases the risk of thromboembolic events. The aim of this systematic review was to investigate which local haemostatic measures can effectively prevent postoperative bleeding in patients continuing oral antithrombotics. A systematic review was conducted by running a search in PubMed, Embase, Web of Science and Cochrane Library. Clinical randomised trials investigating bleeding and haemostatics after tooth removal in patients on antithrombotics were identified. In total, 15 articles were included. The investigated haemostatics included gauze pressure, tranexamic acid-soaked gauze, sponges, glue, calcium sulfate, plant extract Ankaferd Blood Stopper, epsilon-aminocaproic acid and tranexamic acid. In patients treated with vitamin K antagonists, tranexamic acid mouthwash significantly reduced bleeding compared to placebo. Further, histoacryl glue was proven better than gelatin sponges. Other studies failed to show significant differences between haemostatics, but bleeding events were low. Tranexamic acid seems to effectively reduce bleeding, although its superiority to other haemostatics was not proven. ...Continue Reading

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Citations

Jan 30, 2020·Special Care in Dentistry : Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry·Anitha SantoshAdesh Kakade
Aug 20, 2020·JBI Evidence Synthesis·Johana Alejandra Moreno-DradaMauro Henrique Nogueira Guimarães de Abreu
May 18, 2021·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Johana Alejandra Moreno-DradaMauro Henrique Nogueira Guimarães de Abreu

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