Why the study?
Patients requiring dental extractions frequently receive anticoagulant therapy, and the study aimed to clarify potential contraindications as well as short- and long-term complications.
Do direct oral anticoagulants reduce bleeding complications compared to vitamin K antagonists in patients undergoing multiple surgical dental extractions?
Do direct oral anticoagulants reduce bleeding complications compared to vitamin K antagonists in patients undergoing multiple surgical dental extractions?
Direct oral anticoagulants are associated with fewer bleeding complications than vitamin K antagonists in patients undergoing multiple dental extractions.
DOAC use during multiple extractions was associated with fewer bleeding events; leaves open need for RCTs before changing practice.
BACKGROUND: Due to technology and pharmaceutical science and increasing life expectancy, the patient population is continuously aging. Patients requiring dental extractions often have systemic and/or chronic diseases and are undergoing polypharmacologic therapy. Oral surgeons often interface with patients who perform anticoagulant therapy. The main aim of this study was to clarify what the contraindications and short-/long-term complications may be. METHODS: A sample of 298 patients (mean age 58 years) who required multiple surgical dental extractions has been taken in consideration. Patients were divided into groups and subgroups according to the anticoagulant drug therapy. RESULTS: Long-term complications represented variable bleeding between groups from 8 hours to 7 days after surgery. The One-Way ANOVA Test was used to compare the results between groups. Patients treated with direct oral anticoagulants showed fewer intraoperative problems, but further studies and further collaboration between doctors, cardiologists and oral dentists/surgeons are certainly needed to manage these patients in a predictable manner. CONCLUSIONS: This study showed that using direct oral anticoagulants drugs results in few intraoperative bleeding, less postoperative hemorrhagic complications, and an easier administration of the drugs respect vitamin K antagonists, with mild and manageable complications.
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Matarese et al. (2021) studied this question.
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