Key result
Continuation of single or dual antiplatelet therapy during minor oral surgical procedures resulted in no postoperative bleeding within 24 hours when appropriate local hemostatic measures were applied.
Why the study?
Discontinuing antiplatelet therapy during dental treatment increases thrombotic risk, whereas continuation may increase postoperative bleeding, creating ongoing debate.
Does continuing single or dual antiplatelet therapy increase the risk of bleeding in patients undergoing minor oral surgical procedures compared to healthy controls?
Cross-Sectional (n=200)
No
Does continuing single or dual antiplatelet therapy increase the risk of bleeding in patients undergoing minor oral surgical procedures compared to healthy controls?
Minor oral surgical procedures can be safely accomplished in patients receiving single or dual antiplatelet therapy without discontinuation when appropriate local hemostatic measures are taken.
Answers are grounded in this paper and cite their sources.
May support continuing antiplatelet therapy in minor oral surgery with local measures; leaves open need for randomized confirmation.
Background: Dental treatment in patients on antiplatelet drug therapy is a long standing debate. Discontinuation of medication increases the risk of thrombotic complications, whereas continuation leads to increased postoperative bleeding. Aim: We conducted this prospective cross-sectional study to assess risk of bleeding in patients continuing antiplatelet medication while performing minor oral surgical procedures such as single or multiple teeth extraction, transalveolar extraction of third molar, biopsy, and alveoloplasty. Materials and Methods: We calibrated the steps taken to achieve hemostasis, time taken to arrest bleeding, and correlated time taken to achieve hemostasis in patients under antiplatelet drug therapy (Group A [n = 64] - aspirin, Group B [n = 36] - aspirin and clopidogrel) and in patients without any drug therapy (Group C [n = 100] healthy patients). Results: Out of 200 patients, Level 1 hemostatic measures were required for 129 (64.5%) patients, Level 2 hemostatic measures were taken for 68 (34.0%) patients, and Level 3 hemostatic measures were taken for 3 (1.5%) patients. Chi-square test conducted to compare the local hemostatic measures taken for minor oral surgical procedure for all groups was statistically significant ( P ≤ 0.001). Conclusion: Overall, there was no postoperative bleeding within 24 h of extraction in any patient group. In conclusion, surgical procedures can be safely accomplished in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken.
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Kumar et al. (2021) conducted a cross-sectional in Minor oral surgical procedures (n=200). Antiplatelet therapy (aspirin and/or clopidogrel) vs. No antiplatelet therapy was evaluated on Postoperative bleeding within 24 hours. Continuation of single or dual antiplatelet therapy during minor oral surgical procedures resulted in no postoperative bleeding within 24 hours when appropriate local hemostatic measures were applied.
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