Impact of continued antithrombotic use on bleeding risk in oral surgery- a retrospectively study in a population patients treated in a Korean university hospital

Background/purpose: With the growing elderly population and their increasing prevalence of systemic diseases, the use of antithrombotic medications is on the rise. These medications are essential for preventing thromboembolic events in patients with cardiovascular, cerebrovascular diseases. However, their use poses challenges in dental surgeries, where the risk of postoperative bleeding needs to be carefully balanced against the risks of discontinuing antithrombotic therapy. This study aimed to assess whether continuing antithrombotic therapy increases the risk of postoperative bleeding during dental procedures. Materials and methods: Retrospective analysis was conducted on 118 patients who underwent oral surgeries, including extractions and dental implants. Patients were categorized based on whether they continued or discontinued antithrombotic therapy before the procedure. Data on age, sex, type of antithrombotic agent, and occurrence of delayed bleeding were collected. Multiple regression analysis was used to identify potential risk factors for postoperative bleeding. Results: Of the 118 patients, 78 continued antithrombotic therapy, while 40 discontinued it. Delayed postoperative bleeding occurred in 10 patients (8.47 %), with no statistically significant difference between those who continued and those who discontinued their medication. The type of antithrombotic agent, interaction between drug cessation and procedure, preoperative platelet count, prothrombin time, and partial thromboplastin time did not significantly affect the incidence of bleeding. Conclusion: Continuing antithrombotic therapy does not significantly increase the risk of postoperative bleeding in patients undergoing oral surgeries. Dental practitioners can consider maintaining antithrombotic therapy during certain procedures, emphasizing the importance of balancing bleeding risks with the potential for thromboembolic events.