ORIGINAL ARTICLE   

Minerva Dental and Oral Science 2021 October;70(5):196-205

DOI: 10.23736/S2724-6329.21.04551-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

A cohort study on anticoagulant therapy risks in dental patients after multiple extractions

Marco MATARESE ^{1, 2}, Gabriele CERVINO ¹, Luca FIORILLO ^{1, 3} ✉, Carmelo STELITANO ¹, Martina IMBESI BELLANTONI ¹, Aida METO ⁴, Alberta GRECO LUCCHINA ⁵, Flavio A. TORNELLO ⁶, Michele RUNCI ANASTASI ^{2, 7}, Carlo RENGO ⁸

¹ School of Dentistry, Department of Biomedical and Dental Sciences, Morphological and Functional Images, G. Martino Polyclinic, University Hospital of Messina, Messina, Italy; ² IRCCS Centro Neurolesi “Bonino-Pulejo,” Messina, Italy; ³ Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy; ⁴ Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, Tirana, Albania; ⁵ Saint Camillus International University of Health Sciences, Rome, Italy; ⁶ Private Practitioner, Grammichele, Catania, Italy; ⁷ Department of Maxillo-Facial Surgery, Sapienza University, Rome, Italy; ⁸ Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy

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.

KEY WORDS: Surgery, oral; Quality of life; Hemorrhage; Anticoagulants