Systematic review on the effects of the discontinuation of the anticoagulant therapy and the postoperative bleeding, in patients under new oral anticoagulants after dental extraction

Abstract

Background: The present systematic review compares the effects of the discontinuation of the anticoagulant therapy and the postoperative bleeding, in patients under new oral anticoagulants after dental extraction. The purpose of this study is to determine the postoperative complications of the DOACs after a simple dental extraction in comparison to the VKAs and with patients not under anticoagulants. This study aims to determine the postoperative complications of the DOACs in the case of an alteration of the anticoagulant regimen before a dental extraction. Material and Methods: The electronic search was conducted on two databases (MedLine complete and Scopus). The research included patients under DOACs undergoing simple dental extraction. The inclusion criteria included randomized controlled trials, cohort studies, case series, retrospective cohort, prospective cohort and studies on human individuals. Results: 7 studies were selected, complying to all the inclusion criteria. 931 patients were treated. The bleeding rate was ranging from none, minor, moderate. All the studies included a postoperative follow up from the day of the surgery. The bleeding is immediate and minor after a dental extraction for patients under DOACs, VKAs and with no-OAT. Conclusions: The most frequent postoperative complication for patients under DOACs and patients under VKAs after a simple dental extraction is minor bleeding: immediate or delayed. DOACs seem to be a safe drug and do not require the discontinuation/alteration of the therapy for a simple dental extraction. Further studies are required to determine if surgical procedures in dentistry require an alteration of the DOAC regimen