Antiplatelets, Anticoagulants and Its Implications in Dentistry-A Review of Literature
Journal of Pharmaceutical Research International,
Page 134-146
DOI:
10.9734/jpri/2020/v32i2530835
Abstract
Oral health care providers must be aware of the impact of bleeding disorders on their patients during any dental procedure and management of such mishaps. Adequate knowledge of the mechanisms underlying hemostasis, and the optimised management of such patients, are therefore very important for these issues. Initial recognition of a bleeding disorder, in such patients with a systemic pathologic process, may occur in dental practice. The dental treatment of these patients might get complicated during the course of the treatment due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in the daily practice of dental professionals. Adequate hemostasis is critical for the success of any invasive dental procedure, because bleeding problems can give rise to complications associated with important morbidity-mortality. Besides, prophylactic, restorative and surgical dental care of patients with any bleeding disorders is handled skilfully by practitioners who are well educated regarding the pathology, complications which could arise and treatment options associated with these conditions. The purpose of this paper is to review common bleeding disorders and their effects on the dental aspect. Many authors consider that patient medication indicated for the treatment of background disease should not be altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown to suffice for controlling possible bleeding problems resulting from dental treatment.
Keywords:
- Tooth extraction
- oral surgery
- hemostasis
- platelet aggregation inhibitors
- antiplatelet drugs
- anticoagulants
- warfarin.
How to Cite
Ganapathi, A., & Vijayakumar, J. (2020). Antiplatelets, Anticoagulants and Its Implications in Dentistry-A Review of Literature. Journal of Pharmaceutical Research International, 32(25), 134-146. https://doi.org/10.9734/jpri/2020/v32i2530835
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Meechan JG, Greenwood M. General medicine and surgery for dental practitioners Part 9: haematology and patients with bleeding problems. Br Dent J. 2003;195(6):305–10.
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Mansour D, McPherson S. Management of decompensated cirrhosis. Clin Med. 2018; 18(2):60–5.
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Adeyemo TA, Adeyemo WL, Adediran A, Akinbami AJA, Akanmu AS. Orofacial manifestations of hematological disorders: Anemia and hemostatic disorders. Indian J Dent Res. 2011;22(3):454–61.
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Senthil Kumar MS, Ramani P, Rajendran V, Lakshminarayanan P. Inflammatory pseudotumour of the maxillary sinus: Clinicopathological report. Oral Surg. 2019; 12(3):255–9.
Wahab PUA, Madhulaxmi M, Senthilnathan P, Muthusekhar MR, Vohra Y, Abhinav RP. Scalpel versus diathermy in wound healing after mucosal incisions: A split-mouth study. J Oral Maxillofac Surg. 2018;76(6):1160–4.
JPC, Marimuthu T, CK, Devadoss P, Kumar SM. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study. Clin Implant Dent Relat Res. 2018;20(4):531– 4.
Eapen BV, Baig MF, Avinash S. An assessment of the incidence of prolonged postoperative bleeding after dental extraction among patients on uninterrupted low dose aspirin therapy and to evaluate the need to stop such medication prior to dental extractions. J Maxillofac Oral Surg. 2017;16(1):48–52.
Marimuthu M, Andiappan M, Wahab A, Muthusekhar MR, Balakrishnan A, Shanmugam S. Canonical Wnt pathway gene expression and their clinical correlation in oral squamous cell carcinoma. Indian J Dent Res. 2018;29(3): 291–7.
Jain M, Nazar N. Comparative evaluation of the efficacy of intraligamentary and supraperiosteal injections in the extraction of maxillary teeth: A randomized controlled clinical trial. J Contemp Dent Pract. 2018; 19(9):1117–21.
Abhinav RP, Selvarasu K, Maheswari GU, Taltia AA. The patterns and etiology of maxillofacial trauma in South India. Ann Maxillofac Surg. 2019;9(1):114–7.
Sweta VR, Abhinav RP, Ramesh A. Role of virtual reality in pain perception of patients following the administration of local anesthesia. Ann Maxillofac Surg. 2019;9(1):110–3.
Abdul Wahab PU, Senthil Nathan P, Madhulaxmi M, Muthusekhar MR, Loong SC, Abhinav RP. Risk factors for post-operative infection following single piece osteotomy. J Maxillofac Oral Surg. 2017; 16(3):328–32.
Ramadorai A, Ravi P, Narayanan V. Rhinocerebral mucormycosis: A prospective analysis of an effective treatment protocol. Ann Maxillofac Surg. 2019;9(1):192–6.
Patil SB, Durairaj D, Suresh Kumar G, Karthikeyan D, Pradeep D. Comparison of extended nasolabial flap versus buccal Fat pad graft in the surgical management of oral submucous fibrosis: A prospective pilot study. J Maxillofac Oral Surg. 2017; 16(3):312–21.
Sugerman DT. Blood thinners. JAMA. 2013;310(23):2579–80.
Garmo C, Bajwa T, Burns B. Physiology, clotting mechanism. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
Dym H, Ogle O. Oral surgery for the general dentist, an issue of dental clinics. Elsevier Health Sciences. 2012;240.
Cañigral A, Silvestre FJ, Cañigral G, Alós M, Garcia-Herraiz A, Plaza A. Evaluation of bleeding risk and measurement methods in dental patients. Med Oral Patol Oral Cir Bucal. 2010;15(6):863–8.
Eikelboom JW, Hirsh J, Spencer FA, Baglin TP, Weitz JI. Antiplatelet drugs: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):89 –119.
Davì G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med. 2007; 357(24):2482–94.
Koenig-Oberhuber V, Filipovic M. New antiplatelet drugs and new oral anticoagulants. Br J Anaesth. 2016;117(2): 74–84.
Napeñas JJ, Oost FCD, DeGroot A, Loven B, Hong CHL, Brennan MT, et al. Review of postoperative bleeding risk in dental patients on antiplatelet therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 115(4):491–9.
Napeñas JJ, Hong CHL, Brennan MT, Furney SL, Fox PC, Lockhart PB. The frequency of bleeding complications after invasive dental treatment in patients receiving single and dual antiplatelet therapy. J Am Dent Assoc. 2009; 140(6):690–5.
van Diermen DE, van der Waal I, Hoogstraten J. Management recommenda-tions for invasive dental treatment in patients using oral antithrombotic medication, including novel oral anticoagulants. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(6):709–16.
van Diermen DE, Aartman IHA, Baart JA, Hoogstraten J, van der Waal I. Dental management of patients using antithrombotic drugs: Critical appraisal of existing guidelines. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(5):616–24.
Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: A systematic review and meta-analysis. J Can Dent Assoc. 2009;75(1):41.
Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6):299–339.
Armstrong MJ, Gronseth G, Anderson DC, Biller J, Cucchiara B, Dafer R, et al. Summary of evidence-based guideline: periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease: Report of the guideline development subcommittee of the American academy of neurology. Neurology. 2013;80(22):2065–9.
Perry DJ, Noakes TJC, Helliwell PS, British dental society. Guidelines for the management of patients on oral anticoagulants requiring dental surgery. Br Dent J. 2007;203(7):389–93.
Institute of Medicine, Board on Health Care Services, Committee on Identifying and Preventing Medication Errors. Preventing medication errors. National Academies Press. 2007;480.
Alaali Y, Barnes GD, Froehlich JB, Kaatz S. Management of oral anticoagulation in patients undergoing minor dental procedures. J Mich Dent Assoc. 2012; 94(8):36–41.
Weltman NJ, Al-Attar Y, Cheung J, Duncan DPB, Katchky A, Azarpazhooh A, et al. Management of dental extractions in patients taking warfarin as anticoagulant treatment: A systematic review. J Can Dent Assoc. 2015;81:20.
Grines CL, Bonow RO, Casey DE, Gardner TJ, Lockhart PB, Moliterno DJ, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: A science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007;49(6):734–9.
Grines CL, Bonow RO, Casey DE Jr. Society for cardiovascular angiography and interventions. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: A science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007;49(6):734–9.
Alexopoulos D, Katogiannis K, Sfantou D, Lekakis J. Combination antiplatelet treatment in coronary artery disease patients: A necessary evil or an overzealous practice? Platelets. 2018; 29(3):228–37.
Decker SH, Pyrooz DC. The handbook of gangs. John Wiley & Sons; 2015;592.
Sherman DG, Dyken ML, Gent M, Harrison MJG, Hart RG, Mohr JP. Antithrombotic therapy for cerebrovascular disorders [Internet]. Chest. 1995;108:444– 456S. Available:http://dx.doi.org/10.1378/chest.108.4_supplement.444s
Members AF, Authors/Task Force Members, Graham I, Atar D, Borch-Johnsen K, Boysen G, et al. European guidelines on cardiovascular disease prevention in clinical practice. Executive summary: Fourth joint task force of the European society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) [Internet]. European Heart Journal. 2007;28:2375–414. Available:http://dx.doi.org/10.1093/eurheartj/ehm316
Moher D, Liberati A, Tetzlaff J, Altman DG, for the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement [Internet]. BMJ. 2009;339:2535–b2535.
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