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Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis
INTRODUCTION: Safety of dental extractions in patients on chronic antiplatelet therapy either with only acetylsalicylic acid (ASA) or clopidogrel or with both combined has been a matter of debate, with no clearly conclusive studies published. AIM: To perform a meta-analysis of published observationa...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Termedia Publishing House
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488835/ https://www.ncbi.nlm.nih.gov/pubmed/31043987 http://dx.doi.org/10.5114/aic.2019.83773 |
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author | Zabojszcz, Michał Malinowski, Krzysztof P. Janion-Sadowska, Agnieszka Lillis, Theodoros Ziakas, Antonios Sławska, Agnieszka Janion, Marianna Siudak, Zbigniew |
author_facet | Zabojszcz, Michał Malinowski, Krzysztof P. Janion-Sadowska, Agnieszka Lillis, Theodoros Ziakas, Antonios Sławska, Agnieszka Janion, Marianna Siudak, Zbigniew |
author_sort | Zabojszcz, Michał |
collection | PubMed |
description | INTRODUCTION: Safety of dental extractions in patients on chronic antiplatelet therapy either with only acetylsalicylic acid (ASA) or clopidogrel or with both combined has been a matter of debate, with no clearly conclusive studies published. AIM: To perform a meta-analysis of published observational studies in order to study the effect of single and double antiplatelet therapy in comparison to controls on the occurrence of immediate local bleeding complications during dental extractions. MATERIAL AND METHODS: PubMed/Scopus/Embase database search revealed 22 papers (13 original and 9 review), 3 of which were finally included in the meta-analysis. Phrases searched: dual[All Fields] AND antiplatelet[All Fields] AND (“therapy”[Subheading] OR “therapy”[All Fields] OR “therapeutics”[MeSH Terms] OR “therapeutics”[All Fields]) AND (“tooth extraction”[MeSH Terms] OR (“tooth”[All Fields] AND “extraction”[All Fields]) OR “tooth extraction”[All Fields]). RESULTS: The overall event incidence (bleeding complication after extraction) in the entire population was 1.59% (42 events in 2637 patients). As compared to the control group, the use of double antiplatelet therapy DAPT was associated with on odd ratio OR of 40.23 (95% CI: 4.37–370.36) increase in risk of bleeding events occurrence (p = 0.0011). Significant heterogeneity was observed (p < 0.001; I (2) of 76.7%). CONCLUSIONS: Dental extractions following strict procedural protocols in patients on double antiplatelet therapy with clopidogrel and ASA are associated with an additional risk of immediate local bleeding complications. |
format | Online Article Text |
id | pubmed-6488835 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-64888352019-05-01 Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis Zabojszcz, Michał Malinowski, Krzysztof P. Janion-Sadowska, Agnieszka Lillis, Theodoros Ziakas, Antonios Sławska, Agnieszka Janion, Marianna Siudak, Zbigniew Postepy Kardiol Interwencyjnej Original Paper INTRODUCTION: Safety of dental extractions in patients on chronic antiplatelet therapy either with only acetylsalicylic acid (ASA) or clopidogrel or with both combined has been a matter of debate, with no clearly conclusive studies published. AIM: To perform a meta-analysis of published observational studies in order to study the effect of single and double antiplatelet therapy in comparison to controls on the occurrence of immediate local bleeding complications during dental extractions. MATERIAL AND METHODS: PubMed/Scopus/Embase database search revealed 22 papers (13 original and 9 review), 3 of which were finally included in the meta-analysis. Phrases searched: dual[All Fields] AND antiplatelet[All Fields] AND (“therapy”[Subheading] OR “therapy”[All Fields] OR “therapeutics”[MeSH Terms] OR “therapeutics”[All Fields]) AND (“tooth extraction”[MeSH Terms] OR (“tooth”[All Fields] AND “extraction”[All Fields]) OR “tooth extraction”[All Fields]). RESULTS: The overall event incidence (bleeding complication after extraction) in the entire population was 1.59% (42 events in 2637 patients). As compared to the control group, the use of double antiplatelet therapy DAPT was associated with on odd ratio OR of 40.23 (95% CI: 4.37–370.36) increase in risk of bleeding events occurrence (p = 0.0011). Significant heterogeneity was observed (p < 0.001; I (2) of 76.7%). CONCLUSIONS: Dental extractions following strict procedural protocols in patients on double antiplatelet therapy with clopidogrel and ASA are associated with an additional risk of immediate local bleeding complications. Termedia Publishing House 2019-04-04 2019 /pmc/articles/PMC6488835/ /pubmed/31043987 http://dx.doi.org/10.5114/aic.2019.83773 Text en Copyright: © 2019 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Zabojszcz, Michał Malinowski, Krzysztof P. Janion-Sadowska, Agnieszka Lillis, Theodoros Ziakas, Antonios Sławska, Agnieszka Janion, Marianna Siudak, Zbigniew Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title | Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title_full | Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title_fullStr | Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title_full_unstemmed | Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title_short | Safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
title_sort | safety of dental extractions in patients on dual antiplatelet therapy – a meta-analysis |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488835/ https://www.ncbi.nlm.nih.gov/pubmed/31043987 http://dx.doi.org/10.5114/aic.2019.83773 |
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