[Dental and oral surgical treatment of medication-induced bleeding patients: Audit of the national guideline in Hungary]

Orv Hetil. 2016 Oct;157(43):1722-1728. doi: 10.1556/650.2016.30568.
[Article in Hungarian]

Abstract

Introduction: In 2015 a new Hungarian guideline was published regarding dental treatment and management of anticoagulated patients in agreement of the Hungarian Association of Oral and Maxillofacial Surgeons and the Dental Implantology Association of Hungarian Dentists.

Aim: The aim of the authors was to evaluate the efficiency and safety of local hemostatic measures recommended by the guideline in anticoagulated patients.

Method: In these patients, postoperative bleeding episodes were examined after dental and oral surgical treatments, retrospectively.

Results: Overall 263 bleeding risk cases were treated; 138 patients with vitamin K antagonists, 97 patients with antiplatelet therapy and 6 patients with novel oral anticoagulants. Six patients (2.3%) had minor postoperative bleeding after the "one hour control", while one patient needed a night duty support (0.5%). In contrast, 86 patients who were treated in rural practices neglecting the guideline attended the night duty with postoperative bleeding (3 patients treated with vitamin K antagonists, 24 patients taking low molecular weight heparin, 30 patients receiving antiplatelet therapy and one patient on novel oral anticoagulant therapy.

Conclusions: The Hungarian guideline can be applied safely, without increasing the risk of postoperative bleeding, however, rural dental practices are frequently unprepared for these treatments. Orv. hetil., 2016, 157(43), 1722-1728.

Keywords: K-vitamin-antagonista; anti-platelet therapy; anticoagulation; antithrombotic treatment; antithromboticus kezelés; dental-; fogorvosi-szájsebészeti ellátás; novel oral anticoagulants; oral surgical treatment; thrombocytaaggregáció-gátló; utóvérzés; vitamin K antagonist; új típusú orális antikoaguláns.

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Blood Loss, Surgical / prevention & control*
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / adverse effects*
  • Humans
  • Hungary
  • Male
  • Oral Surgical Procedures / adverse effects*
  • Postoperative Hemorrhage / chemically induced*
  • Postoperative Hemorrhage / therapy
  • Retrospective Studies
  • Thromboembolism / prevention & control*
  • Tooth Extraction / adverse effects
  • Vitamin K / administration & dosage

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Vitamin K