Investigating the Risk of Bleeding following Minor Oral and Dental Surgery in Patients Taking Oral Anticoagulants: A Meta-Analysis Study

The purpose of this study is to answer the following PICO question: "What is the risk of bleeding in patients who take oral anticoagulants and undergo oral surgery with or without discontinuation of antithrombotic therapy?" Accordingly, by conducting this systematic review, we aim to determine the risk of bleeding during and after dental surgery in patients receiving anticoagulation therapy, as well as provide guidance that will assist dental professionals in making informed clinical decisions.

In this meta-analysis study, we performed searches for eligible clinical trial studies in the Cochrane Library (Cochrane Central Unit for Controlled Trials) and Medline (Ovid and EMBASE) from the databases listed with the keywords oral surgery, extradontia and implants. We performed dental implants, the risk of bleeding events and their synonyms, and oral anticoagulants (vitamin K antagonists). Analyzes were performed for each anticoagulant and expected outcome. For studies that reported dichotomous outcomes, relative risk (RR) with 95% confidence interval was calculated. Random effects associated with meta-analysis were determined using STATA software (version 10/1).

One to three times higher risk of bleeding in patients taking warfarin compared to patients who stopped using anticoagulants during the operation (RR=1.67 and CI: 0.97-2-2.89) and after surgery (RR=1.44 and CI: 0.71-0.2-92) have shown.

There is a risk of bleeding during and after surgery in patients who do not discontinue their anticoagulant medication compared to patients who discontinue their medication during minor oral and dental surgery; however, the findings should be interpreted with caution and new studies on this topic should be initiated.