Objectives: Continuation of anticoagulant therapy in patients undergoing dentoalveolar surgery is recommended because of the risk for thromboembolic events. Little information is available about the incidence of rebleeding in these patients. The objective of this study was to evaluate the incidence of rebleeding after dentoalveolar surgery in patients receiving anticoagulant therapy and compare this to patients without anticoagulant therapy.
Materials and methods: 206 patients were included from which 103 were on anticoagulant therapy and 103 received no anticoagulant therapy. From the patients on anticoagulant therapy 71 used thrombocyte aggregation inhibitors and 32 used coumarin derivatives. The surgery consisted of dental extraction, apicoectomy or implant placement. The patients received standard postoperative care and the wounds were closed with absorbable sutures. Tranexamic acid mouthwash was used postoperatively by the patients receiving coumarin derivatives.
Results: From the 103 patients on anticoagulant therapy, seven suffered from a mild rebleeding after dentoalveolar surgery (6.8%). The patients that used coumarin derivatives had a mean INR of 2.6 (1.9–3.4). In this group three mild rebleedings occurred (9.4%). In the group that used thrombocyte aggregation inhibitors four mild rebleedings were reported (5.6%). In the control group without anticoagulant therapy two patients suffered from a mild rebleeding (1.9%). All bleedings were controlled by the patients themselves with a compressive gauze. In none of the patients a severe rebleeding requiring medical intervention was seen.
Conclusion: These results show that continuation of anticoagulant therapy during dentoalveolar surgery leads to a higher percentage of mild rebleedings. However, no severe rebleedings were reported and therefore we conclude that it is safe to perform dentoalveolar surgery in patients receiving anticoagulant therapy.