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Research article
Mayte Buchbender
Universitatsklinikum Erlangen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8295-9714
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin.
Methods: A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/ osteotomy/ combined extraction and osteotomy) and the prothrombin time.
Results: In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG vs.VG p=0.004; CG vs. BG p<0.001, BG vs.VG p<0.001. A significant correlation of number of the extracted teeth in the BG (p=0.014) and no significance in VG (p=0.298) and CG (p=0.210) and in the BG vs. VG and CG with p<0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time.
Conclusion: Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well- coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences. Key words:
Keywords
anticoagulation therapy, bleeding, bridging with heparin, vitamin K antagonist
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View the published article at BMC Oral Health.
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Posted 21 Jan, 2021
No community comments so far
Reviewer #2 agreed
On 19 Jan, 2021
Reviewers invited
Invitations sent on 14 Jan, 2021
Reviewer #1 agreed
On 14 Jan, 2021
Review #1 received
Received 14 Jan, 2021
Editor assigned
On 09 Jan, 2021
Submission checks complete
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Reviewer #2 agreed
On 30 Dec, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #1 agreed
On 02 Sep, 2020
Editor assigned
On 14 Aug, 2020
Reviewers invited
Invitations sent on 14 Aug, 2020
Submission checks complete
On 13 Aug, 2020
Editor invited
On 13 Aug, 2020
First submitted
On 06 Aug, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Oral Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Mayte Buchbender
Universitatsklinikum Erlangen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8295-9714
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Oral Health.
Version 2
Posted 21 Jan, 2021
No community comments so far
Reviewer #2 agreed
On 19 Jan, 2021
Reviewers invited
Invitations sent on 14 Jan, 2021
Reviewer #1 agreed
On 14 Jan, 2021
Review #1 received
Received 14 Jan, 2021
Editor assigned
On 09 Jan, 2021
Submission checks complete
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Reviewer #2 agreed
On 30 Dec, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #1 agreed
On 02 Sep, 2020
Editor assigned
On 14 Aug, 2020
Reviewers invited
Invitations sent on 14 Aug, 2020
Submission checks complete
On 13 Aug, 2020
Editor invited
On 13 Aug, 2020
First submitted
On 06 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Oral Health.
Background: The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin.
Methods: A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/ osteotomy/ combined extraction and osteotomy) and the prothrombin time.
Results: In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG vs.VG p=0.004; CG vs. BG p<0.001, BG vs.VG p<0.001. A significant correlation of number of the extracted teeth in the BG (p=0.014) and no significance in VG (p=0.298) and CG (p=0.210) and in the BG vs. VG and CG with p<0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time.
Conclusion: Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well- coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences. Key words:
Figure 1
Figure 2
Figure 3
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