Antiplatelet drugs, Anticoagulants and Dental Treatment: A Review Article
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Published:
Dec 28, 2018
Keywords:
Antiplatelet drugs Anticoagulants Dental Treatment
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Abstract
Antiplatelet drugs and anticoagulants play an important role in cardiovascular disease therapy especially prevention of thromboembolism in vein, lung and brain which can lead to ischemic stroke. Patients receiving these drugs are prone to have bleeding problems that effect dental procedures. This article reviews antiplatelet drugs and anticoagulants with respect to their mechanism of action, medical uses, studies of bleeding in oral surgery and proper dental treatment planning.
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How to Cite
1.
Chiang-ngernthanyakun kittanut. Antiplatelet drugs, Anticoagulants and Dental Treatment: A Review Article. Khon Kaen Dent J [Internet]. 2018 Dec. 28 [cited 2024 Apr. 25];21(2):189-204. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/163720
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Section
Review Article
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการลงตีพิมพ์ในวิทยาสารทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นถือเป็นลิขสิทธิ์เฉพาะของคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่น หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด ๆ จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษร จากคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นก่อนเท่านั้น
References
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2. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:521–643.
3. Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. on behalf of the American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42.
4. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014;64–76.
5. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; DOI: 10.1161/CIR.0000000000000503
6. Yeung J, Holinstat M. Newer agents in antiplatelet therapy: a review. J Blood Med 2012;3:33–42
7. Hall R, Mazer CD. Antiplatelet Drugs: A Review of Their Pharmacology and Management in the Perioperative Period. Anesth Analg 2011;112(2):292–318
8. Vane JR, Botting RM. The mechanism of action of aspirin. Thromb Res 2003;110(5-6):255-8
9. Ardekian L, Gaspar R, Peled M, Brener B, Laufer D. Does low-dose aspirin therapy complicate oral surgical procedure? JADA 2000;131(3):331-5
10. Chamnarnphol N. Antiplatelet Therapy in the Patient with Coronary Stent Undergoing Surgery and Dental Procedure. Songkla Med J 2011;29(2):77-87
11. Brennan MT, Valerin MA, Noll JL, Napeñas JJ, Kent ML, Fox PC, et al. Aspirin Use and Post-operative Bleeding from Dental Extractions. J Dent Res 2009;87(8):740-4.
12. Cardona-Tortajada F, Sainz-Gómez E, Figuerido-Garmendia J, de Robles-Adsuar AL, Morte-Casabó A, Giner-Muñoz F, et al. Dental extractions in patients on antiplatelet therapy. A study conducted by the Oral Health Department of the Navarre Health Service (Spain). Med Oral Patol Oral Cir Bucal 2009;14(11):588-92
13. Napeñas JJ, HL Hong C, Brennan MT, Furney SL, Fox PC, Lockhart PB. The Frequency of Bleeding Complications After Invasive Dental Treatment in Patients Receiving Single and Dual Antiplatelet Therapy. J Am Dent Assoc 2009; 140(6):690-5
14. Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 2: Coagulopathies from drugs. Br Dent J 2003;195(9):495-500.
15. Sánchez-Palomino P, Sánchez-Cobo P, Rodriguez-Archilla A, González-Jaranay M, Moreu G, Calvo-Guirado JL, et al. Dental extraction in patients receiving dual antiplatelet therapy. Med Oral Patol Oral Cir Bucal 2015;20(5):616-20.
16. Ouellet N, Riendeau D, Percival MD. A high level of cyclooxygenase-2 inhibitor selectivity is associated with a reduced interference of platelet cyclooxygenase-1 inactivation by aspirin. PNAS 2001;98(25):14583-8.
17. Catella-Lawson F, Reilly MP, Kapoor SC, Cucchiara AJ, Demacro S, Tournier B, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001; 345(25):1809-17.
18. Kurth T, Glynn RJ, Walker AM, Chan KA, Buring JE, Hennekens CH, et al. Inhibition of Clinical Benefits of Aspirin on First Myocardial Infarction by Non steroidal Antiinflammatory Drugs. Circulation 2003;108(10):1191-5.
19. Kimmel SE, Berlin JA, Reilly N, Jaskowiak J, Kishel L, Chittams J, et al. The Effects of Nonselective Non-Aspirin Non-Steroidal Anti-Inflammatory Medications on the Risk of Nonfatal Myocardial Infarction and Their Interaction with Aspirin. Am Coll Cardiol 2004;43(6):985–90
20. MacDonald TM, Wei L. Is there an Interaction between the Cardiovascular Protective Effects of Low-Dose Aspirin and Ibuprofen? Basic Clin Pharmacol Toxicol 2006;98(3):275–80
21. Yokoyama H, Ito N, Soeda S, Ozaki M, Suzuki Y, Watanabe M, et al. Influence of non-steroidal anti-inflammatory drugs on antiplatelet effect of Aspirin. J Clin Pharm Ther 2013;38(1):12-5
22. Krishnaswamy A, Lincoff AM, Cannon CP. The Use and Limitations of Unfractionated Heparin. Crit Pathways in Cardiol 2010;9(1):35–40.
23. Gray E, Mulloy B1, Barrowcliffe TW. Heparin and low-molecular-weight heparin. Thromb Haemost 2008;99(5): 807–18.
24. Bounameux H, DeMoerloose P. Is laboratory monitoring of low-molecular-weight heparin therapy necessary? No. J Thromb Haemost 2004;2(4):551–4.
25. Hirsh J, Fuster V, Ansell J, Halperin JL. American Heart Association/American College of Cardiology Foundation Guide to Warfarin Therapy. J Am Coll Cardiol 2003;41(9):1633–52.
26. Becker DE. Antithrombotic Drugs: Pharmacology and Implications for Dental Practice. Anesth Prog 2013;60(2): 72–80.
27. Morimoto Y, Niwa H, and Minematsu K. Hemostatic Management of Tooth Extractions in Patients on Oral Antithrombotic Therapy. J Oral Maxillofac Surg 2008;66(1): 51-7.
28. Blinder D, Manor Y, Martinowitz U, and Taicher S. Dental extractions in patients maintained on oral anticoagulant therapy: Comparison of INR value with occurrence of postoperative bleeding. Int J Oral Maxillofac Surg 2001 30(6):518–21.
29. Wahl MJ, Pinto A, Kilham J, Lalla RV. Dental surgery in anticoagulated patients - stop the interruption. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119(2):136-57.
30. Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs. Dental Clinical Guidance 2015.
31. Ghaswalla PK, Harpe SE, Tassone D, Slattum PW. Warfarin–Antibiotic Interactions in Older Adults of an Outpatient Anticoagulation Clinic. Am J Geriatr Pharmacother 2012;10(6):352–60.
32. Goodchild JH, Donaldson M. A clinically significant drug interaction between warfarin and amoxicillin resulting in persistent postoperative bleeding in a dental patient. Gen Dent 2013;60(4):50-4.
33. Davydov L, Yermolnik M, Cuni LJ. Case report Warfarin and Amoxicillin/Clavulanate Drug Interaction. Ann Pharmacother 2003;37(3):367-70.
34. Larsen TR, Gelaye A, Durando C. Acute warfarin toxicity: An unanticipated consequence of amoxicillin/clavulanate administration. Am J Case Rep 2014;15:45-8.
35. Lanau N, Mareque J, Giner L, Zabalza M. Direct oral anticoagulants and its implications in dentistry. A review of literature. J Clin Exp Dent 2017;9(11):346-54.
36. Hinojar R, Jime´nez-Natcher JJ, Ferna´ndez-Golfı´n C, Zamorano JJ. New oral anticoagulants: a practical guide for physicians. Eur Heart J Cardiovasc Pharmacother 2015; 1:134–45.
37. Tummala R, Kavtaradze A, Gupta A, Ghosh RK. Reviewspecific antidotes against direct oral anticoagulants: A comprehen¬sivereview of clinical trials data. Int J Cardiol 2016;1: 214:292-8.
38. Schwarb H, andTsakiris DA. ReviewNew Direct Oral Anticoagulants (DOAC) and Their Use Today. Dent J 2016;4(5):1-11.
39. Dinkova AS, Atanasov DT, Vladimirova-Kitova LG. Dabigatran and dental extraction. J of IMAB 2017;23(2):1536-40.
40. Morimoto Y, Yokoe C, Imai Y, Sugihara M, Futatsuki T. Tooth extraction in patients taking nonvitamin K antagonist oral anticoagulants. J Dent Sci 2016;11(1):59-64.
41. Breik O, Cheng A, Sambrook PJ, Goss AN. Protocol in managing oral surgical patients taking dabigatran. Aust Dent J 2014;59(3):296-301.
42. Fawole A, Daw HA, Crowther MA. Practical management of bleeding due to the anticoagulants dabigatran, rivaroxaban, and apixaban. Cleve Clin J Med 2013;80(7):443-51.
43. Clinical Excellence Commission. NOAC Guidelines Non-vitamin K Antagonist Oral Anticoagulant 2017.
44. Madan GA, Madan SG, Madan G, Madan AD. Minor Oral Surgery Without Stopping Daily Low-Dose Aspirin Therapy: A Study of 51 Patients. J Oral MaxillofacSurg 2005; 63:1262-65
45. Morimoto Y, Niwa H, Minematsu K. Risk Factors Affecting Postoperative Hemorrhage After Tooth Extraction in Patients Receiving Oral Antithrombotic Therapy. J Oral MaxillofacSurg 2011;69:1550-6
46. Lillis T, Ziakas A, Koskinas K, Tsirlis A, Giannoglou G. Safety of Dental Extractions During Uninterrupted Single or Dual Antiplatelet Treatment. Am J Cardiol 2011;108:964-7
47. Cieoelik-Bielecka A, Pelc R, Cieoelik T. Oral surgery proce¬dures in patients on anticoagulants. Preliminary report. Kardiol Pol 2005; 63: 137-40
48. Karslı ED, Erdogan O, Esen E, Acartürk E. Comparison of the Effects of Warfarin and Heparin on Bleeding Caused by Dental Extraction: A Clinical Study. J Oral MaxillofacSurg 2011;69:2500-7
49. Svensson R, Hallmer F, Englesson CS, Svensson PJ, Becktor JP. Treatment with local hemostatic agents and primary closure after tooth extraction in warfarin treated patients. Swed Dent J 2013;37(2):71-7.
50. Hong C, Napenas JJ, Brennan M, Furney S, Lockhart P. Risk of postoperative bleeding after dental procedures in patients on warfarin: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(4): 464-8
51. Gomez-Moreno G, Aguilar-Salvatierra A, Fernandez- Cejas E, Delgado-Ruiz RA , Markovic A, Calvo-Guirado JL. Dental implant surgery in patients in treatment with the anticoagulant oral rivaroxaban. Clin Oral Implants Res 2016; 27(6):730-3
52. Mauprivez C, Khonsari, RH, Razouk O, Goudot P, LesclousP, Descroix, V. Management of dental extraction in patients undergoing anticoagulant oral direct treatment: A pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122 e146–e55
53. Hanken H, Gröbe A, Heiland M, Smeets R, Kluwe L, Wikner J, et al. Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy. Clin Oral Investig 2016;20:1279-82
54. Clemm R, Neukam FW, Rusche B, Bauersachs A, Musazada S, Schmitt CM. Management of anticoagulated patients in implant therapy: a clinical comparative study. Clin Oral ImplRes 2016;27(10):1274-82.
2. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:521–643.
3. Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. on behalf of the American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42.
4. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014;64–76.
5. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; DOI: 10.1161/CIR.0000000000000503
6. Yeung J, Holinstat M. Newer agents in antiplatelet therapy: a review. J Blood Med 2012;3:33–42
7. Hall R, Mazer CD. Antiplatelet Drugs: A Review of Their Pharmacology and Management in the Perioperative Period. Anesth Analg 2011;112(2):292–318
8. Vane JR, Botting RM. The mechanism of action of aspirin. Thromb Res 2003;110(5-6):255-8
9. Ardekian L, Gaspar R, Peled M, Brener B, Laufer D. Does low-dose aspirin therapy complicate oral surgical procedure? JADA 2000;131(3):331-5
10. Chamnarnphol N. Antiplatelet Therapy in the Patient with Coronary Stent Undergoing Surgery and Dental Procedure. Songkla Med J 2011;29(2):77-87
11. Brennan MT, Valerin MA, Noll JL, Napeñas JJ, Kent ML, Fox PC, et al. Aspirin Use and Post-operative Bleeding from Dental Extractions. J Dent Res 2009;87(8):740-4.
12. Cardona-Tortajada F, Sainz-Gómez E, Figuerido-Garmendia J, de Robles-Adsuar AL, Morte-Casabó A, Giner-Muñoz F, et al. Dental extractions in patients on antiplatelet therapy. A study conducted by the Oral Health Department of the Navarre Health Service (Spain). Med Oral Patol Oral Cir Bucal 2009;14(11):588-92
13. Napeñas JJ, HL Hong C, Brennan MT, Furney SL, Fox PC, Lockhart PB. The Frequency of Bleeding Complications After Invasive Dental Treatment in Patients Receiving Single and Dual Antiplatelet Therapy. J Am Dent Assoc 2009; 140(6):690-5
14. Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 2: Coagulopathies from drugs. Br Dent J 2003;195(9):495-500.
15. Sánchez-Palomino P, Sánchez-Cobo P, Rodriguez-Archilla A, González-Jaranay M, Moreu G, Calvo-Guirado JL, et al. Dental extraction in patients receiving dual antiplatelet therapy. Med Oral Patol Oral Cir Bucal 2015;20(5):616-20.
16. Ouellet N, Riendeau D, Percival MD. A high level of cyclooxygenase-2 inhibitor selectivity is associated with a reduced interference of platelet cyclooxygenase-1 inactivation by aspirin. PNAS 2001;98(25):14583-8.
17. Catella-Lawson F, Reilly MP, Kapoor SC, Cucchiara AJ, Demacro S, Tournier B, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 2001; 345(25):1809-17.
18. Kurth T, Glynn RJ, Walker AM, Chan KA, Buring JE, Hennekens CH, et al. Inhibition of Clinical Benefits of Aspirin on First Myocardial Infarction by Non steroidal Antiinflammatory Drugs. Circulation 2003;108(10):1191-5.
19. Kimmel SE, Berlin JA, Reilly N, Jaskowiak J, Kishel L, Chittams J, et al. The Effects of Nonselective Non-Aspirin Non-Steroidal Anti-Inflammatory Medications on the Risk of Nonfatal Myocardial Infarction and Their Interaction with Aspirin. Am Coll Cardiol 2004;43(6):985–90
20. MacDonald TM, Wei L. Is there an Interaction between the Cardiovascular Protective Effects of Low-Dose Aspirin and Ibuprofen? Basic Clin Pharmacol Toxicol 2006;98(3):275–80
21. Yokoyama H, Ito N, Soeda S, Ozaki M, Suzuki Y, Watanabe M, et al. Influence of non-steroidal anti-inflammatory drugs on antiplatelet effect of Aspirin. J Clin Pharm Ther 2013;38(1):12-5
22. Krishnaswamy A, Lincoff AM, Cannon CP. The Use and Limitations of Unfractionated Heparin. Crit Pathways in Cardiol 2010;9(1):35–40.
23. Gray E, Mulloy B1, Barrowcliffe TW. Heparin and low-molecular-weight heparin. Thromb Haemost 2008;99(5): 807–18.
24. Bounameux H, DeMoerloose P. Is laboratory monitoring of low-molecular-weight heparin therapy necessary? No. J Thromb Haemost 2004;2(4):551–4.
25. Hirsh J, Fuster V, Ansell J, Halperin JL. American Heart Association/American College of Cardiology Foundation Guide to Warfarin Therapy. J Am Coll Cardiol 2003;41(9):1633–52.
26. Becker DE. Antithrombotic Drugs: Pharmacology and Implications for Dental Practice. Anesth Prog 2013;60(2): 72–80.
27. Morimoto Y, Niwa H, and Minematsu K. Hemostatic Management of Tooth Extractions in Patients on Oral Antithrombotic Therapy. J Oral Maxillofac Surg 2008;66(1): 51-7.
28. Blinder D, Manor Y, Martinowitz U, and Taicher S. Dental extractions in patients maintained on oral anticoagulant therapy: Comparison of INR value with occurrence of postoperative bleeding. Int J Oral Maxillofac Surg 2001 30(6):518–21.
29. Wahl MJ, Pinto A, Kilham J, Lalla RV. Dental surgery in anticoagulated patients - stop the interruption. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119(2):136-57.
30. Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs. Dental Clinical Guidance 2015.
31. Ghaswalla PK, Harpe SE, Tassone D, Slattum PW. Warfarin–Antibiotic Interactions in Older Adults of an Outpatient Anticoagulation Clinic. Am J Geriatr Pharmacother 2012;10(6):352–60.
32. Goodchild JH, Donaldson M. A clinically significant drug interaction between warfarin and amoxicillin resulting in persistent postoperative bleeding in a dental patient. Gen Dent 2013;60(4):50-4.
33. Davydov L, Yermolnik M, Cuni LJ. Case report Warfarin and Amoxicillin/Clavulanate Drug Interaction. Ann Pharmacother 2003;37(3):367-70.
34. Larsen TR, Gelaye A, Durando C. Acute warfarin toxicity: An unanticipated consequence of amoxicillin/clavulanate administration. Am J Case Rep 2014;15:45-8.
35. Lanau N, Mareque J, Giner L, Zabalza M. Direct oral anticoagulants and its implications in dentistry. A review of literature. J Clin Exp Dent 2017;9(11):346-54.
36. Hinojar R, Jime´nez-Natcher JJ, Ferna´ndez-Golfı´n C, Zamorano JJ. New oral anticoagulants: a practical guide for physicians. Eur Heart J Cardiovasc Pharmacother 2015; 1:134–45.
37. Tummala R, Kavtaradze A, Gupta A, Ghosh RK. Reviewspecific antidotes against direct oral anticoagulants: A comprehen¬sivereview of clinical trials data. Int J Cardiol 2016;1: 214:292-8.
38. Schwarb H, andTsakiris DA. ReviewNew Direct Oral Anticoagulants (DOAC) and Their Use Today. Dent J 2016;4(5):1-11.
39. Dinkova AS, Atanasov DT, Vladimirova-Kitova LG. Dabigatran and dental extraction. J of IMAB 2017;23(2):1536-40.
40. Morimoto Y, Yokoe C, Imai Y, Sugihara M, Futatsuki T. Tooth extraction in patients taking nonvitamin K antagonist oral anticoagulants. J Dent Sci 2016;11(1):59-64.
41. Breik O, Cheng A, Sambrook PJ, Goss AN. Protocol in managing oral surgical patients taking dabigatran. Aust Dent J 2014;59(3):296-301.
42. Fawole A, Daw HA, Crowther MA. Practical management of bleeding due to the anticoagulants dabigatran, rivaroxaban, and apixaban. Cleve Clin J Med 2013;80(7):443-51.
43. Clinical Excellence Commission. NOAC Guidelines Non-vitamin K Antagonist Oral Anticoagulant 2017.
44. Madan GA, Madan SG, Madan G, Madan AD. Minor Oral Surgery Without Stopping Daily Low-Dose Aspirin Therapy: A Study of 51 Patients. J Oral MaxillofacSurg 2005; 63:1262-65
45. Morimoto Y, Niwa H, Minematsu K. Risk Factors Affecting Postoperative Hemorrhage After Tooth Extraction in Patients Receiving Oral Antithrombotic Therapy. J Oral MaxillofacSurg 2011;69:1550-6
46. Lillis T, Ziakas A, Koskinas K, Tsirlis A, Giannoglou G. Safety of Dental Extractions During Uninterrupted Single or Dual Antiplatelet Treatment. Am J Cardiol 2011;108:964-7
47. Cieoelik-Bielecka A, Pelc R, Cieoelik T. Oral surgery proce¬dures in patients on anticoagulants. Preliminary report. Kardiol Pol 2005; 63: 137-40
48. Karslı ED, Erdogan O, Esen E, Acartürk E. Comparison of the Effects of Warfarin and Heparin on Bleeding Caused by Dental Extraction: A Clinical Study. J Oral MaxillofacSurg 2011;69:2500-7
49. Svensson R, Hallmer F, Englesson CS, Svensson PJ, Becktor JP. Treatment with local hemostatic agents and primary closure after tooth extraction in warfarin treated patients. Swed Dent J 2013;37(2):71-7.
50. Hong C, Napenas JJ, Brennan M, Furney S, Lockhart P. Risk of postoperative bleeding after dental procedures in patients on warfarin: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(4): 464-8
51. Gomez-Moreno G, Aguilar-Salvatierra A, Fernandez- Cejas E, Delgado-Ruiz RA , Markovic A, Calvo-Guirado JL. Dental implant surgery in patients in treatment with the anticoagulant oral rivaroxaban. Clin Oral Implants Res 2016; 27(6):730-3
52. Mauprivez C, Khonsari, RH, Razouk O, Goudot P, LesclousP, Descroix, V. Management of dental extraction in patients undergoing anticoagulant oral direct treatment: A pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122 e146–e55
53. Hanken H, Gröbe A, Heiland M, Smeets R, Kluwe L, Wikner J, et al. Postoperative bleeding risk for oral surgery under continued rivaroxaban anticoagulant therapy. Clin Oral Investig 2016;20:1279-82
54. Clemm R, Neukam FW, Rusche B, Bauersachs A, Musazada S, Schmitt CM. Management of anticoagulated patients in implant therapy: a clinical comparative study. Clin Oral ImplRes 2016;27(10):1274-82.