The difference of mass of sponges used in the procedure was then converted to volume The outcome was in “milliliters per unit of surgery”: a unit of surgery is a function of the surgical area involved and the risk of hemorrhage
Experimental: 1.4 mL/unit of surgery (0.1–4.5) Control: 2.2 (0.2–6.3) Baseline: 1.4 (0.6–2.1) No statistically significant difference
None
Not mentioned in the study
OAT: if INR is less than 3, warfarin can be continued in minor procedures, if there is an adequate surgical approach Local hemostatic agents: not needed when continuing warfarin
Immediate bleeding: if bleeding continues after 10 minutes of local pressure postprocedurally Delayed bleeding: if bleeding started > 10 minutes after the procedure Description of measures needed to interrupt the hemorrhage
Two patients in the anticoagulant group: one needed admission and the other presented to the ER without admission
Not mentioned in the study
OAT: if INR is in therapeutic range, warfarin can be continued in dental extractions done in a hospital setting with an increase in mild postprocedural hemorrhage Number of teeth removed and risk of bleeding: not associated
Immediate bleeding: this is estimated by the difference of mass of gauze swabs used in the procedure. The outcome in “milligrams” Early bleeding: this is estimated by the number of additional swabs needed during the first 48 hours
Group A: the amount of bleeding: 2194 ± 1418 mg; the median number of additional swabs used: 2.5; the median bleeding time: 50 Group B: the amount of bleeding: 2950 ± 1694 mg; the median number of additional swabs used: 3; the median bleeding time: 60 Greater immediate bleed in group B () Greater early bleed in group B () Greater bleeding time in group B ()
None
None
OAT: if INR is in therapeutic range, warfarin can be continued in dental extractions when patients have prosthetic valves LMWH bridging: this increases the risk of bleeding Number of teeth removed and amount of bleeding: positively correlated
Mild bleeding: less than 10 minutes of duration Moderate bleeding: 10 to 20 minutes of duration Severe bleeding: this needs a new operation or a transfusion
Group A: 10 (15%) mild bleeding Group B: 6 (9.2%) mild bleeding No statistically significant difference ()
None
None
OAT: if INR is in therapeutic range, warfarin can be continued in dental and alveolar procedures Local hemostatic agents: needed if warfarin is continued
Bleeding assessed by a blinded examiner: Bleeding is present, if a fresh clot is eliminated without difficulty or if a discharge of blood is seen Bleeding is absent, if solid clot exists
Group 1: day 1: 12%, day 3: 4%, day 7: 0% Group 2: day 1: 21%, day 3: 3%, day 7: 0% Group 3: day 1: 17%, day 3: 3%, day 7: 4% Group 4: day 1: 29%, day 3: 5%, day 7: 0% No statistically significant difference, except groups 2 and 4 at day 3 ()
None
None
OAT: if INR <3, warfarin can be continued in dental extractions Local hemostatic agents: needed if warfarin is continued. Suturing should not always be performed Number of teeth removed and risk of bleeding: not associated INR levels and postoperative bleeding: positively correlated, but without any clinical significance
Bleeding is noted, when local pressure or further surgeries are needed Immediate bleeding: bleeding occurring until discharge Late bleeding: bleeding occurring after discharge
Group A: 8 (7.34%) had bleeding: 6 (75%) immediate and 4 (50%) late bleeding Group B: 5 (4.76%) had bleeding: 3 (60%) immediate and 3 (60%) late bleeding No statistically significant difference
None
None
OAT: if INR is in therapeutic range, VKAs can be continued in dental extractions Local hemostatic agents: needed if VKAs are continued. Suturing should not always be performed LMWH bridging: not needed for minor procedures INR levels and postoperative bleeding: no association Bleeding increases with local inflammation
Mild bleeding: hemorrhage ending alone or with mild pressure Severe bleeding: hemorrhage that requires more advanced methods to stop
Group 0: 85% mild, 15% severe bleeding Group 1: 50% mild, 50% severe bleeding Group 2: 64% mild, 36% severe bleeding Group 3: 83% mild, 17% severe bleeding Group 4: 69% mild, 31% severe bleeding Group 5: 96% mild, 4% severe bleeding There was no statistically significant difference between the groups when compared with group 0 So the risk of a major bleed is the same when reducing acenocoumarol with heparin use and when continuing the same dose with local antifibrinolytic use
Not mentioned in the study
Not mentioned in the study
OAT: if INR is in therapeutic range, acenocoumarol can be continued in dental extractions Local hemostatic agents: antifibrinolytic agent is needed, like tranexamic acid for two days, if acenocoumarol is continued Heparin and reduced acenocoumarol given together have multiple drawbacks INR levels and postoperative bleeding associated especially in groups that took reduced acenocoumarol with heparin Number of teeth removed and risk of bleeding: not associated
Immediate bleeding: <24 h after the procedure Delayed bleeding: >24 h after the procedure Low severity: mild, controlled by local pressure Moderate severity: blood clots noticed, controlled by additional hemostatic methods Severe: bleeding artery noticed, controlled by more advanced methods
Experimental: on VKAs: low (6.7%); on VKAs bridged with LMWH: 1 (12.5%); on antiplatelets: 1 (1.6%); on NOACs: 0 (0%) Control: 3 (0.6%) There is a statistically significant difference between the VKA group and the control, where there is an increased risk of mild bleeding ()
Two patients: one in the antiplatelet group and the other in the nonanticoagulated group
None
OAT: VKAs and NOACs can be continued during implant procedures, if the least invasive method is adopted, with an increase of mild postprocedural bleed in those on VKAs Implant surgery has a low bleeding risk regardless of the invasiveness of the procedure
Cannon and Dharmar, 2003
Immediate bleeding: up until 30 minutes after the procedure Delayed bleeding: >30 minutes Description of severity, time, and length
Experimental: 2 (5.7%) minor delayed bleeding Control: 3 (8.5%) minor delayed bleeding
None
None
OAT: if INR is in the therapeutic range, warfarin can be continued in minor procedures Local hemostatic agents: not needed
Immediate bleeding: up until 30 minutes after the procedure Delayed bleeding: >30 minutes Description of severity, time, and length
Experimental: 1 (3%) minor delayed bleeding Control: 1 (3.1%) minor delayed bleeding
None
None
OAT: if INR is in therapeutic range, warfarin can be continued in dental extractions if no other medications are taken that affect the liver or hemostasis Local hemostatic agents: needed
