Dental implant placement in patients on anticoagulant or antiplatelet therapy

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The use of dental implants has steadily increased and in recent years the largest increase has been noted in patients aged between 65-74 years.  This age group are also likely to be on long-term prescription of antiplatelet and oral anticoagulants as prophylaxis against thromboembolic events. Dental implant placement as a surgical procedure presents a risk [read the full story…]

Oral anticoagulant therapy: Preventing bleeding in patients having dental extractions

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This Cochrane review of antifibrinolytic agents for preventing bleeding in people on oral anticoagulants undergoing dental extractions or minor oral surgery included 4 RCTs. Topical tranexamic acid was effective in reducing post-operative bleeding following dental procedures.

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Tranexamic acid for minor oral surgery in anticoagulated patients

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5 good but small RCTs were identified for this review of topical tranexamic acid (TXA) for minor oral surgery in patients on anticoagulants. The findings suggest that TXA irrigation and mouthwash may reduce the risk of bleeding.

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Prolonged bleeding after tooth extraction – no evidence on treatment from trials

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This Cochrane review did not identify any randomised controlled trials that evaluated the effects of different interventions for the treatment of post-extraction bleeding. Clinicians must use their clinical experience to determine the most appropriate means of treating this condition, depending on patient-related factors.

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Preventing bleeding in patients with congenital bleeding disorders having dental surgery

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This Cochrane review only identified 2 RCTs involving a total of 59 patients that show a beneficial effect of systemically administered tranexamic acid and epsilon aminocaproic acid in preventing postoperative bleeding in people with haemophilia undergoing dental extraction.

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Orthognathic surgery: intra-operative bleeding reduced with tranexamic acid

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This review looked at the efficacy of haemostatic adjuncts on intra-operative blood loss in orthognathic surgery. 11 RCTs were included and found that tranexamic acid reduced blood loss by about a third whether used topically or intravenously.

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Congenital bleeding disorders and dental extractions

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This Cochrane review looked at the effectiveness of haemostatic regimens for patients with bleeding disorders. Two small trials involving 59 patients demonstrated the efficacy of antifibrinolytic agents acid in people with bleeding disorders having dental extractions.

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Review shows that tranexamic acid reduced blood loss in orthognathic surgery

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Significant blood loss can occur during orthognathic surgery and there are risks associated with blood transfusion so minimizing blood loss during surgery is important.  A large number of trials and reviews have shown that the antifibrinolytic agent tranexamic acid ( a synthetic amino acid lysine analog )  can effectively reduce bleeding in a number of [read the full story…]

Tranexamic acid is effective in controlling blood loss in orthognathic surgery

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Conservation of blood is important in all forms of surgery and approximately 30% of patietns undergoing bimaxillary osteotomies require a transfusion. The aim of this trial was to assess the effect of tranexamic acid on blood loss, quality of surgical field and duration of surgery compared to the effect of nitroglycerin induced moderate hypotension alone [read the full story…]