Direct Oral Anticoagulants and Management of Blleding Following Dental Extractions. A Prospective Cohort Study.

NCT ID: NCT06365242

Last Updated: 2024-05-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

49 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-07-23

Study Completion Date

2022-12-23

Brief Summary

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Evaluation of DOACs treatment on post-extraction bleeding

Detailed Description

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Consecutive patients requiring at least one dental extraction were enrolled. DOACs regimen was either maintained or suspended. Patients were classified in subgroups depending on the number of teeth extracted per procedure (≤ 3 or \> 3), the need for flap raising and the performance of osteotomy. Bleeding was recorded intraoperatively, perioperatively at 20, 40, 60 and 80 minutes after the procedure, and in the first seven days post-operatively.

Conditions

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Post Operative Hemorrhage

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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DOACs treated patients

Patients treated with DOACs undergoing oral extractions

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* age \>18 years
* patients under pharmacological treatment with DOACs
* patients requiring at least one dental extraction
* patients willing to take part in the study and to sign informed consent

Exclusion Criteria

* patients below 18 years of age
* patients treated with antiplatelet therapy or vitamin K antagonists
* patients presenting with an International Normalized Ratio (INR) \>3.0
* patients suffering from congenital or acquired coagulopathies (e.g. haemophilia, coagulation factors deficiency, von Willebrand disease, thrombocytopenia, cirrhosis)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pisa

OTHER

Sponsor Role lead

Responsible Party

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Antonio Barone

Full Professor of Oral Surgery and Implantology, Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Antonio Barone

Role: PRINCIPAL_INVESTIGATOR

University of Pisa

Locations

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U.O. Odontostomatologia e Chirurgia del Cavo Orale

Pisa, , Italy

Site Status

Countries

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Italy

References

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Lee JY, Park SH, Kim DM, Ko KA, Park JY, Lee JS, Jung UW, Cha JK. Risk of post-operative bleeding after dentoalveolar surgery in patients taking anticoagulants: a cohort study using the common data model. Sci Rep. 2024 Apr 2;14(1):7787. doi: 10.1038/s41598-024-57881-7.

Reference Type RESULT
PMID: 38565933 (View on PubMed)

Darwish G. The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review. BMC Oral Health. 2023 Oct 11;23(1):743. doi: 10.1186/s12903-023-03427-8.

Reference Type RESULT
PMID: 37821865 (View on PubMed)

Lababidi E, Breik O, Savage J, Engelbrecht H, Kumar R, Crossley CW. Assessing an oral surgery specific protocol for patients on direct oral anticoagulants: a retrospective controlled cohort study. Int J Oral Maxillofac Surg. 2018 Jul;47(7):940-946. doi: 10.1016/j.ijom.2018.03.009. Epub 2018 Apr 10.

Reference Type RESULT
PMID: 29653869 (View on PubMed)

Cocero N, Basso M, Grosso S, Carossa S. Direct Oral Anticoagulants and Medical Comorbidities in Patients Needing Dental Extractions: Management of the Risk of Bleeding. J Oral Maxillofac Surg. 2019 Mar;77(3):463-470. doi: 10.1016/j.joms.2018.09.024. Epub 2018 Sep 26.

Reference Type RESULT
PMID: 30347201 (View on PubMed)

Hiroshi I, Natsuko SY, Yutaka I, Masayori S, Hiroyuki N, Hirohisa I. Frequency of hemorrhage after tooth extraction in patients treated with a direct oral anticoagulant: A multicenter cross-sectional study. PLoS One. 2022 Apr 7;17(4):e0266011. doi: 10.1371/journal.pone.0266011. eCollection 2022.

Reference Type RESULT
PMID: 35390010 (View on PubMed)

Patel JP, Woolcombe SA, Patel RK, Obisesan O, Roberts LN, Bryant C, Arya R. Managing direct oral anticoagulants in patients undergoing dentoalveolar surgery. Br Dent J. 2017 Feb 24;222(4):245-249. doi: 10.1038/sj.bdj.2017.165.

Reference Type RESULT
PMID: 28232717 (View on PubMed)

Cabbar F, Cabbar AT, Cosansu K, Cekirdekci EI. Effects of Direct Oral Anticoagulants on Quality of Life During Periprocedural Management for Dental Extractions. J Oral Maxillofac Surg. 2019 May;77(5):904-911. doi: 10.1016/j.joms.2018.11.032. Epub 2018 Dec 12.

Reference Type RESULT
PMID: 30611688 (View on PubMed)

Johnston S. An evidence summary of the management of patients taking direct oral anticoagulants (DOACs) undergoing dental surgery. Int J Oral Maxillofac Surg. 2016 May;45(5):618-30. doi: 10.1016/j.ijom.2015.12.010. Epub 2016 Jan 7.

Reference Type RESULT
PMID: 26774397 (View on PubMed)

Mauprivez C, Khonsari RH, Razouk O, Goudot P, Lesclous P, 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 Nov;122(5):e146-e155. doi: 10.1016/j.oooo.2016.06.003. Epub 2016 Jun 22.

Reference Type RESULT
PMID: 27554378 (View on PubMed)

Other Identifiers

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DOACS1_2024

Identifier Type: -

Identifier Source: org_study_id

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