Antiplatelet therapy in patients undergoing oral surgery: a systematic review and meta-analysis

• Julio Villanueva ^[1] ; Josefina Salazar ^[1] ; Ana Alarcón ^[1] ; Ignacio Araya ^[1] ; Nicolás Yanine ^[1] ; Stefan Domancic ^[1] ; Alonso Carrasco-Labra ^[2]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Oral & Maxillofacial Department. Cochrane Associated Center at School of Dentistry. University of Chile; Department of Health Research methodology, Evidence and Impact. Mc Master University, Hamilton, Ontario, Canada
• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 24, Nº. 1 (January ), 2019
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • The number of patients under antiplatelet therapy (APT) continues to raise as current recommendations foster this practice. Although some recommendations to manage this treatment during oral surgery procedures exist, these have methodological shortcomings that preclude them from being conclusive.

    A systematic review and meta-analysis of the best current evidence was carried out; The Cochrane Library, EMBASE and MEDLINE databases were searched for Randomized Controlled Trials (RCT) concerning patients undergoing oral surgery with APT, other relevant sources were searched manually.

    5 RCTs met the Inclusion criteria. No clear tendency was observed (RR= 0.97 CI 95%: 0,41–2,34; p=0,09; I2= 51%), moreover, they weren’t clinically significant.

    According to these findings and as bleeding is a manageable complication it seems unreasonable to undermine the APT, putting the patient in danger of a thrombotic event and its high inherent morbidity, which isn’t comparable in severity and manageability to the former.”