Effectiveness of local hemostatic to prevent bleeding in dental patients on anticoagulation: A systematic review and network meta-analysis.

Autor: Moreno-Drada JA; School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: joalmodra@hotmail.com., Abreu LG; School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Lino PA; School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Parreiras Martins MA; Department of Pharmaceutical Products, Universidade Federal of Minas Gerais, Belo Horizonte, Brazil., Pordeus IA; School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Nogueira Guimarães de Abreu MH; School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Jazyk: angličtina
Zdroj: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2021 Jul; Vol. 49 (7), pp. 570-583. Date of Electronic Publication: 2021 Apr 29.
DOI: 10.1016/j.jcms.2021.04.014
Abstrakt: This study aimed to determine the effectiveness of hemostatic protocols to prevent bleeding in dental procedures among individuals undergoing oral anticoagulation therapy. A systematic review and network meta-analysis were accomplished. Searches of literature and grey literature were performed in different electronic databases. Clinical trials were considered as part of the inclusion criteria. Data extraction and assessment of the risk of bias of the included articles were performed. Assessment of the certainty of evidence was also performed. As results we find that the N-butyl-2-cyanoacrylate [RR -35.00 (95% CI - 107.12, -5.78)], calcium sulfate (CaSO 4 ) [RR -5.62 (95% CI -11.41, -1.03)], and tranexamic acid (TXA) [RR -3.46 (95% CI -7.63, -0.77)] showed beneficial effects compared to placebo. However, only TXA presented beneficial effects with moderate certainty evidence. N-butyl-2-cyanoacrylate and CaSO 4 presented very low certainty evidence. In the comparisons between the hemostatic agents, no differences were observed. For the mean bleeding time, no significant difference in the comparisons was observed as well. Concluding, bleeding events in individuals on oral anticoagulation decreased with the use of TXA compared to placebo. N-butyl-2-cyanoacrylate and CaSO 4 were also superior to placebo, but the certainty of evidence was low. For the mean bleeding time, no significant difference in hemostatic agents was observed.
Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare that are relevant to the content of this article.
(Copyright © 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: