The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis.

Autor: Mahardawi B; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand., Jiaranuchart S; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand., Arunjaroensuk S; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand., Tompkins KA; Office of Research Affairs, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand., Somboonsavatdee A; Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand., Pimkhaokham A; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand. atiphan.p@chula.ac.th.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Aug 02; Vol. 13 (1), pp. 12519. Date of Electronic Publication: 2023 Aug 02.
DOI: 10.1038/s41598-023-39023-7
Abstrakt: This network meta-analysis was done to thoroughly evaluate the available literature on the use of different hemostatic agents for dental extraction in patients under oral antithrombotic therapy, aiming to identify the agent with the best/worst performance in bleeding control. Considering that such patients have a higher risk of bleeding, choosing the right hemostatic is essential. Twenty-three randomized clinical trials articles were included after completing the literature search. Cyanoacrylate tissue adhesive showed a reduction in the odds of postoperative bleeding events compared with conventional methods (i.e., gauze/cotton pressure, sutures), with a tendency toward a statistical significance (OR 0.03, P = 0.051). Tranexamic acid was the only agent that demonstrated a significantly lower risk of developing postoperative bleeding events (OR 0.27, P = 0.007). Interestingly, chitosan dental dressing and collagen plug had the shortest time to reach hemostasis. However, they ranked last among all hemostatic agents, regarding bleeding events, revealing higher odds than conventional measures. Therefore, it is concluded that the use of cyanoacrylate tissue adhesive and tranexamic acid gives favorable results in reducing postoperative bleeding events following dental extractions. Although chitosan dental dressing and collagen exhibited a faster time to reach hemostasis, they led to a higher occurrence of bleeding events.
(© 2023. The Author(s).)
Databáze: MEDLINE
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