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Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy

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Abstract

Objectives

To investigate factors influencing postoperative bleeding occurrence after dental extraction in older patients receiving anticoagulation therapy.

Materials and methods

This retrospective study included patients aged ≥ 65 years receiving one of the following anticoagulants: apixaban, edoxaban, rivaroxaban, and warfarin. Patients who underwent one to multiple tooth extractions in the geriatric dentistry clinic at Tokyo Medical and Dental University Hospital between August 1, 2016, and November 30, 2020, were included. The outcome variable was postoperative bleeding occurrence. Logistic regression analysis was performed with the following ten factors as explanatory variables: age, sex, maximum systolic blood pressure during the extraction, type of local anesthesia, vertical incision, osteotomy, usage of surgical splints, the mesiodistal width of the extracted tooth on a radiograph, use of antiplatelet agents, and history of diabetes requiring medication.

Results

Among 395 participants (mean age, 82.3 ± 6.5 years) included in this study, 75 patients experienced postoperative bleeding after tooth extraction. Logistic regression analysis revealed that the odds ratios for the vertical incision (18.400, p < 0.001), osteotomy (3.630, p = 0.00558), usage of surgical splints (1.860, p = 0.0395), and the mesiodistal width of the extracted tooth on a radiograph (1.060, p = 0.0261) were statistically significant.

Conclusions

For dental extraction in older patients receiving anticoagulants, postoperative bleeding is more likely to occur in patients with vertical incision, osteotomy, and posterior or multiple tooth extractions.

Clinical relevance

Dentists should consider suturing and adjunctive hemostatic procedures for patients undergoing vertical incision, osteotomy, and multiple tooth extractions while receiving anticoagulation therapy to minimize the risk of postoperative bleeding.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan

    Kaori Ueda, Masanao Inokoshi, Kazumasa Kubota, Eijiro Yamaga & Shunsuke Minakuchi

  2. Kubota Dental Clinic, 1-16-2 Iguchi, Mitaka, Tokyo, 181-0011, Japan

    Kazumasa Kubota

Authors
  1. Kaori Ueda
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  2. Masanao Inokoshi
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  3. Kazumasa Kubota
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  4. Eijiro Yamaga
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  5. Shunsuke Minakuchi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and data analysis were performed by Kaori Ueda, Masanao Inokoshi, Kazumasa Kubota, Eijiro Yamaga, and Shunsuke Minakuchi. The first manuscript draft was written by Kaori Ueda. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Masanao Inokoshi.

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Competing interests

The authors declare no competing interests.

Ethical approval

This study was approved by the ethical committee at Tokyo Medical and Dental University (Tokyo, Japan; approval no. D2019–080).

Consent to participate

Informed consent was obtained in accordance with the Ethical Guidelines for Medical and Biological Research involving Human Subjects in Japan.

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Not applicable.

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Ueda, K., Inokoshi, M., Kubota, K. et al. Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy. Clin Oral Invest 28, 22 (2024). https://doi.org/10.1007/s00784-023-05424-1

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