ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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| Title |
Preoperative Continuation of Aspirin with Appropriate Hemostatic Measures Is Currently Recommended |
| Clinical Question |
In patients taking daily aspirin as anticoagulant therapy, is it safe to perform dental surgery without withdrawal of aspirin? |
| Clinical Bottom Line |
Evidence indicates that appropriate local hemostatic measures are sufficient to control bleeding problems resulting from dental surgery for patients taking daily aspirin. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 25767068 | Zhao/2015 | 1752 patients in 10 included studies | Meta-Analysis | | Key results | The risk of hemorrhage after tooth extraction was higher in the group continuing their aspirin therapy (relative risk [RR]=2.46; 95% confidence interval [CI]: 1.45-4.81; P= .0009) but the bleeding time of both groups was not significantly different (standardized mean difference [SMD]=0.63; 95% CI:-0.04 to 1.31). Authors recommend improving hemostatic measures along with continuation of preoperative aspirin. | |
| Evidence Search |
("aspirin"[MeSH Terms] OR "aspirin"[All Fields]) AND extraction[All Fields] |
Comments on
The Evidence |
Validity: The meta-analysis (Zhao/2015) includes randomized controlled trials and controlled trials (nonramdomized). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to select the studies.
Perspective: This meta-analysis utilized PRISMA guidelines to select studies and conducted sensitivity analyses. The authors only searched the literatures in English and Chinese and may have missed some studies. However, the conclusion of the meta-analysis is adequate to answer the clinical question. |
| Applicability |
Aspirin is commonly used as anticoagulant therapy for patients with cardiovascular disease. It is important for dentists to be aware of benefits and risks of continuing preoperative aspirin to minimize the risks of complications: either bleeding or thrombosis. |
| Specialty/Discipline |
(Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Periodontics) |
| Keywords |
Aspirin, acetylsalicylic acid, extraction, coagulant
|
| ID# |
2850 |
| Date of submission: |
04/09/2015 |
| E-mail |
hans3@livemail.uthscsa.edu |
| Author |
Sehee Han |
| Co-author(s) |
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| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Richard Finlayson, DDS |
| Faculty mentor/Co-author e-mail |
finlaysonr@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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