title: Extractions without eliminating anticoagulant treatment: a literature review.
abstract: OBJECTIVE
  To establish whether there is a high enough risk of bleeding in patients who take oral anticoagulants, such that it would justify not using oral anticoagulants when performing a dental extraction, as well as if the reason for and anatomical location of the extraction increases such risk.
  
  
  METHODS
  We performed a bibliographic search in order to carry out a meta-analytic study using descriptive statistics.
  
  
  RESULTS
  We compiled a sample of 1194 patients from the articles selected. Of these patients, a total of 2392 simple, serial surgical extractions were performed; none of the patients interrupted their anticoagulant treatment with warfarin sodium. Of the sample, 83 patients presented a certain degree of bleeding; in 77 of such cases, the bleeding was controlled with local hemostasis, whereas 6 patients required their dose of oral anticoagulants to be adjusted. There was a higher incidence of bleeding in patients presenting a periodontal pathology, compared to deep caries and pericoronitis.
  
  
  CONCLUSIONS
  Patients being treated with oral anticoagulants represent a risk that we should be aware of, but local hemostasis has proven to be effective when performing extractions, provided that the INR value is less than 4. There is an increased incidence of bleeding in patients with periodontal problems, due to the greater presence of inflammation in the soft tissues. If the extraction is performed in the maxilla, the incidence of hemorrhagic complications is slightly higher than in the mandible, although this difference is considered to be insignificant.
authors.affiliation: Madrid Hospital, Madrid, Spain. crisbarona@hotmail.com
authors.forename: Manuel-Alejandro
authors.initials: MA
authors.lastname: Rodríguez-Cabrera
authors.forename: Cristina
authors.initials: C
authors.lastname: Barona-Dorado
authors.forename: Isabel
authors.initials: I
authors.lastname: Leco-Berrocal
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gómez-Moreno
authors.forename: José-Maria
authors.initials: JM
authors.lastname: Martínez-González
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D000075202:Contraindications; D006801:Humans; D014081:Tooth Extraction
chemical_list: D000925:Anticoagulants