title: Postoperative bleeding risk for oral surgery under continued clopidogrel antiplatelet therapy.
abstract: OBJECTIVE
  To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group.
  
  
  METHODS
  A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.
  
  
  RESULTS
  We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0-1.7%, 0-4.7%, and 0-7.8%, respectively, and the incidences did not differ significantly among the three groups (P > 0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.
  
  
  CONCLUSIONS
  Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Alexander
authors: 0000-0002-2822-2006
authors: A
authors: Gröbe
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Meike
authors: 0000-0002-2151-9990
authors: M
authors: Fraederich
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Ralf
authors: 0000-0002-0207-5474
authors: R
authors: Smeets
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Max
authors: 0000-0002-4987-2913
authors: M
authors: Heiland
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Lan
authors: 0000-0001-9919-4551
authors: L
authors: Kluwe
authors: Department of Oral and Maxillofacial Surgery, General Hospital Balingen, Tuebinger Straße 30, 72336 Balingen, Germany.
authors: Jürgen
authors: J
authors: Zeuch
authors: Department of Oral and Maxillofacial Surgery, General Hospital Balingen, Tuebinger Straße 30, 72336 Balingen, Germany.
authors: Martina
authors: M
authors: Haase
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Johannes
authors: 0000-0002-2458-1861
authors: J
authors: Wikner
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Henning
authors: 0000-0001-7600-9181
authors: H
authors: Hanken
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Jan
authors: J
authors: Semmusch
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
authors: Ahmed
authors: 0000-0002-2855-1918
authors: A
authors: Al-Dam
authors: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany ; Department of Oral and Maxillofacial Surgery, General Hospital Balingen, Tuebinger Straße 30, 72336 Balingen, Germany.
authors: Wolfgang
authors: W
authors: Eichhorn
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
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