title: Should aspirin be stopped before tooth extraction? A meta-analysis.
abstract: OBJECTIVE
  To carry out a standard meta-analysis to determine if aspirin should be stopped before tooth extraction.
  
  
  METHODS
  The PubMed, ScienceDirect, EBSCOhost, and Science Citation Index databases were searched for studies published up to September 30, 2014. Eligible studies were restricted to randomized controlled trials (RCTs) and controlled, nonrandomized trials.
  
  
  RESULTS
  Three RCTs and seven controlled trials met the inclusion criteria (covering 1752 patients: 529 on aspirin therapy and 1223 not on aspirin therapy). The results showed that the risk of postoperative hemorrhage was significantly higher in patients on aspirin therapy (relative risk [RR] = 2.46; 95% confidence interval [CI]: 1.45-4.81) but that bleeding time (BT) was not significantly different between the two groups (standardized mean difference [SMD] = 0.63; 95% CI: -0.04 to 1.31). Sensitivity analyses showed that the results were unstable.
  
  
  CONCLUSIONS
  We could reach a conclusion that BT is prolonged or hemorrhage is exacerbated by long-term use of aspirin. We recommend not stopping long-term aspirin use before tooth extraction but enhancing hemostasis methods, if necessary.
authors.affiliation: College of Stomatology, Shandong University, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China; Shandong Provincial Key Laboratory of Oral Biomedicine, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China.
authors.forename: Bingjie
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Stomatology, Jinan Military General Hospital, Jinan City, Shandong Province 250012, China.
authors.forename: Peihuan
authors.initials: P
authors.lastname: Wang
authors.affiliation: College of Stomatology, Shandong University, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China; Shandong Provincial Key Laboratory of Oral Biomedicine, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China.
authors.forename: Yabing
authors.initials: Y
authors.lastname: Dong
authors.affiliation: College of Stomatology, Shandong University, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China; Shandong Provincial Key Laboratory of Oral Biomedicine, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: College of Stomatology, Shandong University, Number 44, Wen Hua Xi Lu, Jinan City, Shandong Province 250012, China. Electronic address: Zhaohq@sdu.edu.cn.
authors.forename: Huaqiang
authors.initials: H
authors.lastname: Zhao
mesh_terms: D001241:Aspirin / Q000008:administration & dosage*; D006801:Humans; D006472:Oral Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D014081:Tooth Extraction
chemical_list: D001241:Aspirin