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Vol. 16 No. 2 (2025)
DOI: 10.59987/ads/2025.2.164-168
Articles
2025-07-08

Exodontic surgery in patients with coagulation disorders: a literature review

Authors

Liliana Ottria, Alberta Barlattani , Patrizio Bollero, Marco Gargari, Francesco Gianfreda, Alessandro D’Aurelio, Pasquale Giallaurito, Mirko Martelli

Keywords: dental extraction, exodontic surgery, anticoagulants, antiplatelet, hemophilia

Abstract

BACKGROUND: Nowadays, patients with coagulation disorders, whether inherited or acquired, have grown significantly. Anticoagulant drugs (vitamin K antagonists, VKA, and the new oral anticoagulants, NAO) and Antiplatelet drugs are a powerful means for prophylaxis and treatment of thromboembolic events. In oral surgery, patients on anticoagulant or anti-aggregating therapies require special precautions because the use of these drugs, which act on the coagulation cascade or platelet aggregation, may result in prolonged bleeding following dental extraction. OBJECTIVE: As this is a controversial issue among physicians, dentists, and patients, this review aims to analyze, through a literature review, the risk of bleeding due to coagulopathy and to provide evidence-based principles of operative management to minimize this risk. METHODS: This Review was guided and reported according to PRISMA parameters. To conduct this review, searches were performed on the online search engines: PubMed, Google Scholar, and Scopus from January 1, 2014, to January 31, 2025. The search strategy included the following terms: dental extraction, anticoagulants, antiplatelet agents, and hemophilia. RESULTS: From the 124 articles obtained by entering search terms into various scientific databases, eliminating duplicates, and filtering them according to the inclusion criteria, we selected 27 articles for the final review. Cases of post extraction bleeding, including principles of prevention and treatment methods, were observed. DISCUSSION: The survey helped us understand the real risks that can occur during extractive surgery in patients with coagulation deficiency and the new protocols used in these cases. These findings showed that due to the variability of the medication taken, the comorbidities of the patient, and the procedure performed, it is impossible to create a single protocol. Therefore, the clinician must evaluate each case on a case-by-case basis and implement all the procedures known to them to stop bleeding.

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Authors

Liliana Ottria - Department of Clinical Science and Translational Medicine, University of Rome Tor Ver gata, Rome, Italy; U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy; U.O.S.D. of Orthodontics- University of Rome Tor Vergata, Rome, Italy

Alberta Barlattani - Department of Clinical Science and Translational Medicine, University of Rome Tor Ver gata, Rome, Italy; U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy

Patrizio Bollero - U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy; Department of System Medicine - University of Rome Tor Vergata, Rome, Italy

Marco Gargari - Department of Clinical Science and Translational Medicine, University of Rome Tor Ver gata, Rome, Italy; U.O.C. of Dentistry “Fra G.B. Orsenigo”, San Pietro Fatebenefratelli Hospital, Rome, Italy

Francesco Gianfreda - U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy

Alessandro D’Aurelio - U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy; Department of System Medicine - University of Rome Tor Vergata, Rome, Italy

Pasquale Giallaurito - U.O.S.D. of Dentistry with protected pathways, Diagnosis, Hygiene and Oral Prevention Centre, Tor Vergata Hospital, Rome, Italy; Department of System Medicine - University of Rome Tor Vergata, Rome, Italy

Mirko Martelli - Department of Clinical Science and Translational Medicine, University of Rome Tor Ver gata, Rome, Italy; U.O.C. of Dentistry “Fra G.B. Orsenigo”, San Pietro Fatebenefratelli Hospital, Rome, Italy; Department of System Medicine - University of Rome Tor Vergata, Rome, Italy

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Copyright (c) 2025 LILIANA OTTRIA

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Authors contributing to Annali di Stomatologia agree to publish their articles under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows third parties to copy and redistribute the material providing appropriate credit and a link to the license but does not allow to use the material for commercial purposes and to use the material if it has been remixed, transformed or built upon.

How to Cite
Ottria, L., Barlattani , A. ., Bollero, . P. ., Gargari, M. ., Gianfreda, . F. ., D’Aurelio, A. ., Giallaurito, . P. ., & Martelli, M. . (2025). Exodontic surgery in patients with coagulation disorders: a literature review. Annali Di Stomatologia, 16(2). https://doi.org/10.59987/ads/2025.2.164-168

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