Kanagawa Dental University, Yokosuka-shi, Japan.
Department of Dentistry and Oral Surgery International University of Health and Welfare Hospital, Nasushiobara-shi, Japan.
PLoS One. 2022 Apr 7;17(4):e0266011. doi: 10.1371/journal.pone.0266011. eCollection 2022.
Few studies have compared the frequency of hemorrhages after tooth extraction between patients taking direct oral anticoagulants (DOACs) and those taking warfarin or no anticoagulants. Further, the effects of the timing of DOAC administration and tooth extraction on the frequency of post-extraction hemorrhage have not been demonstrated. Therefore, we compared the frequency of post-extraction hemorrhages in patients in these different conditions and examined the effects of the timing of DOAC administration and tooth extraction on the frequency.
Prospective multicenter study.
Eighty-six Japanese hospitals.
In total, 182 teeth extracted from 145 individuals (119 teeth from adult males) receiving dabigatran and 88 teeth from individuals (62 teeth from adult males) receiving rivaroxaban were included.
Tooth extraction was followed by a 7-day observational period between November 1, 2008 and December 31, 2015. Dabigatran was administered twice daily; rivaroxaban was administered once a day.
Hemorrhage after tooth extraction.
The frequency of hemorrhage after tooth extraction was 1.65%, 3.41%, and 3.63% in those treated with dabigatran, rivaroxaban, and warfarin, respectively, and 0.39% in those who did not receive anticoagulants. Hemorrhages after tooth extraction were significantly higher in the rivaroxaban group than in patients who did not receive anticoagulants (P = 0.008). These frequencies did not differ significantly in the dabigatran and rivaroxaban groups compared to the warfarin group (P = 0.221 and P = 1.000, respectively).
The frequency of hemorrhaging after tooth extraction appeared to be similar in patients receiving continuous dabigatran or rivaroxaban and in those receiving continuous warfarin.
比较服用直接口服抗凝剂（DOAC）、华法林或未服用抗凝剂的患者拔牙后出血的频率。此外，DOAC 给药时间和拔牙时间对拔牙后出血频率的影响尚未得到证实。因此，我们比较了这些不同情况下患者拔牙后出血的频率，并研究了 DOAC 给药时间和拔牙时间对出血频率的影响。
前瞻性多中心研究。
86 家日本医院。
共纳入 145 名患者（119 名成年男性）接受达比加群治疗的 182 颗牙和 88 名接受利伐沙班治疗的患者（62 颗成年男性）的 88 颗牙。
拔牙后于 2008 年 11 月 1 日至 2015 年 12 月 31 日进行为期 7 天的观察。达比加群每日两次给药；利伐沙班每日一次给药。
拔牙后出血。
服用达比加群、利伐沙班和华法林的患者拔牙后出血的频率分别为 1.65%、3.41%和 3.63%，未服用抗凝剂的患者为 0.39%。与未服用抗凝剂的患者相比，利伐沙班组拔牙后出血的发生率明显更高（P = 0.008）。达比加群组和利伐沙班组与华法林组的出血频率差异无统计学意义（P = 0.221 和 P = 1.000）。
连续服用达比加群或利伐沙班的患者与连续服用华法林的患者拔牙后出血的频率似乎相似。
