Does Platelet-Rich Fibrin Prevent Hemorrhagic Complications After Dental Extractions in Patients Using Oral Anticoagulant Therapy?

PhD Student at Postgraduate Program in Dentistry, Division of Oral and Maxillofacial Surgery, Federal University of Ceará, Fortaleza, Ceará, Brazil; Professor, Division of Oral and Maxillofacial Surgery, Christus University (UNICHRISTUS), Fortaleza, Ceará, Brazil. MSc Student at Postgraduate Program in Dentistry, Division of Oral and Maxillofacial Surgery, Christus University (UNICHRISTUS), Fortaleza, Ceará, Brazil; Professor, Division of Oral and Maxillofacial Surgery, Doctor Leão Sampaio University Center (UNILEÃO), Juazeiro do Norte, Ceará, Brazil. Professor, Division of Patients with Special Needs, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil. Professor, Division of Oral Pathology, Christus University (UNICHRISTUS), Fortaleza, Ceará, Brazil. Electronic address: paulo_goberlanio@yahoo.com.br. Professor, Division of Oral Radiology, Federal University of Ceará, Postgraduate Program in Dentistry, Fortaleza, Ceará, Brazil.

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 2021

Other resources

Abstract
PURPOSE The number of anticoagulated patients requiring dental extractions and other minor dentoalveolar surgical procedures has increased significantly. The purpose of this study was to determine whether the use of platelet-rich fibrin (PRF) prevents hemorrhagic complications after dental extractions in patients being treated with oral anticoagulants. METHODS A 2-phase PROSPERO-registered systematic review of published within-subject controlled trials (CRD42020186678) was conducted in accordance with the PRISMA statement. Searches were conducted through Medline via PubMed, Web of Science, LILACS, Central Cochrane, Scopus, DOSS, and Google Scholar, until May 2020. The predictor variable was the study group (PRF vs use/non-use of other hemostatic agents). The main outcome of interest was the risk of bleeding after tooth extraction and the covariates were postoperative complications. Data analysis included synthesis of results, risk of bias (RoB) evaluation, meta-analysis (random effects; I²-based heterogeneity; 95% confidence), and certainty of evidence assessment. RESULTS From a total of 216 articles, 3 articles (low-moderate RoB) were included for evaluation in this systematic review and meta-analysis. A total of 130 patients were involved. The outcomes of the meta-analysis showed that the use of PRF in extraction wounds did not reduce the risk of bleeding after extraction in anticoagulated patients (P= .330; I² = 99%). Furthermore, the use of PRF did not improve pain scores (P = .470; I² = 96%) or the risk of postoperative alveolitis (P = .4300; I² = 38%) in anticoagulated patients. The certainty of the evidence ranged from moderate to low. CONCLUSIONS The findings of this systematic review and meta-analysis suggest that PRF does not prevent hemorrhagic complications after tooth extraction in patients using oral anticoagulant therapy.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine