Veele, W.A. (2010) Lokale hemostatica binnen de tandheelkunde : Toegepast bij patienten met gecontinueerde antistollingstherapie. thesis, Dentistry.
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Abstract
Background: Current concepts in dentistry state that patients with anticoagulant therapy, no longer discontinue their medication, previous to invasive dental procedures. This is based on the findings that the risk for tromboembolic events caused by (temporarily) discontinuation of anticoagulant medication outweighs the risk for bleeding complications when the medication is continued. To prevent bleeding complications, topical hemostatic agents can be used. Collagen, oxidized cellulose, gelatin, fibrin glue, cyanoacrylate glues en chitosan are known hemostatic agents. The use of local hemostatics has been reported in several surgical fields, however there is no review of their application in dentistry. Methods: With the use of a PICO, a systematic search was performed in the international literature. Used databases included EMBASE, PubMed and the Cochrane Library. The search period ranged from 1966 to 201 0, only articles written in English and Dutch language were included. The studies included patients with anticoagulant therapy who underwent invasive dental procedures and were treated with topical hemostatics. The study selection contains 25 articles and consists of reviews, ACT's, CCT's and case-series, published between 1989 and 2010. Results: Since heterogenity existed between studies, the possibility of pooling was limited. The fewest bleeding complications were reported after use of tranexamic acid. Oxidized cellulose, gelatin and fibrin glue seem to be equally effective in preventing bleeding complications. Chitosan looks a promising substance, however more research after its properties is required. In cases where no hemostatic agent was applied, 18o/o suffered from post-operative bleeding complications. Discussion: The extent of the current study is limited. A comparison between different local hemostatic modalities is difficult to make and requires further research. Manual usability and cost aspects have not been taken into account in this study. Conclusion: Tranexamic acid seems to be the best hemostatic agent to use in patients who continue their anticoagulant medication and undergo invasive dental procedures.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleiders and Bos, Prof. Dr. R.R.M. and Broekema, Drs. F.l. and Afdeling Kaakchirurgie, UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:02 |
| Last Modified: | 25 Jun 2020 11:02 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2185 |
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