Med Oral Patol Oral Cir Bucal. 2011 Sep 1;16 (6):e800-4. Oral anticoagulants and dental extraction e800 Journal section: Oral Surgery Publication Types: Review Extractions without eliminating anticoagulant treatment: A literature review Manuel-Alejandro Rodríguez-Cabrera 1 , Cristina Barona-Dorado 2 , Isabel Leco-Berrocal 3 , Gerardo Gómez- Moreno 4 , José-Mª Martínez-González 5 1 Resident in the Master’s in Oral and Dental Implant Surgery program. Madrid Hospital 2 Associate Professor of Oral Surgery. School of Dentistry. Complutense University of Madrid. Assistant Director of the Master’s in Oral and Dental Implant Surgery program. Madrid Hospital 3 Associate Professor of Oral Surgery. School of Dentistry. Complutense University of Madrid. Professor of the Master’s in Oral and Dental Implant Surgery program. Madrid Hospital 4 Tenured Full-Time Professor. School of Dentistry, University of Granada 5 Full Professor of Maxillofacial Surgery. School of Dentistry. Complutense University of Madrid. Head of the Department of Oral Facial and Implant Surgery. Madrid Hospital Correspondence: Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, s/n, Madrid, Spain crisbarona@hotmail.com Received: 20/04/2010 Accepted: 27/08/2010 Abstract Objectives: To establish whether there is a high enough risk of bleeding in patients who take oral anticoagulants, such that it would justify not using oral anticoagulants when performing a dental extraction, as well as if the rea- son for and anatomical location of the extraction increases such risk. Study Design: We performed a bibliographic search in order to carry out a meta-analytic study using descriptive statistics. Results: We compiled a sample of 1194 patients from the articles selected. Of these patients, a total of 2392 sim- ple, serial surgical extractions were performed; none of the patients interrupted their anticoagulant treatment with warfarin sodium. Of the sample, 83 patients presented a certain degree of bleeding; in 77 of such cases, the bleeding was controlled with local hemostasis, whereas 6 patients required their dose of oral anticoagulants to be adjusted. There was a higher incidence of bleeding in patients presenting a periodontal pathology, compared to deep caries and pericoronitis. Conclusions: Patients being treated with oral anticoagulants represent a risk that we should be aware of, but local hemostasis has proven to be effective when performing extractions, provided that the INR value is less than 4. There is an increased incidence of bleeding in patients with periodontal problems, due to the greater presence of infammation in the soft tissues. If the extraction is performed in the maxilla, the incidence of hemorrhagic com- plications is slightly higher than in the mandible, although this difference is considered to be insignifcant. Key words: Oral surgery, anticoagulants, coumarin. Rodríguez-Cabrera MA, Barona-Dorado C, Leco-Berrocal I, Gómez- Moreno G, Martínez-González JM. �xtractions without elimina-ting an- �xtractions without elimina-ting an- ticoagulant treatment: A literature review. Med Oral Patol Oral Cir Bucal. 2011 Sep 1;16 (6):e800-4. http://www.medicinaoral.com/medoralfree01/v16i6/medoralv16i6p800.pdf Article Number: 17065 http://www.medicinaoral.com/ © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 eMail: medicina@medicinaoral.com Indexed in: Science Citation Index �xpanded Journal Citation Reports Index Medicus, M�DLIN�, PubMed Scopus, �mbase and �mcare Indice Médico �spañol doi:10.4317/medoral.17065 http://dx.doi.org/doi:10.4317/medoral.17065