Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline

Background Dentoalveolar procedures in immune thrombocytopenia (ITP) pose a risk of bleeding due to thrombocytopenia and infection due to immunosuppressive treatments. We aimed to systematically review the safety and management of dentoalveolar procedures in ITP patients to create practical recommen...

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Autores principales:	Wobke E. M. van Dijk, Robert J. J. van Es, Maria E. P. Correa, Roger E. G. Schutgens, Karin P. M. van Galen
Formato:	article
Lenguaje:	EN
Publicado:	Georg Thieme Verlag KG 2021
Materias:	dentoalveolar itp immune thrombocytopenia dental surgery oral care Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/1975cd99e95b4cb3988950abdc64553e
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spelling	oai:doaj.org-article:1975cd99e95b4cb3988950abdc64553e2021-11-17T00:05:57ZDentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline2512-946510.1055/a-1641-7770https://doaj.org/article/1975cd99e95b4cb3988950abdc64553e2021-09-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1641-7770https://doaj.org/toc/2512-9465Background Dentoalveolar procedures in immune thrombocytopenia (ITP) pose a risk of bleeding due to thrombocytopenia and infection due to immunosuppressive treatments. We aimed to systematically review the safety and management of dentoalveolar procedures in ITP patients to create practical recommendations. Methods PubMed, Embase, Cochrane, and Cinahl were searched for original studies on dentoalveolar procedures in primary ITP patients. We recorded bleeding- and infection-related outcomes and therapeutic strategies. Clinically relevant bleeding was defined as needing medical attention. Results Seventeen articles were included, of which 12 case reports/series. Overall, the quality of the available evidence was poor. Outcomes and administered therapies (including hemostatic therapies and prophylactic antibiotics) were not systematically reported. At least 73 dentoalveolar procedures in 49 ITP patients were described. The range of the preoperative platelet count was 2 to 412 × 109/L. Two clinically relevant bleedings (2%) were reported in the same patient of which one was life-threatening. Strategies used to minimize the risk of bleeding were heterogeneous and included therapies to increase platelet count, antifibrinolytics, local measures, and minimally invasive techniques. Reports on the occurrence of bleedings due to anesthetics or infection were lacking. Conclusion Based on alarmingly limited data, clinically relevant bleedings and infections after dentoalveolar procedures in ITP patients seem rare. Awaiting prospective and controlled studies to further evaluate these risks and the efficacy of therapeutic interventions, we provided our institutional guideline to guide the management of dentoalveolar procedures in ITP patients.Wobke E. M. van DijkRobert J. J. van EsMaria E. P. CorreaRoger E. G. SchutgensKarin P. M. van GalenGeorg Thieme Verlag KGarticledentoalveolaritpimmune thrombocytopeniadental surgeryoral careDiseases of the circulatory (Cardiovascular) systemRC666-701ENTH Open, Vol 05, Iss 04, Pp e489-e502 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dentoalveolar itp immune thrombocytopenia dental surgery oral care Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	dentoalveolar itp immune thrombocytopenia dental surgery oral care Diseases of the circulatory (Cardiovascular) system RC666-701 Wobke E. M. van Dijk Robert J. J. van Es Maria E. P. Correa Roger E. G. Schutgens Karin P. M. van Galen Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
description	Background Dentoalveolar procedures in immune thrombocytopenia (ITP) pose a risk of bleeding due to thrombocytopenia and infection due to immunosuppressive treatments. We aimed to systematically review the safety and management of dentoalveolar procedures in ITP patients to create practical recommendations. Methods PubMed, Embase, Cochrane, and Cinahl were searched for original studies on dentoalveolar procedures in primary ITP patients. We recorded bleeding- and infection-related outcomes and therapeutic strategies. Clinically relevant bleeding was defined as needing medical attention. Results Seventeen articles were included, of which 12 case reports/series. Overall, the quality of the available evidence was poor. Outcomes and administered therapies (including hemostatic therapies and prophylactic antibiotics) were not systematically reported. At least 73 dentoalveolar procedures in 49 ITP patients were described. The range of the preoperative platelet count was 2 to 412 × 109/L. Two clinically relevant bleedings (2%) were reported in the same patient of which one was life-threatening. Strategies used to minimize the risk of bleeding were heterogeneous and included therapies to increase platelet count, antifibrinolytics, local measures, and minimally invasive techniques. Reports on the occurrence of bleedings due to anesthetics or infection were lacking. Conclusion Based on alarmingly limited data, clinically relevant bleedings and infections after dentoalveolar procedures in ITP patients seem rare. Awaiting prospective and controlled studies to further evaluate these risks and the efficacy of therapeutic interventions, we provided our institutional guideline to guide the management of dentoalveolar procedures in ITP patients.
format	article
author	Wobke E. M. van Dijk Robert J. J. van Es Maria E. P. Correa Roger E. G. Schutgens Karin P. M. van Galen
author_facet	Wobke E. M. van Dijk Robert J. J. van Es Maria E. P. Correa Roger E. G. Schutgens Karin P. M. van Galen
author_sort	Wobke E. M. van Dijk
title	Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
title_short	Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
title_full	Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
title_fullStr	Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
title_full_unstemmed	Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline
title_sort	dentoalveolar procedures in immune thrombocytopenia; systematic review and an institutional guideline
publisher	Georg Thieme Verlag KG
publishDate	2021
url	https://doaj.org/article/1975cd99e95b4cb3988950abdc64553e
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Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline

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