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Bleeding risk in patients using oral anticoagulants submitted to surgical procedures in dentistry: a systematic review protocol
  1. Rogério Heládio Lopes Motta1,
  2. Cristiane de Cássia Bergamaschi2,
  3. Natalia Karol de Andrade1,
  4. Caio Chaves Guimaraes1,
  5. Juliana Cama Ramacciato1,
  6. Jimmy de Oliveira Araújo1,
  7. Luciane Cruz Lopes2
  1. 1 Pharmacology, Anesthesiology and Therapeutics, São Leopoldo Mandic Dental School and Research Center, Campinas, São Paulo, Brazil
  2. 2 Department of Pharmaceutical Sciences Graduate Program, University of Sorocaba, Sorocaba, São Paulo, Brazil
  1. Correspondence to Dr Cristiane de Cássia Bergamaschi; cristiane.motta{at}


Introduction The management of patients undergoing oral surgical procedures using anticoagulants raises concerns regarding the risk of bleeding. Bleeding rates in those patients during or after oral surgical procedures are uncertain. The aim of this study will be to determine the bleeding rate during and after oral surgeries in patients using anticoagulants.

Methods and analysis A systematic review will be conducted and if appropriate, a meta-analysis of randomised clinical trials evaluating the bleeding risk during and after oral surgical procedures in patients using anticoagulants were selected. The literature search will be conducted using electronic databases, such as the Cochrane Central Register of Controlled Trials, MEDLINE (via Ovid), Embase (via Ovid), Cumulative Index to Nursing and Allied Health Literature (via Ovid), LILACS (SciELO) and CAPES database, without restriction of languages or date of publication. The primary outcome will be the occurrence of local bleeding rate during and after oral surgical procedures, and as secondary outcome, the following complications will be considered: implant failure, healing problems and infections. Groups of two independent reviewers will select the titles and abstracts for full-text eligibility. For eligible studies, the same reviewers will perform data extraction, bias risk assessment and determination of the overall quality of evidence for each of the outcomes using the Grading of Recommendations Assessment, Development and Evaluation classification system. Meta-analysis and subgroup analyses will be conducted, to all outcomes, if appropriate.

Ethics and dissemination The systematic review will be published in a peer-reviewed journal, and brief reports of the review’s findings will be released directly to the intended audience. The results will help dentists in the decision-making process to minimise the risk of bleeding in patients using anticoagulants in their clinical practice.

PROSPERO registration number CRD42017056986.

  • oral surgery
  • anticoagulants
  • bleeding
  • systematic review

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors RHLM is the principal investigator and led the writing of the manuscript. LCL and CdCB are the project managers and coinvestigators and contributed to the writing and revision of the manuscript. NKdA, CCG, JCR and JdOA are coinvestigators and contributed to the writing and revision of the manuscript. All authors read and approved the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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