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Cited by 3Cardiac, Anesthesia and Surgical OutcomesDental Anxiety and Anesthesia TechniquesBone health and treatments

Oral surgery considerations in patients at high-risk of complications related to drug intake: A systematic review

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Morgado-Sevillano, D., Rodríguez-Molinero, J., García-Bravo, C., Peña-Cardelles, J.F., Ruiz-Roca, J.A., García-Guerrero, I., Gómez-de Diego, R·2024·The Saudi Dental Journal
DOI 10.1016/j.sdentj.2024.12.004PMC PMC11976089
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Abstract

Purpose: This study aims to identify and comprehend the management of the most frequent complications in oral surgery that arise from the consumption of multiple drugs. Materials and Methods: A comprehensive review of 23 articles was conducted, focusing on the complications that arise from the consumption of drugs in patients undergoing oral surgery treatment, in addition to the strategies for prevention and treatment. Results: All the reviewed articles offered insightful knowledge into preventing complications through well-defined protocols that encompass both pre- and post-operative measures. These measures include local interventions such as periodontal treatments, dental prophylaxis, and hygiene instructions, as well as systemic approaches like antibiotic prophylaxis and post-surgical antibiotic coverage. Additionally, specific measures like monitoring prothrombin time with the International Normalized Ratio in patients with coagulation disorders, and implementing hemostatic techniques, were also discussed. Conclusion: The most prevalent complications in oral surgery are hemorrhage in anticoagulated patients, infections in immunosuppressed patients, and osteonecrosis in patients who take antiresorptive drugs. Edema, pain, and inflammation are also common post-operative concerns. When managing high-risk patients pharmacologically, it is crucial to provide effective antibiotic coverage both pre- and post-procedure and to utilize minimally invasive dental procedures with local hemostatic measures.

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  • The addition of typical perioperative drugs such as NSAIDs, acetaminophen and other analgesics, corticosteroids, and antibiotics further increases the risk of clinically significant drug-drug interactions in oral surgery patients.

    “The addition of typical perioperative drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen and other analgesics, corticosteroids, and antibiotics further increases the risk of clinically significant drug-drug interactions (DDIs) in this population [4,5].”

    From Comparing Artificial Intelligence (ChatGPT, Gemini, DeepSeek) and Oral Surgeons in Detecting Clinically Relevant Drug–Drug Interactions in Dental Therapy (2025) · cites this paper as [4]

    The Discussion (page unavailable) warns that NSAIDs can increase bleeding risk and that broad-spectrum antibiotics can reduce vitamin K production; it also discusses analgesic and antibiotic use around surgery. It does not establish that adding the full listed group—including acetaminophen and corticosteroids—increases clinically significant drug-drug interactions. (LLM, conf=0.78)

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Authors
Morgado-Sevillano, D., Rodríguez-Molinero, J., García-Bravo, C., Peña-Cardelles, J. F., Ruiz-Roca, J. A., García-Guerrero, I., & Gómez-de Diego, R.
Affiliations
Universidad Rey Juan Carlos (ES)
ORCID
Rodríguez-Molinero, J.
Venue
The Saudi Dental Journal
Publisher
Springer Science and Business Media LLC
Published
2024-12
Volume
36
Issue
12
Pages
1503-1508
ISSN
1013-9052 (ISSN-L)
DOI
10.1016/j.sdentj.2024.12.004
PMC
PMC11976089
OpenAlex
W4404909566
Cited by
3
References
1
Citations by year
2026: 3
FWCI
0.24
Type
journal article
Language
en
Open access
Licence
Locations
  • The Saudi Dental Journal (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Hispana (publishedVersion, cc-by-nc-nd)
  • BURJC Digital (King Juan Carlos University) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Hispana (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
  • Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
  • Health Sciences › Medicine › Oncology › Bone health and treatments
Keywords
oral surgery complications, polypharmacy, anticoagulants, immunosuppression, bisphosphonates, avascular necrosis, postoperative bleeding, antibiotic prophylaxis, prothrombin time monitoring, hemostasis, periodontal treatment, postoperative swelling, high-risk patients

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