Non-Cochrane · prognostic · PM41612139
Platelet Levels Associated With Bleeding Risk for Dental Interventions: A Systematic Review.
Lim Guang Xu David, Al Sarraf Fatima, Cho Hana, et al. · Oral diseases · 2026 · PubMed · doi:10.1111/odi.70211
Findings
7 findings
| Population | ||||
|---|---|---|---|---|
| Patients aged 16 years or older undergoing oral surgery procedures | Preoperative platelet count below 50,000/μL | Preoperative platelet count of 50,000/μL or above | Postoperative bleeding Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery · Direct calculation without weight adjustment | RR 2.63 [1.63, 4.24] 4.9% vs 12.9% GRADE not reported 10 studies · 958 participants |
| Patients aged 16 years or older undergoing oral surgery procedures | Preoperative platelet count below 50,000/μL | Preoperative platelet count of 50,000/μL or above | Postoperative bleeding Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery | RR 2.95 [1.76, 4.96] 4.9% vs 12.9% GRADE not reported 10 studies · 958 participants |
| Patients aged 16 years or older with thrombocytopenia undergoing any dental intervention | Preoperative platelet count at or below 50,000/uL | Preoperative platelet count above 50,000/uL | Crude postoperative bleeding risk in the control group (all cases) Postoperative bleeding (first week where timing specified) · Dental interventions (98.6% oral surgery) | Risk (%) 4.9 GRADE not reported 20 studies · 758 participants |
| Patients aged 16 years or older undergoing oral surgery procedures | Preoperative platelet count below 50,000/μL | None | Postoperative bleeding rate (sample group) Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery | Crude risk (%) 12.9 GRADE not reported 10 studies · 202 participants |
| Patients aged 16 years or older undergoing any dental intervention | Preoperative platelet count below 50,000/μL | None | Postoperative bleeding rate (sample group) Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery · All studies with and without control, all dental interventions | Crude risk (%) 12.4 GRADE not reported 20 studies · 225 participants |
| Patients aged 16 years or older undergoing oral surgery procedures | Preoperative platelet count of 50,000/μL or above | None | Postoperative bleeding rate (control group) Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery | Crude risk (%) 4.9 GRADE not reported 10 studies · 756 participants |
| Patients aged 16 years or older undergoing any dental intervention (sample and control groups) | Any dental intervention | None | Overall postoperative bleeding risk Postoperative bleeding (mostly within first postoperative week) · Dental/oral surgery | Crude risk (%) 6.6 GRADE not reported 20 studies · 983 participants |
Included primary studies 20
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Akashi 2018 Delayed Socket Healing After Dental Extraction in Patients Undergoing Myelosuppressive Chemotherapy for Hematological Malignancy:… PMID:29932940 | 2018 | this review only | not stated | not extracted yet |
| Barnard and Scully 1993 Epstein's syndrome. Implications for oral surgery. PMID:8351117 | 1993 | this review only | not stated | not extracted yet |
| Cocero 2017 Oral Surgical Treatment of Patients With Chronic Liver Disease: Assessments of Bleeding and Its Relationship With Thrombocytopenia and… PMID:27677683 | 2017 | this review only | Postoperative bleeding | not extracted yet |
| Fillmore 2013 Dental extraction in the thrombocytopenic patient is safe and complications are easily managed. PMID:23932116 | 2013 | this review only | Postoperative bleeding | not extracted yet |
| Givol 2012 Thrombocytopenia and bleeding in dental procedures of patients with Gaucher disease. PMID:21545377 | 2012 | this review only | not stated | not extracted yet |
| Helenius-Hietala 2016 Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications. PMID:27068309 | 2016 | this review only | Postoperative bleeding | not extracted yet |
| Kang 2021 The incidence of postoperative hemorrhage after tooth extraction in patients with thrombocytopenia. PMID:34187959 | 2021 | this review only | Postoperative bleeding | not extracted yet |
| Lee 2018 Life-threating outcomes after dental implantation in patient with idiopathic thrombocytopenic purpura: a case report and review of… PMID:30588476 | 2018 | this review only | not stated | not extracted yet |
| Lucas 1964 ORAL SURGERY IN THROMBOCYTOPENIC PATIENTS. PMID:14131575 | 1964 | this review only | Postoperative bleeding | not extracted yet |
| Morikawa 2021 Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report. PMID:34893080 | 2021 | this review only | not stated | not extracted yet |
| Morimoto 2004 Dental management prior to hematopoietic stem cell transplantation. PMID:15686278 | 2004 | this review only | not stated | not extracted yet |
| Oyaizu 2005 Periodontal treatment in severe aplastic anemia. PMID:16018767 | 2005 | this review only | not stated | not extracted yet |
| Patel 2016 Oral surgery in a patient with cirrhosis and thrombocytopenia: a case report. PMID:26625941 | 2016 | this review only | not stated | not extracted yet |
| Perdigao 2012 Postoperative bleeding after dental extraction in liver pretransplant patients. PMID:22374059 | 2012 | this review only | Postoperative bleeding | not extracted yet |
| Pereira 2016 Postoperative complications after dental extraction in liver pretransplant patients. PMID:27061180 | 2016 | this review only | Postoperative bleeding | not extracted yet |
| Rarick 1991 Intravenous immune globulin use in patients with human immunodeficiency virus-related thrombocytopenia who require dental extraction. PMID:1812630 | 1991 | this review only | not stated | not extracted yet |
| Sandhu 2020 Bleeding risk in thrombocytopenic patients after dental extractions: a retrospective single-center study. PMID:32001240 | 2020 | this review only | Postoperative bleeding | not extracted yet |
| Souza 2022 Hemorrhagic complications in individuals with liver disease submitted to minor oral surgery. PMID:35867941 | 2022 | this review only | Postoperative bleeding | not extracted yet |
| Stanca 2010 Intranasal desmopressin versus blood transfusion in cirrhotic patients with coagulopathy undergoing dental extraction: a randomized… PMID:20006168 | 2010 | this review only | Postoperative bleeding | not extracted yet |
| Vogel 1981 Periodontal disease associated with amegakaryocytic thrombocytopenia in systemic lupus erythematosus. PMID:6937647 | 1981 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Humans aged 16 years and older with preoperative platelet counts of 50,000/uL or below due to primary or secondary thrombocytopenia undergoing dental procedures with bleeding potential | Patients with thrombocytopenia (983 cases; 225 sample, 758 control) in 20 studies |
| Intervention | Dental procedures (oral surgery, periodontal, operative dentistry, endodontics, prosthodontics, dental anaesthesia, orthodontics, oral medicine) | Oral surgery 968 cases; periodontology 10; dental anaesthesia 5 |
| Comparison | Patients with platelet counts above 50,000/uL | Platelets above 50,000/uL (758 cases) |
| Outcomes | Primary: postoperative bleeding; secondary: infection, facial swelling, pain | Postoperative bleeding 65/983 (6.6%); pooled RR 2.95 (95% CI 1.76-4.96) from 10 studies |
| Study designs | No restriction on study design; English language only | 6 case reports, 4 case series, 9 cohort studies, 1 RCT |
| Timing | Early (within 24 h), late (2-5 days) and recurrent bleeding | Mostly within first postoperative week |