Antiplatelet Therapy Continuation Versus Discontinuation in Patients Undergoing Dental Extraction: A Systematic Review

Antiplatelet medications are widely prescribed for the prevention of cardiovascular and cerebrovascular thrombotic events; however, their continuation during dental extraction remains a clinical concern because of the potential for postoperative bleeding.This systematic review evaluated the available randomized controlled evidence on whether antiplatelet therapy should be discontinued before dental extraction.A systematic literature search was conducted in PubMed/MEDLINE, the Cochrane Library, Scopus, Web of Science, and Google Scholar for studies published between January 2000 and July 2026.Randomized controlled trials (RCTs) involving patients receiving antiplatelet therapy who underwent dental extraction and comparing continuation with discontinuation of treatment were eligible.Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool.Seven RCTs involving 646 participants were included in the qualitative synthesis.The included studies evaluated aspirin and/or clopidogrel therapy and reported interruption periods ranging from 72 hours to seven days.Four studies reported no postoperative bleeding in either treatment group, whereas the remaining studies reported only mild or limited postoperative oozing.Bleeding events were generally managed successfully with local hemostatic measures, including pressure application, suturing, and local hemostatic materials.Six studies had some concerns regarding the risk of bias, and one was judged to have a high risk of bias.Owing to heterogeneity in antiplatelet regimens, extraction procedures, bleeding definitions, and assessment time points, a quantitative meta-analysis was not performed.Available evidence suggests that continuation of antiplatelet therapy during dental extraction is generally associated with manageable postoperative bleeding, although the certainty of evidence remains limited.