Background: The risk of excessive bleeding often prompts physicians to interrupt the antiplatelet agents as acetylsalicilyc acid and clopidogrel before dental extractions which puts patients at risk of adverse thrombotic events. Aim: To assess the bleeding risk during dental extractions in patients with continued antiplatelet therapy. Materials and methods: The study included 130 patients (64 men and 66 women) aged between 18 and 99 years old. Sixty-eight of the patients received 100 mg acetilsalicilic acid (ASA); these were divided into two groups: 34 patients continued taking ASA and 34 patients stopped it 72 hours before extraction. Sixty-two of the patients were treated with 75 mg clopidogrel; these were also divided into two groups: 31 continued taking clopidogrel and 31 patients stopped it 72 hours before extractions. Extraction was performed under local anaesthesia as no more than 3 teeth per visit were extracted. Local haemostasis with gelatine sponge and/or suturing was used to control bleeding. Results: Mild bleeding was observed most frequently in the first 30 minutes, successfully managed by local haemostasis. Only 1 patient in the control and 1 in the experimental group receiving ASA reported mild bleeding in the first 24 hours, controlled by compression with gauze. No major haemorrhage requiring emergency or more than local haemostasis occurred. No statistically significant difference in bleeding between two groups was found. Conclusion: Single and multiple dental extractions in patients receiving acetylsalicylic acid or clopidogrel can be safely performed without discontinuation of the therapy with provided appropriate local haemostasis.

Effective local hemostasis is essential in oral surgery to prevent complications such as delayed healing, infection, and the need for re-intervention. Postoperative bleeding occurs in 4–6% of cases, increasing to 9–12% in patients receiving anticoagulant or antiplatelet therapy. This review evaluates the efficacy, safety, and clinical utility of local hemostatic agents based on 51 studies published between 1990 and 2023. Traditional agents, such as oxidized cellulose and gelatin sponges, control bleeding in over 85% of standard cases but offer limited regenerative benefits. Autologous platelet concentrates (APCs), including platelet-rich plasma (PRP) and leukocyte- and platelet-rich fibrin (L-PRF), reduce bleeding time by 30–50% and enhance soft tissue healing. Studies show the PRP may reduce postoperative bleeding in dental surgery by 30–50%, and in orthopedic and cardiac surgery by 10–30%, particularly in patients on anticoagulants. Tranexamic Acid mouthwash can reduce postoperative bleeding by up to 50–60%. Fibrin sealants achieve a 70–90% reduction in bleeding among high-risk patients, while topical tranexamic acid decreases hemorrhagic events by up to 80% in anticoagulated individuals without increasing thromboembolic risk. However, comparative studies remain limited, particularly in medically compromised populations. Additional gaps persist regarding long-term outcomes, cost-effectiveness, and the standardized use of emerging agents such as nanomaterials. Future research should prioritize high-quality trials across diverse patient groups and develop clinical guidelines that integrate both safety and regenerative outcomes.

Antiplatelet drugs are currently widely used in primary and especially secondary prevention of cardiovascular events. Dental management of patients on antiplatelet therapy is still not clearly defined: the discontinuation of antiplatelet therapy increases the risk of thrombotic complications, whereas uninterrupted antiplatelet therapy is assumed to increase the bleeding complications after dental surgical procedures. The aim of this article is to review the main antiplatelet drugs used for long-term oral antiplatelet therapy, the laboratory methods for evaluating effectiveness of this therapy, to identify the studies and guidelines available for dental management of patients on antiplatelet drugs and to summarize their conclusions and recommendations.The methodology used through the research for the literature review includes the following sources: Medscape, Pubmed - Medline database, Science Direct, and EBSCO host, the data base of Medical University Plovdiv and specialised published books in general medicine and dentistry

Dental treatment performed in patients receiving oral anticoagulant drug therapy is becoming increasingly common in dental offices.The aim of oral anticoagulant therapy is to reduce blood coagulability to an optimal therapeutic range within which the patient is provided some degree of protection from thromboembolic events. This is achieved at the cost of a minor risk of haemorrhage. Frequently raised questions concern the safety and efficacy of the various anticoagulation regimens and their accompanying thromboembolic and bleeding risks relative to invasive dental procedures.The aim of this literature review is to evaluate the available evidence on the impact of anticoagulant medications on dental treatment and highlight certain patient management issues closely interrelated to various aspects of dental treatment. For that purpose literature search in the electronic database of Medscape, Pubmed-Medline, Science Direct, and EBSCO host, in the data base of Medical University Plovdiv and specialised published books in general medicine and dentistry was made.A total of 33 publications between 1995 and 2013 were identified: 12 review articles, 11 randomized controlled and non-randomised studies, 6 guidelines and practical guides, 1 meta-analysis and 3 specialised books

For many years the oral infection, especially periodontitis, is considered as a potential contributing factor to a variety of clinically important systemic diseases.\ud Alopecia areata (AA) is an autoimmune disease with unclear etiology and pathogenesis, rarely associated with dental foci. This disease has a strong psychological impact on the patient, because it presents with hair loss and can affect any hair-bearing area, but usually involves the face and scalp, where esthetic considerations play an important role in self perception.\ud In this article is presented a case of alopecia areata resulting from dental foci that was effectively resolved by eliminating a focalized dental infection via dental extraction.\ud In this sense, patients with AA should be subjected to careful exploration of the oral cavity in search of possible dental infections. Close collaboration between dentist, dermatologist, endocrinologist and other medical specialists in the interdisciplinary approach of diagnosis and treatment is needed