Maxillofacial and oral surgery in patients with thrombophilia: safe territory for the oral surgeon? A single-center retrospective study

Abstract

The aim of this study was to analyze patients with thrombophilia who underwent oral and/or maxillofacial surgery at our center. We performed a retrospective analysis of patients with hereditary or acquired thrombophilia who had undergone oral/maxillofacial surgery between January 1, 2000 and December 31, 2019. Data regarding demographic and patient characteristics, surgical treatment modalities, antithrombotic therapies, and complications were analyzed. A total of 76 eligible patients (26 male, 50 female) were included in this study, with a mean follow-up period of 3.8 months (range, 0-51 months). The mean age at time of surgery was 44.7 ± 19.4 years. Seven different hereditary and acquired thrombophilia were identified: factor V Leiden (n=31; 40.8%), prothrombin G20210A mutation (n=5; 6.6%), protein C deficiency (n=4; 5.3%), protein S deficiency (n=11; 14.5%), antiphospholipid syndrome (n=10; 13.2%), hyperhomocysteinemia (n=8; 10.5%), and elevated factor VIII (n=2; 2.6%). Complications occurred in 9 patients (11.8%) and included postoperative infections (n=6; 7.9%) and postoperative bleeding (n=3; 3.9%). Our data suggest that oral and/or maxillofacial surgery in patients with a confirmed diagnosis of thrombophilia is not associated with a burden of thrombosis or high complication rates. Furthermore, we formulated a guideline for preoperative antithrombotic therapy for patients with thrombophilia undergoing oral and/or maxillofacial surgery.