New oral anticoagulants - newest update in dental medicine

Dimova, Cena (2012) New oral anticoagulants - newest update in dental medicine. In: VI Macedonian Dental Congress, 24-27 May 2012, Ohrid.

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Introduction: Although their first application in clinical practice occurred in the 1940s, vitamin K antagonists remain the only form of oral anticoagulant medication approved for longterm use. During the past 20 years, the approval of anticoagulants such as low-molecular-weight heparins (LMWHs), indirect factor Xa inhibitors and direct thrombin inhibitors has signaled a growing interest in antithrombotic compounds that have relatively discrete targets within the coagulation pathway.The oral and maxillofacial surgeons are frequently asked to manage patients who are receiving oral anticoagulants. The goal of treatment is to minimize the risk of hemorrhage while continuing to protect the patient against thromboembolism formation. Aim of this study is to review the evidence of different therapy approach, to highlight the areas of major concern, and to suggest specific oral surgery treatment for patients on new oral anticoagulants. Material and method: A Medline and an extensive hand search were performed on English-language publications beginning in 1971 till now. The pertinent literature and clinical protocols of hospital dentistry departments have been extensively reviewed, presented and discussed. Results: Several evolving clinical practices in the last years have been detected: - anticoagulants are generally not discontinued; - oral surgery is performed despite laboratory values showing significant bleeding tendency; - new effective local haemostatic modalities are used to prevent bleeding; - patients at risk are referred to hospital-based clinics. Conclusion: The management of oral surgery procedures on patients treated with new anticoagulants should be influenced by several factors: laboratory values, extent and urgency of the intervention, treating physician’s recommendation, available facilities, dentist expertise, and patient’s oral, medical, and general condition.

Item Type: Conference or Workshop Item (Lecture)
Subjects: Medical and Health Sciences > Basic medicine
Medical and Health Sciences > Clinical medicine
Medical and Health Sciences > Other medical sciences
Divisions: Faculty of Medical Science
Depositing User: Cena Dimova
Date Deposited: 27 Nov 2012 13:26
Last Modified: 30 Sep 2013 13:24

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