6533b7d5fe1ef96bd1264938
RESEARCH PRODUCT
Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature.
Ramírez-martínez-acitores LHernández-vallejo GCasañas-gil ERosa María López-pintorMarta Muñoz-corcuerasubject
medicine.medical_specialtyOral Surgical ProceduresPsychological interventionMEDLINEAdministration OralReviewCochrane LibraryPostoperative Hemorrhagelaw.inventionDabigatran03 medical and health sciences0302 clinical medicineRandomized controlled triallawMedicineHumansIntensive care medicineGeneral DentistryStrokebusiness.industryAnticoagulants030206 dentistry:CIENCIAS MÉDICAS [UNESCO]medicine.diseaseMedically compromised patients in DentistrySurgeryDabigatranClinical trialOtorhinolaryngologyEmbolism030220 oncology & carcinogenesisUNESCO::CIENCIAS MÉDICASSurgerybusinessmedicine.drugdescription
Background Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. Material and Methods We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library. We excluded articles dealing with all anticoagulants other than dabigatran, and works about surgical treatments in anatomical locations other than the oral cavity. Results We included a total of 13 papers of which 1 was a randomized clinical trial, 9 narrative literature reviews, 1 case series, 2 clinical cases and 1 expert opinion. Because we did not obtain any properly designed clinical trials, we were unable to conduct a meta-analysis. Conclusions Currently, there is no consensus on the procedure to be followed in patients taking dabigatran. However, all authors agree to treat each case individually in accordance to the risk of embolism, postoperative bleeding and renal function. Also, it is necessary to perform minimally invasive interventions, and take the appropriate local anti-hemolytic measures. Key words:Oral anticoagulants, dabigatran, risk of bleeding, oral surgery, dentistry.
year | journal | country | edition | language |
---|---|---|---|---|
2015-12-21 | Medicina oral, patologia oral y cirugia bucal |