Controversies in Stoppage of Antiplatelet and Anticoagulant Medications Prior to Oral Surgery - 09/11/23
Résumé |
Dental procedures can pose a risk of bleeding, and it is not uncommon for dentists to consult prescribing physicians regarding a mutual patient's antiplatelet and anticoagulant medication to prevent excessive bleeding during or after an upcoming procedure. However, there has been a growing controversy in the dental community surrounding the stoppage of these medications prior to dental procedures. Some believe that stopping these medications prior to dental procedures is necessary to reduce the risk of bleeding complications, while others argue that stopping them can increase the risk of stroke or other thromboembolic events. The debate has left many dentists and specialists unsure about the best course of action when it comes to managing bleeding risk during dental procedures.In this article, we will review the antithrombotic medications, indications, mechanism of action, and its effects on the coagulation pathway, laboratory testing and reversal agents. Also, we will explore the controversy surrounding the stoppage of novel anitplatelets (eg,: prasurgrel and ticagrelor), dual-antiplatelets, triple-antiplatelet, vitamin K antagonists (eg,: wafarin, coumadin), and direct oral anticoagulants (eg,: dabigatran, rivaroxaban, xarelto and endoxaban) in dentistry and examine the current evidence and guidelines for managing dental patients undergoing oral surgery.
Le texte complet de cet article est disponible en PDF.Keywords : DOAC dental management, Antiplatelet dental management, Dental extractions, Bleeding risk assessment, Factor Xa inhibitor, Thrombin inhibitor, Dual antiplatelet therapy dental management, Oral surgery
Plan
Vol 68 - N° 1
P. 21-45 - janvier 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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