Key result
For low-bleeding risk oral surgery procedures, maintaining direct oral anticoagulant therapy without interruption is generally safe when adequate local hemostatic measures are applied.
Why the study?
With increasing numbers of patients taking newly approved direct oral anticoagulants, familiarity with their properties and peri-operative management during oral surgery is needed.
This review highlights the pharmacological properties and peri-operative management strategies for patients on direct oral anticoagulants undergoing oral surgery.
Cautious support for uninterrupted DOAC in low-risk oral surgery; leaves open confirmation by randomized trials.
Recently, four new oral anticoagulant – dabigatran etexilate (direct thrombin inhibitor) and rivaroxaban, apixaban and edoxaban (Xa factor direct inhibitor) – have been approved for the prevention of venous thrombosis and cardiovascular events. As the number of patients taking these drugs is increasing, it is important that the dentist is familiar with these new oral anticoagulants, their indications, methods of action and in particular the management of the patients undergoing oral surgery. This literature review is conducted to highlight the medical uses of these new oral anticoagulants and their pharmacologic properties, the clinical condition of the patient that may influence the choice to discontinue the DOAC and peri-operative management of the patient. Collaboration with the attending physician is crucial.
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Lupi et al. (2019) conducted a review in Patients taking DOACs undergoing oral surgery. Direct Oral Anticoagulants (DOACs) was evaluated. For low-bleeding risk oral surgery procedures, maintaining direct oral anticoagulant therapy without interruption is generally safe when adequate local hemostatic measures are applied.
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