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The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review

BACKGROUND: Direct oral anticoagulants (DOACs) were developed to overcome the drawbacks of oral anticoagulants. However, not much has been discussed about the perioperative management of patients on DOACs during oral surgical procedures. Thus, we aim to determine the risk of perioperative and postop...

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Autor principal: Darwish, Ghassan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566068/
https://www.ncbi.nlm.nih.gov/pubmed/37821865
http://dx.doi.org/10.1186/s12903-023-03427-8
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author Darwish, Ghassan
author_facet Darwish, Ghassan
author_sort Darwish, Ghassan
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description BACKGROUND: Direct oral anticoagulants (DOACs) were developed to overcome the drawbacks of oral anticoagulants. However, not much has been discussed about the perioperative management of patients on DOACs during oral surgical procedures. Thus, we aim to determine the risk of perioperative and postoperative bleeding during oral surgical procedures in patients on DOACs. METHODS: A detailed literature search was performed to find potentially relevant studies using the Cochrane Library, Clinical Key, ClinicalTrials.gov, Google Scholar, Ovid, ScienceDirect, and Scopus. Every article available for free in English literature for the past 10 years, between 2012 and 2022, was searched. RESULTS: A total of 2792 abstracts were selected through a search strategy across various search engines. Based on inclusion and exclusion criteria, eleven clinical studies using DOACs as anticoagulants or studies comparing patients with and without DOACs under oral surgery procedures were found. The results were inconsistent and varied, with a few studies recommending DOAC administration with the bare minimum reported complications and others finding no statistically significant difference between discontinuation or continuation of drugs, especially across basic dental procedures. CONCLUSION: Within the limitations of the study, it can be concluded that minor oral surgical procedures are safe for patients on DOAC therapy. However, the continuation or discontinuation of DOACs in patients undergoing oral surgical procedures remains controversial and requires further studies to extrapolate the results. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-023-03427-8.
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spelling pubmed-105660682023-10-12 The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review Darwish, Ghassan BMC Oral Health Research BACKGROUND: Direct oral anticoagulants (DOACs) were developed to overcome the drawbacks of oral anticoagulants. However, not much has been discussed about the perioperative management of patients on DOACs during oral surgical procedures. Thus, we aim to determine the risk of perioperative and postoperative bleeding during oral surgical procedures in patients on DOACs. METHODS: A detailed literature search was performed to find potentially relevant studies using the Cochrane Library, Clinical Key, ClinicalTrials.gov, Google Scholar, Ovid, ScienceDirect, and Scopus. Every article available for free in English literature for the past 10 years, between 2012 and 2022, was searched. RESULTS: A total of 2792 abstracts were selected through a search strategy across various search engines. Based on inclusion and exclusion criteria, eleven clinical studies using DOACs as anticoagulants or studies comparing patients with and without DOACs under oral surgery procedures were found. The results were inconsistent and varied, with a few studies recommending DOAC administration with the bare minimum reported complications and others finding no statistically significant difference between discontinuation or continuation of drugs, especially across basic dental procedures. CONCLUSION: Within the limitations of the study, it can be concluded that minor oral surgical procedures are safe for patients on DOAC therapy. However, the continuation or discontinuation of DOACs in patients undergoing oral surgical procedures remains controversial and requires further studies to extrapolate the results. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-023-03427-8. BioMed Central 2023-10-11 /pmc/articles/PMC10566068/ /pubmed/37821865 http://dx.doi.org/10.1186/s12903-023-03427-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Darwish, Ghassan
The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title_full The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title_fullStr The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title_full_unstemmed The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title_short The Effect of Direct Oral Anticoagulant Therapy (DOACs) on oral surgical procedures: a systematic review
title_sort effect of direct oral anticoagulant therapy (doacs) on oral surgical procedures: a systematic review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566068/
https://www.ncbi.nlm.nih.gov/pubmed/37821865
http://dx.doi.org/10.1186/s12903-023-03427-8
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