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Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature

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 pat...

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Autores principales: Muñoz-Corcuera, Marta, Ramírez-Martínez-Acitores, Lucía, López-Pintor, Rosa Mª, Casañas-Gil, Elisabeth, Hernández-Vallejo, Gonzalo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medicina Oral S.L. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116109/
https://www.ncbi.nlm.nih.gov/pubmed/27694780
http://dx.doi.org/10.4317/medoral.21202
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author Muñoz-Corcuera, Marta
Ramírez-Martínez-Acitores, Lucía
López-Pintor, Rosa Mª
Casañas-Gil, Elisabeth
Hernández-Vallejo, Gonzalo
author_facet Muñoz-Corcuera, Marta
Ramírez-Martínez-Acitores, Lucía
López-Pintor, Rosa Mª
Casañas-Gil, Elisabeth
Hernández-Vallejo, Gonzalo
author_sort Muñoz-Corcuera, Marta
collection PubMed
description 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.
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spelling pubmed-51161092016-11-29 Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature Muñoz-Corcuera, Marta Ramírez-Martínez-Acitores, Lucía López-Pintor, Rosa Mª Casañas-Gil, Elisabeth Hernández-Vallejo, Gonzalo Med Oral Patol Oral Cir Bucal Review 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. Medicina Oral S.L. 2016-11 2016-10-01 /pmc/articles/PMC5116109/ /pubmed/27694780 http://dx.doi.org/10.4317/medoral.21202 Text en Copyright: © 2016 Medicina Oral S.L. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Muñoz-Corcuera, Marta
Ramírez-Martínez-Acitores, Lucía
López-Pintor, Rosa Mª
Casañas-Gil, Elisabeth
Hernández-Vallejo, Gonzalo
Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title_full Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title_fullStr Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title_full_unstemmed Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title_short Dabigatran: A new oral anticoagulant. Guidelines to follow in oral surgery procedures. A systematic review of the literature
title_sort dabigatran: a new oral anticoagulant. guidelines to follow in oral surgery procedures. a systematic review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116109/
https://www.ncbi.nlm.nih.gov/pubmed/27694780
http://dx.doi.org/10.4317/medoral.21202
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