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Introduction: For over 50 years, vitamin K antagonists such as warfarin (Aldocumar®) and acenocoumarol (Sintrom
®) have been the gold standard for reducing the risk of cerebrovascular events. In the last 5 years alternative
anticoagulants have been evaluated that act directly upon a concrete target within the coagulation cascade, thereby
affording a more predictable anticoagulant effect. The present study offers an update on the new oral anticoagulants
and reviews the implications referred to the dental care of patients administered these substances.
Material and methods: An exhaustive PubMed-Medline and Cochrane Library search was made of the main alternatives
to conventional oral anticoagulation, covering those studies published in English and Spanish over the
last 10 years. Specialized textbooks and pharmaceutical catalogs were also consulted. A total of 184 articles were
identified, of which 76 met the inclusion criteria.
Results: The new oral anticoagulants dabigatran, rivaroxaban and apixaban are safe and effective, and offer a series
of advantages, including rapid action, no need for constant monitoring, few drug and food interactions, and a broad
therapeutic margin. These drugs are expensive, however, and some lack a specific antidote, while others must be
administered twice a day. Regarding the dental treatment of patients receiving these drugs, suspension or modification
of the background medication is not required when performing invasive dental procedures, except where
indicated by the prescribing physician.
Conclusions: The new oral anticoagulants do not pose significantly greater risks than conventional oral anticoagulants
when providing invasive dental treatment, and their suspension is not strictly required in such situations.
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