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Introduction: Adequate hemostasis is crucial for the success of invasive dental treatment, since bleeding problems
can give rise to complications associated with important morbidity-mortality. The dental treatment of patients who
tend to an increased risk of bleeding due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in
the daily practice of dental professionals. Adequate knowledge of the mechanisms underlying hemostasis, and the
optimized management of such patients, are therefore very important issues.
Objectives: A study is made of the anticoagulant / antiplatelet drugs currently available on the market, with evaluation
of the risks and benefits of suspending such drugs prior to invasive dental treatment. In addition, a review is
made of the current management protocols used in these patients.
Material and Methods: A literature search was made in the PubMed, Cochrane Library and Scopus databases, covering
all studies published in the last 5 years in English and Spanish. Studies conducted in humans and with scientific
evidence levels 1 and 2 (metaanalyses, systematic reviews, randomized phase 1 and 2 trials, cohort studies
and case-control studies) were considered. The keywords used for the search were: tooth extraction, oral surgery,
hemostasis, platelet aggregation inhibitors, antiplatelet drugs, anticoagulants, warfarin, acenocoumarol.
Results and Conclusions: Many management protocols have been developed, though in all cases a full clinical history
is required, together with complementary hemostatic tests to minimize any risks derived from dental treatment.
Many authors consider that patient medication indicated for the treatment of background disease should not be
altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown
to suffice for controlling possible bleeding problems resulting from dental treatment.
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