title: Apixaban and oral implications.
abstract: BACKGROUND
  Thrombotic disorders remain a leading cause of death in the Western world, and in this regard a number of anticoagulation treatment have been used, including heparins, fondaparinux, vitamin K antagonists (warfarin, acenocoumarol), and new oral anticoagulants such as apixaban. For years there has been great controversy regarding the use of anticoagulants in planning dental treatments that imply bleeding. The main concerns about using new oral anticoagulants in invasive dental procedures are bleeding due to the lack of an antidote, and the thrombotic risk of the disease for which anticoagulation was indicated in the first place.
  
  
  METHODS
  A literature search was conducted through May 2014 using the keyword "apixaban" for publications in the ISI Web of Knowledge. The search was extended to other databases (PubMed, Scopus and the Cochrane Library).
  
  
  RESULTS
  Based on the results of the different studies, apixaban seems to be a good alternative to conventional anticoagulation and a reasonable treatment option, though its main and most common adverse effect is bleeding. Dose adjustment is needed in some patients, though regular laboratory monitoring is not required. The use of the drug in different patient populations will define its final indications and doses.
  
  
  CONCLUSIONS
  Regarding the use of apixaban in the dental setting, there is a compelling need for further clinical studies in order to establish more evidence-based guidelines for patients requiring antithrombotic treatment.
  
  
  BACKGROUND
  Apixaban, dental treatment, dental implications.
authors.affiliation: Associate Professor, PhD, Dentistry Department, European University of Valencia, Valencia, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: Lopez-Galindo
authors.affiliation: Dentistry Department, University of Valencia, Valencia, Spain. Chairman of Oral Medicine, University of Valencia. Head of the Department of Stomatology and Maxillofacial Surgery,Valencia University General Hospital, Valencia, Spain.
authors.forename: Jose V
authors.initials: JV
authors.lastname: Bagán