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 patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment.


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.
Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain, martamcorcuera@gmail.com.
M
M
Muñoz-Corcuera
L
L
Ramírez-Martínez-Acitores
R-M
RM
López-Pintor
E
E
Casañas-Gil
G
G
Hernández-Vallejo
D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D000069604:Dabigatran / Q000627:therapeutic use*; D006801:Humans; D019647:Oral Surgical Procedures; D019106:Postoperative Hemorrhage / Q000517:prevention & control
D000925:Anticoagulants; D000069604:Dabigatran
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