| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.45 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: Na sociedade moderna existem cada vez mais doentes polimedicados cujas
patologias e/ou terapêuticas podem, de alguma forma, interferir com o tratamento médico
dentário e a forma como este é aplicado. Em particular, os procedimentos em cirurgia oral
podem pressupor complicações intra e pós-operatórias a nível hemorrágico em pacientes sob
tratamento com anticoagulantes orais. A decisão de manter ou suspender a terapêutica
anticoagulante é baseada no risco hemorrágico e a probabilidade de haver uma complicação
tromboembólica.
Objetivos: Avaliar os padrões de suspensão ou não da terapêutica anticoagulante e
antiagregante plaquetar e, por conseguinte, criar recomendações e protocolos para as
principais situações clínicas associadas a esta problemática, promovendo desta forma as boas
práticas clínicas junto dos médicos dentistas.
Metodologia: Procedeu-se a uma revisão bibliográfica nas plataformas Pubmed, Rcaap,
Google académico, para analisar os princípios gerais e protocolos nos quais a terapêutica
anticoagulante/antiagregante plaquetar está inserida e qual a sua relação com as principais
situações médico-dentárias. Foi aplicado um questionário aos médicos dentistas portugueses
de forma a avaliar se respeitam os protocolos que se encontram em vigor quer na literatura
quer nas principais entidades governamentais de saúde.
Resultados e discussão: Apesar de a amostra obtida neste estudo não ser representativa da
classe, existe grande variabilidade nos padrões de suspensão da terapêutica
anticoagulante/antiagregante plaquetar pelos médicos dentistas inquiridos. Uma das razões
poderá ser baseada no facto de os profissionais terem uma preferência por utilizarem a sua
experiência e prática clínica ao invés de se orientarem por estudos e guidelines atualizadas e
com base científica.
Conclusão: São necessários mais estudos e com amostras mais significativas sobre o impacto
dos anticoagulantes orais e antiagregantes plaquetares em pacientes que necessitam ser
intervencionados em cirurgias orais. É importante criar guidelines nacionais e internacionais,
compostas por um comité científico multidisciplinar, que incluam toda a gama de
anticoagulantes orais e antiagregantes plaquetares e avaliarem os riscos individuais dos
pacientes.
Background: In modern society, polymedicated patients whose diseases and/or therapies may somehow interfere with the dental treatment are increasing. In particular, oral surgery procedures may involve intraoperative and postoperative bleeding in patients under treatment with oral anticoagulants. The decision to continue or to suspend anticoagulant therapy is based on the risk of bleeding and the probability of a thromboembolic complication. Objectives: To assess anticoagulation and antiplatelet suspension patterns by Portuguese dentists and therefore create recommendations and protocols for the main clinical conditions associated with this problem promoting good clinical practice among dentists. Methodology: It proceeded to a literature review in Pubmed database, Rcaap, ScienceDirect and Google scholar to analyse the general principles and protocols in which anticoagulant/antiplatelet therapy is included and what is its relationship with leading medical and dental situations. In order to assess whether respect the protocols that are in place either in literature or in major government health entities was applied questionnaires to Portuguese dentists. Results and discussions: Although the sample obtained in this study is not representative of professional board, there is high variability in suspension patterns of anticoagulants/antiplatelet agents. One reason may be based on the fact that dentists have a preference for using their experience and clinical practice rather than be guided by studies and updated evidence-based guidelines. Conclusion: Further studies are needed and more significant samples about the impact of oral anticoagulants and antiplatelet in patients who need an oral surgery. It is important to create national and international guidelines composed by a multidisciplinary scientific committee, including the full range of oral anticoagulants and antiplatelet agents and evaluate the patient individual risk.
Background: In modern society, polymedicated patients whose diseases and/or therapies may somehow interfere with the dental treatment are increasing. In particular, oral surgery procedures may involve intraoperative and postoperative bleeding in patients under treatment with oral anticoagulants. The decision to continue or to suspend anticoagulant therapy is based on the risk of bleeding and the probability of a thromboembolic complication. Objectives: To assess anticoagulation and antiplatelet suspension patterns by Portuguese dentists and therefore create recommendations and protocols for the main clinical conditions associated with this problem promoting good clinical practice among dentists. Methodology: It proceeded to a literature review in Pubmed database, Rcaap, ScienceDirect and Google scholar to analyse the general principles and protocols in which anticoagulant/antiplatelet therapy is included and what is its relationship with leading medical and dental situations. In order to assess whether respect the protocols that are in place either in literature or in major government health entities was applied questionnaires to Portuguese dentists. Results and discussions: Although the sample obtained in this study is not representative of professional board, there is high variability in suspension patterns of anticoagulants/antiplatelet agents. One reason may be based on the fact that dentists have a preference for using their experience and clinical practice rather than be guided by studies and updated evidence-based guidelines. Conclusion: Further studies are needed and more significant samples about the impact of oral anticoagulants and antiplatelet in patients who need an oral surgery. It is important to create national and international guidelines composed by a multidisciplinary scientific committee, including the full range of oral anticoagulants and antiplatelet agents and evaluate the patient individual risk.
Description
Keywords
Anticoagulantes Antiagregante plaquetar Cirurgia oral Extração dentária Anticoagulant Antiplatelet agent Oral surgery Dental extraction