Clinical practice guideline of the spanish society of oral surgery for oral surgery in patients with coagulation disorders

• Javier Valenzuela-Mencia ^[1] ; María Ángeles Serrera-Figallo ^[1] ; Daniel Torres-Lagares ^[1] ; Guillermo Machuca-Portillo ^[1] ; Elena Sánchez-Fernández ^[2] ; Eduard Valmaseda-Castellón ^[3] ; María Peñarrocha-Diago ^[4] ; Nuria Fernández-Mosteirín ^[6] ; José Manuel Somoza-Martin ^[7] ; Alba Pérez-Jardón ^[8] ; Cintia Micaela Chamorro-Petronacci ^[5] ; Abel García-García ^[5]
  1. [1] Universidad de Sevilla

     Universidad de Sevilla

     Sevilla, España

     
  2. [2] Universidad de Granada

     Universidad de Granada

     Granada, España

     
  3. [3] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  4. [4] Universitat de València

     Universitat de València

     Valencia, España

     
  5. [5] Universidade de Santiago de Compostela

     Universidade de Santiago de Compostela

     Santiago de Compostela, España

     
  6. [6] Medical Area Specialist in Haematology and Haemotherapy. Haemostasis Department. Haematology and Haemotherapy Service. Miguel Servet University Hospital. Zaragoza
  7. [7] Associate Professor. Department of Surgery and Medical-Surgical Specialities. Faculty of Medicine and Dentistry. University of Santiago
  8. [8] 0Health Research Institute of Santiago de Compostela (IDIS)

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 29, Nº. 1 (January), 2024
• Idioma: inglés
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• Resumen

  • The number of patients treated with coagulation disorders, and more specifically with anticoagulant therapy, has increased worldwide in recent years due to increased life expectancy in developed countries. The protocols for managing this type of patient in oral surgery has varied over recent years, especially after the appearance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patient when undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general practitioners. The objective of this document is to offer recommendations, based on evidence, for decision making for patients with coagulopathies who require dental surgical intervention.

    Based on the indications of the “Preparation of Clinical Practice guidelines in the National Health System. Methodological manual”, we gathered a group of experts who agreed on 15 PICO questions based on managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dental extractions.

    The 15 PICO questions were answered based on the available evidence, being limited in most cases due to the lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation, while the rest were answered with grade D.

    The results of this review highlight the need to undertake well designed clinical trials with control groups and with a representative sample size.