Contributor

Assoc. Prof. A.Tsirlis

Country - Institution

School of Dentistry, Aristotle University of Thessaloniki, Greece

Title

Perioperative management of antithrombotic therapy in oral surgery

Summary

The pusrpose of the current lecture is to present up to date information about the management of patients on antithrombotic therapy in oral surgery.

            Antithrombotic drugs include two major categories, the antiplatelets and the anticoagulants. Antiplatelets (aspirin, clopidogrel, ticlopidine, dipyridamole) mainly used for primary or secondary prevention of thromboebolism in patients with atherosclerotic lesions. Anticoagulants (dicoumarol, warfarin, heparins) mainly used for prevention of thromboembolism in patients with prosthetic heart valves, atrial fibrillation, pulmonary embolism etc. For many years antithrombotic drugs were discontinued before invasive dental treatment, in order to prevent severe bleeding complications. Resent research showed that minor oral surgery procedures can be carried out safely without discontinuation of drug therapy. Severe bleeding complications are rare, if adequate local haemostatic measures are ensured. On the other hand, when discontinuing antithrombotic therapy, there is a substantial danger of thromboembolic complications, which maybe even fatal.

            Current research data and guidelines on the management of these patients in oral surgery will be discussed.