Abstract
Introduction
The purpose of this study was to review evidence-based recommendations for the safe
perioperative management of patients undergoing endodontic microsurgery who are currently
taking antiplatelet or anticoagulant medications. Using the PICO (Population, Intervention,
Comparison, Outcome) format, the following scientific question was asked: In patients
taking anticoagulant or antiplatelet agents, what is the available evidence in the
management of endodontic microsurgery?
Methods
MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov databases were searched
to identify current recommendations regarding the management of antiplatelet and anticoagulant
medications in the context of outpatient dental surgical procedures. Additionally,
the authors hand searched the bibliographies of all relevant articles, the gray literature,
and textbooks. Because of the lack of clinical studies and evidence on this subject,
articles and guidelines from other organizations and association position statements
were included.
Results
Because any minor surgery can become a major surgery, the treating doctor needs to
best assess the risk of bleeding, especially if the surgery is anticipated to take
longer than 45 minutes. Every patient should be stratified on a case-by-case basis.
Consultation with the patient’s physician is highly recommended.
Conclusions
In order to maximize the effects of these medications (to prevent thrombosis) while
minimizing the potential risks (procedural hemorrhage), clinicians should be aware
of the best available evidence when considering continuation or discontinuation of antiplatelet
and anticoagulant agents perioperatively for endodontic microsurgery. Ideally, a joint
effort from an expert panel for microsurgery would be warranted.
Key Words
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Article info
Publication history
Published online: July 11, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
