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Exodontia em Paciente Usuário de Anticoagulante Oral

DOI: http://dx.doi.org/10.15600/2238-1236/fol.v25n1p47-54

https://www.metodista.br/revistas/revistas-unimep/index.php/FOL/index 

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Monique M. M. Mouchrek1, Mayara C. A. Frazão2, Marjorie A. da C. Nunes3, Gisele Q. T. L. da Silva4, Erika M. Pereira5 & Maria C. F. da Cruz6

 

Resumo: Introdução: Quando pacientes em tratamento com anticoagulantes orais precisam ser submetidos a algum procedimento de cirurgia oral existe um risco aumentado de sangramento. Dessa forma, há uma grande diversidade de opinião, tanto na área médica quanto na odontológica, em como realizar um tratamento odontológico seguro em pacientes anticoagulados. Se suspende-se o anticoagulante e expõe o paciente ao risco de trombose ou se continua-se a medicação e expõe o paciente ao risco de hemorragias. Objetivo: Buscar na literatura a melhor forma de atendimento aos pacientes usuários de anticoagulante oral quando submetidos a procedimentos odontológicos cirúrgicos. Metodologia: Foi realizada uma pesquisa na base de dados PubMed com os descritores: “surgery oral”, “anticoagulants” e “tooth extraction” e fizeram parte da revisão os estudos onde foi realizada pesquisa em campo trazendo evidências clínicas. Resultados: Foram encontrados 20 estudos de acordo com o critério de inclusão adotado. Nos estudos selecionados foi observada uma diversidade no valor da Razão normalizada internacional dos pacientes submetidos à exodontia e encontrado também o uso de diferentes medidas hemostáticas. O número de casos de hemorragia foi baixo quando comparado com a quantidade de exodontias realizadas. Conclusão: Foi observado que não há necessidade de expor o paciente ao risco de sofrer uma trombose ao suspender o uso do anticoagulante oral para realizar a exodontia. A terapêutica de manutenção do anticoagulante oral vem sendo preconizada, considerando a importância do valor da Razão normalizada internacional dentro do adequado e o uso de medida hemostática local.

Palavras-chave: Cirurgia bucal. Anticoagulantes. Extração dentária.

 

Abstract: Background: When patients were treated with oral anticoagulants have to undergo a procedure oral surgery there is an increased risk of bleeding. Thus, there is a great diversity of opinion both in the medical field and in dental on how to perform a secure dental treatment in anticoagulated patients is the anticoagulant is suspended and exposes the patient to risk of thrombosis or if the medication is continued and exposes the patient to the risk of bleeding. Objective: The aim of search the literature how best to care for patients undergoing oral anticoagulant therapy when undergoing surgical dental procedures. Methods: A survey was conducted in the PubMed database using the keywords: “oral surgery”, “anticoagulants” and “tooth extraction” and only made part of the review studies where field research was conducted bringing clinical evidence. Results: Were found 20 studies according to the inclusion criteria. In selected studies diversity was observed in the value of international normalized ratio in patients undergoing dental extraction and also found the use of different hemostatic measures. The number of cases of bleeding was low compared to the amount of dental extractions. Conclusion: We found that there is no need to expose the patient to the risk of suffering a stroke by suspending the use of anticoagulants. Maintenance therapy of oral anticoagulation has been recommended, considering the importance of the value of international normalized ratio in the proper use and local hemostatic measure.

Key words: Surgery oral. Anticoagulants. Tooth extraction.

 

1 Pós-graduanda, Mestrado em Odontologia, Programa de Pós-Graduação em Odontologia, UFMA Universidade Federal do Maranhão
2 Pós-graduanda, Mestrado em Odontologia, Programa de Pós-Graduação em Odontologia, UFMA Universidade Federal do Maranhão
3 Pós-graduanda, Mestrado em Odontologia, Programa de Pós-Graduação em Odontologia, UFMA Universidade Federal do Maranhão
4 Pós-graduanda, Doutorado em Odontologia, Programa de Pós-Graduação em Odontologia, UFMA Universidade Federal do Maranhão
5 Professora Doutora do Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, UFMA Universidade Federal do Maranhão
6 Professora Doutora do Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, UFMA Universidade Federal do Maranhão

 

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