Manejo odontológico del paciente en tratamiento de  anticoagulante oral sometido a cirugía oral:  una revisión narrativa  [Versión Original en Español]

Javiera  Cancino; Diego Fonseca; Fernando Parada

doi:10.59334/ROV.v2i39.552

Autores/as

Javiera Cancino Universidad Finis Terrae
Diego Fonseca Universidad Andrés Bello
Fernando Parada Universidad Andrés Bello

DOI:

https://doi.org/10.59334/ROV.v2i39.552

Palabras clave:

Cirugía bucal, anticoagulantes, atención dental, hemorragia oral

Resumen

Los pacientes que se encuentran bajo tratamiento de anticoagulantes orales, presentan alteraciones en distintas etapas de la hemostasia, lo que conlleva a tener implicancias y consideraciones médico/quirúrgicas durante su atención. En la actualidad, no existe un consenso en relación con el manejo odontológico de estos pacientes que serán sometidos a procedimientos quirúrgicos, llevando a protocolos clínicos que siguen diversas posturas, como la de disminuir la ingesta farmacológica del anticoagulante, sustituir con heparina y la de mantener el tratamiento bajo control. Objetivo: Establecer el manejo estomatológico del paciente que se encuentra en tratamiento de anticoagulante oral mediante una revisión profunda de la literatura. Materiales y métodos: Se realizó una búsqueda de revisión bibliográfica manualmente de artículos indexados a las bases de datos de PUBMED y EBSCO que correspondiesen a las palabras “cirugía bucal”, “anticoagulantes”, “atención dental” y “hemorragia oral”. En cuanto a los criterios de inclusión, se consideraron revisiones bibliográficas, estudios observacionales, ensayos clínicos, guías, revisiones sistemáticas y metaanálisis publicados entre noviembre de 2005 y 2022, en idiomas inglés o español. Conclusiones: Existen múltiples protocolos para la atención del paciente anticoagulado que será sometido bajo procedimiento de cirugía oral menor. Es importante considerar el anticoagulante utilizado, motivo, control de este, el procedimiento a realizar en el paciente y medidas hemostáticas tanto intra como postoperatorias por realizar, tras analizar lo anterior, se advierte que disminuir la ingesta del fármaco para realizar el procedimiento, puede ser más perjudicial al paciente como al clínico, por lo tanto se sugiere mantener el tratamiento antitrombótico y realizar un correcto manejo médico/quirúrgico.

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Citas

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