Manejo dos Pacientes Anticoagulados em Cirurgia Oral

Abstract

Increased life expectancy and the increasing use of anticoagulants pose a challenge for dentistry, especially in oral surgical procedures. This study is a literature review conducted in PubMed, PMC, ResearchGate, BJIHS Journal, and institutional repositories, using the descriptors "Oral surgery," "Direct oral anticoagulants (DOACs)," "Perioperative management," and "Oral anticoagulants." Articles published in the last ten years, in English and Portuguese, addressing the perioperative management of patients using anticoagulants undergoing oral surgery were included. The results show that low-risk procedures, such as simple extractions and single implants, can be performed without discontinuing therapy, as long as local hemostatic measures are applied. Medium- and high-risk surgeries require individualized assessment, considering renal function, type of anticoagulant, and thromboembolic risk, with communication with the attending physician being essential. Strategies such as suturing, the use of physical/biological hemostatic agents, and antifibrinolytics, along with specific postoperative guidelines, have proven effective in controlling bleeding. It is concluded that the safe management of anticoagulated patients in oral surgery requires individualized planning, interdisciplinary communication, and rigorous application of hemostatic techniques to balance bleeding and thromboembolic risk.