BackgroundA new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments.Material and MethodsA literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords “dabigatran”, “rivaroxaban”, “apixaban”, “edoxaban”, “new oral anticoagulants”, “novel oral anticoagulants”, “bleeding” and “dental treatment”.ResultsThere is no need for regular coagulation monitoring of patients on dabigatran therapy. Whether or not to temporarily discontinue dabigatran must be assessed according to the bleeding risk involved in the dental procedure to be performed.ConclusionsThe number of patients under treatment with new oral anticoagulants will increase in the coming years. It is essential to know about the pharmacokinetics and pharmacodynamics of new oral anticoagulants and about their interactions with other drugs. It is necessary to develop clinical guidelines for the perioperative and postoperative management of these new oral anticoagulants in oral surgical procedures, and to carefully evaluate the bleeding risk of dental treatment, as well as the thrombotic risk of suppressing the new oral anticoagulant. Key words:Dabigatran, rivaroxaban, apixaban, edoxaban, novel oral anticoagulants, bleeding.
The aim of this study was to investigate whether statistically significant differences exist regarding pain and the impact on oral quality of life of orthodontic treatment. A conventional brackets system was compared with low-friction brackets. A total of 90 patients (male = 35, female = 55) were chosen for this randomized clinical trial. Pain was assessed at 4, 8, and 24 hours and 2, 3, 4, 5, 6, and 7 days after the start of treatment using the McGill Pain Questionnaire. Oral health-related quality of life (OHRQoL) was assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Oral quality of life was assessed at one month, with patients with low-friction brackets describing lower levels of pain. The patients with conventional brackets indicated a worse impact on their quality of life compared to the group with low-friction brackets. Statistically significant differences were found between the groups, with maximum pain observed between the first 24 and 48 hours, and the values of minimum pain are reached after 7 days. The pain and impact on oral quality of life was statistically worse in patients with conventional brackets compared to patients with low-friction brackets. The type of bracket system used was therefore shown to influence patients’ perceptions of pain and impact on their OHRQoL.
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