Johnston S
Balfour Oral Surgery Unit, NHS Orkney, Balfour Hospital, Kirkwall, Orkney, Scotland, UK.
Int J Oral Maxillofac Surg. 2016 May;45(5):618-30. doi: 10.1016/j.ijom.2015.12.010. Epub 2016 Jan 7.
Direct oral anticoagulant (DOAC) drugs (dabigatran, rivaroxaban, and apixaban) have emerged in the last decade to overcome some of the drawbacks of existing medications. To date, little is known about the dental management of patients taking these drugs. This study was undertaken to establish the evidence for the management of patients undergoing dental procedures while taking these medications. A rapid review approach was used to identify clinical and scientific research related to dental surgery performed in patients taking DOACs in order to produce an evidence summary. The rapid review did not identify any systematic reviews or original clinical trials and the overall quality of evidence found was poor. Most of the literature consisted of non-structured review articles and guidance documents based on assumptions from non-dental data and expert opinion, and recommendations on best practice varied throughout. The findings from the review of the literature varied considerably. Currently, recommendations are based on poor quality scientific data and clinical trials are required to establish best evidence-based practice guidance.
直接口服抗凝剂（DOAC）药物（达比加群、利伐沙班和阿哌沙班）在过去十年中出现，以克服现有药物的一些缺点。迄今为止，对于服用这些药物的患者的牙科管理知之甚少。本研究旨在为服用这些药物的患者进行牙科手术的管理建立证据。采用快速回顾方法来识别与服用DOACs的患者进行牙科手术相关的临床和科学研究，以生成证据总结。快速回顾未发现任何系统评价或原始临床试验，所发现证据的总体质量较差。大多数文献由基于非牙科数据和专家意见假设的非结构化综述文章和指导文件组成，关于最佳实践的建议各不相同。文献综述的结果差异很大。目前，建议基于质量较差的科学数据，需要进行临床试验以建立最佳的循证实践指南。
