[Antithrombotics: backgrounds with haemostasis and antithrombotic therapy]

Area of Science:

• Oral Healthcare
• Pharmacology
• Hematology

Background:

• Clinical guidelines for antithrombotics in dentistry address bleeding risks.
• Understanding haemostasis, thrombosis, and antithrombotic mechanisms is crucial for risk assessment.
• Normal haemostasis involves vasoconstriction, platelet aggregation, and fibrin formation.

Purpose of the Study:

• To provide advice on policy for dental procedures involving bleeding.
• To highlight the necessity of background knowledge in haemostasis and antithrombotic processes.
• To inform professional assessment of bleeding risks in patients undergoing dental procedures.

Main Methods:

• Review of clinical guidelines on antithrombotics.
• Explanation of the steps in normal haemostasis.
• Description of thrombosis and the mechanisms of various antithrombotic agents.

Main Results:

• Antithrombotic medications vary in their mechanisms, affecting primary or secondary haemostasis.
• Thrombocyte aggregation inhibitors impact primary haemostasis.
• Vitamin K antagonists and direct oral anticoagulants affect secondary haemostasis; low-molecular-weight heparin also inhibits coagulation factors.

Conclusions:

• Professional assessment of bleeding risks in dental procedures requires comprehensive knowledge of haemostasis and antithrombotic therapies.
• Guidelines allow for professional judgment, necessitating a solid understanding of coagulation and antithrombotic mechanisms.
• Various antithrombotics, including direct oral anticoagulants, play significant roles in preventing and treating thrombosis.