Purpose: In general clinical practice, the oral and maxillofacial surgeon is frequently required to treat patients on anticoagulant therapy. The purpose of this paper is to review the literature in order to provide evidence-based guidelines for the management of anticoagulated patients undergoing oral and maxillofacial surgery. Materials and Methods: Literature published over the past 40 years was reviewed. The management of patients on anticoagulant therapy as well as laser-assisted oral and maxillofacial surgery is discussed. Results: Currently, the continuation of anticoagulant therapy is strongly encouraged when INR is within the therapeutic range and meticulous local hemostatic measures are taken. Conclusion: It may be concluded that the risk of postoperative bleeding is outweighed by the higher risk of thromboembolism after withdrawal of the anticoagulant therapy and thus continuation of the anticoagulant regimen is encouraged. Laser-assisted oral and maxillofacial surgery in daily practice has enabled surgeons to achieve controlled hemostasis and minimize intra- and postoperative hemorrhage without discontinuing anticoagulants.
Keywords: hemostasis, CO2, diode, Nd:YAG, Er:YAG-YSGG, anticoagulants, oral and maxillofacial surgery