CLINICAL AND SURGICAL MANAGEMENT OF PATIENTS WITH SYSTEMIC COMORBIDITIES
DOI:
https://doi.org/10.63330/aurumpub.061-002Keywords:
Oral Surgery, Systemic Comorbidities, Preoperative Risk Assessment, Diabetes Mellitus, Hypertension, Anticoagulants, Patient SafetyAbstract
Population aging and the significant increase in the prevalence of chronic non-communicable diseases have made the care of systemically compromised patients a constant in dental practice. This text aims to provide structured guidelines for the individualized clinical-surgical management of individuals with comorbidities, focusing on diabetes mellitus, hypertension, heart disease, and anticoagulant therapy. Thorough preoperative assessment, risk stratification using the ASA classification, and continuous interprofessional communication are highlighted as the primary pillars for the prevention of peri- and postoperative complications. Contemporary protocols based on scientific evidence are discussed, such as the safe maintenance of antithrombotic therapies in minor surgeries (prioritizing the use of local hemostatics over drug discontinuation), perioperative care with hypoglycemic agents and glycemic monitoring for diabetic patients, as well as the safe use of anesthetics with vasoconstrictors in compensated cardiac patients. Additionally, the need for the team's technical preparedness for the prompt recognition and management of medical emergencies in the outpatient setting is emphasized. It is concluded that modern dentistry requires the dentist to have a deep understanding of systemic pathophysiology and a multidisciplinary vision, ensuring a safe, predictable, and effective approach for the patient.
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