Management of anticoagulated patients in implant therapy: a clinical comparative study

Journal article


Publication Details

Author(s): Clemm R, Neukam FW, Rusche B, Bauersachs A, Musazada S, Schmitt C
Journal: Clinical Oral Implants Research
Publication year: 2016
Volume: 27
Journal issue: 10
Pages range: 1274-1282
ISSN: 0905-7161


Abstract


This prospective clinical comparative study aimed to analyze the postoperative bleeding risk of patients continuing their anticoagulation therapy (AT) and undergoing implant surgery and bone grafting procedures.The treatments ranged from the insertion of single or multiple dental implants over implant exposures to sinus floor augmentation and vertical and/or lateral bone grafting with autologous bone grafts. The patients of the test groups (AT groups) were treated with platelet aggregation inhibitors (PAIs), Vitamin-K inhibitors, Vitamin-K inhibitor withdrawal bridged with heparin (LMWH), or new/direct oral anticoagulants (NOACs/DOACs). Patients of the control group were non-anticoagulated (non-AT group). Surgical procedures were performed in the same manner in all groups. Pre, intra, and postoperative data concerning the treatment, extent of the surgery and bleedings was recorded and statistically evaluated.There were seven postoperative bleedings in 564 patients (1.2%), four in the AT groups (3.4%), and three in the non-AT group (0.6%). No thromboembolic complication occurred in the whole observation period. The invasiveness of the surgical procedure had no statistically significant effect on bleeding frequencies. Patients taking Vitamin-K inhibitors had a significantly higher risk of a postoperative bleeding compared to patients without any AT (P = 0.038). Two patients were hospitalized due to the severity of the bleeding as a precautionary measure (one in the non-AT and one in the PAI group). All bleedings were easily controllable with local hemostatic measures. There was no postoperative bleeding recorded for patients taking DOACs.Anticoagulation therapy should be continued in patients undergoing implant surgery and bone grafting procedures avoiding thromboembolic complications. Surgeons should always apply the most minimally invasive approach to reduce postoperative risks and be able to apply local hemostatic measures in terms of a bleeding complication.



FAU Authors / FAU Editors

Clemm, Raphael
Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie
Neukam, Friedrich Wilhelm Prof. Dr. Dr.
Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie
Rusche, Birgit
Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie
Schmitt, Christopher Dr. med.
Anästhesiologische Klinik


How to cite

APA:
Clemm, R., Neukam, F.W., Rusche, B., Bauersachs, A., Musazada, S., & Schmitt, C. (2016). Management of anticoagulated patients in implant therapy: a clinical comparative study. Clinical Oral Implants Research, 27(10), 1274-1282. https://dx.doi.org/10.1111/clr.12732

MLA:
Clemm, Raphael, et al. "Management of anticoagulated patients in implant therapy: a clinical comparative study." Clinical Oral Implants Research 27.10 (2016): 1274-1282.

BibTeX: 

Last updated on 2018-10-10 at 08:27