Abstract
The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient’s physician.
Highlights
Oral Anticoagulant medications (OAM) have been used successfully in the prevention of thrombotic diseases, caused by myocardial infarction, cardiovascular stroke, atrial fibrillation, Int
The present investigation was designed as a retrospective clinical study based on data from patients recruited and treated between September 2015 and November 2018 for immediate full-arch rehabilitation at the Unit of Oral Surgery and Implantology, University-Hospital of Geneva, Switzerland, and at the Department of Surgical, Medical, Molecular and of Critical Area Pathologies, University of Preoperative, intraoperative, and postoperative clinical data were retrieved from the patient records
The decision of whether or not to interrupt the Direct Oral Anticoagulants (DOACs) was taken in agreement with a medical evaluation since the decision could not be taken by a dentist without a treating physician’s advice, based on general medical status, bleeding risk of the surgery procedure, and thromboembolic/hemorrhagic risk as a function of two test evaluations such as
Summary
Oral Anticoagulant medications (OAM) have been used successfully in the prevention of thrombotic diseases, caused by myocardial infarction, cardiovascular stroke, atrial fibrillation, Int. J. Res. Public Health 2020, 17, 4607; doi:10.3390/ijerph17124607 www.mdpi.com/journal/ijerph. Res. Public Health 2020, 17, 4607 placement of a mechanical heart-valve prosthesis or deep venous thromboembolism [1]. Vitamin K antagonists (VKAs), such as Warfarin, were used for decades for the treatment of such diseases; and in patients with contraindications for VKAs, antiplatelet medications were prescribed as an alternative [2]
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