Bleeding Disorders and Dental Implants: Review and Clinical Indications

Abstract

Background: Bleeding disorders can be divided into three categories: congenital coagulation disorders (CCDs), antiplatelet-induced bleeding disorders (APBDs) and anticoagulant-induced bleeding disorders (ACBDs). Implant placement can be challenging in these kinds of patients. The aim of this study is to provide evidence on implant surgery in patients with bleeding disorders and to generate some practical recommendations for clinicians. Material and Methods: Pubmed/MEDLINE, Scopus, Web of Science and Cochrane Library databases were screened. The latest search was performed in July 2022. Case reports, case series, cohort studies, cross-sectional studies, case control studies, reviews, consensus reports, surveys and animal studies were included in the analysis. Results: Seventeen articles on CCDs were found, fourteen on APBDs and twenty-six on ACBDs. Most of these articles were case reports or case series. Patients with CCDs can be treated after the infusion of the missing coagulation factor. Patients with APBDs can be treated without withdrawing the therapy. Patients with ACBDs should be treated depending on the anticoagulative medication. Conclusion: Despite the low level of evidence, dental implants can be safely placed in patients with bleeding disorders. However, careful preoperative evaluation and the adoption of local and post-operative bleeding control measures are mandatory.

Flapless Dental Implant Surgery in Bleeding Disorders

“…Its use has been validated in oral surgery (even for topic use) by two independent equipes in different geographical areas [27,28], and, thanks its use, implant treatment has also been validated [29].…”

“…However, we do anticipate post-operative bleeding and complications. Patients using antiaggregation agents and heparin are excluded because of these substances' mediocre treatment levels, which have been noted in the literature [29,31].…”