Factors Affecting the Occurrence of Complications in the Early Stages After Dental Implant Placement

Okamoto, Toshihiro; Hoshi, Keika; Fukada, Kazuhiro; Kataoka, Takao; Kumasaka, Akira; Kaibuchi, Nobuyuki; Fukuzawa, Satoshi; Ando, Tomohiro

doi:10.1097/id.0000000000000753

Cited by 3 publications

(9 citation statements)

References 26 publications

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“…Full texts of 12 articles were obtained for further assessment, resulting in exclusion of a further 4 studies. Finally, 8 studies [6,[11][12][13][14][15][16][17] met eligibility criteria for this review and were included for full analysis (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…All articles included were observational cohort studies. There were 4 retrospective [6,11,12,17] and 4 prospective [13][14][15][16]; of the prospective studies, 3 [13,14,16] blinded the operator from which patients were taking anticoagulants. A total of 1467 participants were included with a minimum of 2366 implants placed across all studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…A total of 1467 participants were included with a minimum of 2366 implants placed across all studies. There were 3 studies [6,15,17] which did not report the number of implants placed within their respective cohorts; therefore, the total number of implants was under-estimated to reflect a singular implant for the number of participants within those studies. Further information on the study characteristics are included in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In order to minimise clinical heterogeneity with study protocols, the analysis was split into two subgroups. The studies were split dependant upon their peri-operative protocols in which one group (1) continued anticoagulation perioperatively without a pause [6,12,13,[15][16][17] and those which (2) discontinued in the immediate pre-operative period [11,14] and restarted 6-12 h post-operatively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…One study [17] did not qualify the criteria for bleeding complications and was based on subjective assessment of the patient. One study [15] defined their own criteria of bleeding as low, moderate or severe with escalating levels of intervention for haemostatic control.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Dental implants and risk of bleeding in patients on oral anticoagulants: a systematic review and meta-analysis

et al. 2021

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Background Dental implant placement is safe and predictable, yet optimal management of anticoagulated patients remains controversial. Whilst cessation of anticoagulation pre-operatively should decrease risks of bleeding, risk of thrombosis increases. We aim to define risk of bleeding in patients on oral anticoagulation who are undergoing dental implant placement, in order to establish best management. Methods This systematic review is registered with the National Institute for Health Research (NIHR) PROSPERO database (Registration No: CRD42021233929). We performed a systematic review as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Studies were identified using an agreed search strategy within the OVID Gateway (this included Pubmed, MEDLINE, Cochrane Collaborative). Studies assessing bleeding complications in patients who were undergoing dental implant placement were selected. The primary outcome was bleeding events in anticoagulated patients undergoing dental implant placement. Secondary outcomes included any complication requiring further intervention. Results We identified 182 studies through screening, and after review of titles and abstracts reduced this to 8 studies. In these studies, 1467 participants received at least 2366 implants. Studies were analysed for quality using the ROBINS-I risk of bias tool. Four studies were retrospective case reviews, and four were prospective reviews, three of which also blinded the operator to anticoagulation status. There was significant heterogeneity between the included studies. Meta-analysis showed an increased risk of bleeding (RR, 2.30; 95% CI, 1.25-4.24 p = 0.37 I = 7%) when implants were placed in the presence of anticoagulation however these were not clinically significant haemorrhagic events. Conclusion The continuation of anticoagulants peri-operatively during dental implant surgery does increase the risk of clinically non-significant peri- and post-operative bleeding. Dental implant surgery encompasses a broad spectrum of procedures ranging from minor to more invasive surgery with simple local haemostatic measures mitigating the risk of bleeding. The decision to discontinue anticoagulants prior to dental implant surgery must consider patient and surgical factors with the clinician undertaking a risk-balance assessment.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Dental implants and risk of bleeding in patients on oral anticoagulants: a systematic review and meta-analysis

et al. 2021

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Systematic review on diabetes mellitus and dental implants: an update

et al. 2022

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Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.

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Bleeding Disorders and Dental Implants: Review and Clinical Indications

Bacci,

Schiazzano,

Zanon

et al. 2023

JCM

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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.

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Factors Affecting the Occurrence of Complications in the Early Stages After Dental Implant Placement

Abstract: Our results show that age is a significant factor influencing the occurrence of complications in the early stages after dental implant placement. Therefore, clinicians should consider this factor when developing their treatment strategies.

Cited by 3 publications

References 26 publications

Dental implants and risk of bleeding in patients on oral anticoagulants: a systematic review and meta-analysis

Dental implants and risk of bleeding in patients on oral anticoagulants: a systematic review and meta-analysis

Systematic review on diabetes mellitus and dental implants: an update

Bleeding Disorders and Dental Implants: Review and Clinical Indications

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