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

Clemm, R.; Neukam, Friedrich Wilhelm; Rusche, B.; Bauersachs, Anne; Musazada, Saida; Schmitt, Christian

doi:10.1111/clr.12732

Cited by 56 publications

(75 citation statements)

References 33 publications

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“…However, one case of excessive bleeding was observed during and after surgery in the same patient, an 84‐year‐old diabetic man, who was treated in an operating room for multiple teeth extractions (18 teeth) and contemporary facial abscess drainage (Breik et al., ). The intra‐operative bleeding events were classified in one study involving implant surgeries as low (3/16), moderate (11/16), and severe (2/16; Clemm et al., ). Another study recorded minor intra‐operative bleeding during an incisional biopsy, controlled by suturing (Hassona et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the six studies, one study was assessed as good quality, four were evaluated as fair quality, and one of poor quality (Table ). Risk of bias of the 21 studies was assessed using the Newcastle‐Ottawa scale: two studies received a low risk of bias score (seven stars, Miller & Miller, ; Zeevi et al., ), 16 studies received a high risk of bias score (six stars, Andrade et al., ; Berton et al., ; Caliskan et al., ; Clemm et al., ; Gómez‐Moreno et al., , ; Hanken et al., ; Kwak et al., ; Lababidi et al., ; Mauprivez et al., ; Miclotte et al., ; Miranda et al., ; Morimoto et al., ; Patel et al., ; Yagyuu et al., and five stars, Johnston, ), and three case‐series received a very high risk of bias score (one star, Abayon et al., ; Breik et al., ; Hassona et al., ; Table ).…”

Section: Resultsmentioning

confidence: 99%

“…None of the included studies was a randomized controlled trial (RCT). Nine articles were prospective case-control studies (Andrade et al, 2018;Berton et al, 2018;Caliskan, Tükel, Benlidayi, & Deniz, 2017;Clemm et al, 2016;Gómez-Moreno et al, 2016Mauprivez et al, 2016;Miclotte et al, 2017;Miranda et al, 2016), four were retrospective case-control studies (Hanken et al, 2016;Kwak et al, 2018;Lababidi et al, 2018;Yagyuu et al, 2017), and five studies were retrospective (Johnston, 2015;Miller & Miller, 2018;Morimoto, Yokoe, Imai, Sugihara, & Futatsuki, 2016;Zeevi et al, 2017) and prospective (Patel et al, 2017) observational studies, reporting data from medical records. Three studies were case-series (Abayon, Kolokythas, Siu, & Elad, 2016;Breik, Cheng, Sambrook, & Goss, 2014;Hassona, Malamos, Shaqman, Baqain, & Scully, 2018).…”

Section: Search Results and Study Designsmentioning

confidence: 99%

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World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis

et al. 2019

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Objectives This systematic review aimed to evaluate the current literature regarding the importance of discontinuing or not discontinuing direct oral anticoagulants (DOACs) before invasive oral procedures, and to establish the frequency and type of postoperative bleeding events in patients. Material and Methods We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library up until November 5, 2018. Selection of the studies, extraction of data, qualitative, and bias assessment was performed independently by two authors. Results Twenty‐one studies were included. No randomized controlled studies were identified. Six studies reported a direct comparison between patients taking DOACs and those who discontinued DOACs. The meta‐analysis of these studies resulted in an OR of 0.92 (95% CI = 0.37–2.27, I2 = 9%) for postoperative bleeding events for patients taking DOACs. We found that 59/497 (11.8%) postoperative bleeding events occurred in patients who continued DOACs, while 27/200 (13.5%) events were reported for patients who discontinued treatment. All postoperative bleeding events were controlled with local measures. Conclusion Results from the included studies did not discern any important differences in postoperative bleeding events in patients who continued versus patients who discontinued DOACs. Furthermore, no thromboembolic events were recorded. However, the low quality of the studies must be considered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Search Results and Study Designsmentioning

confidence: 99%

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World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis

et al. 2019

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“…These infectious diseases impair immune system, increase oxidative stresses induced by the viral proteins, and cause virus-associated organ damage including liver fibrosis, steatosis, or hepatocellular carcinoma [48]. [45] Postoperative bleeding risk of patients continuing their anticoagulation therapy (antiaggregant, vit-K inhibitors, vitamin-K inhibitor withdrawal bridged with heparin, direct oral anticoagulants) and undergoing implant surgery and advanced bone grafting procedures 564 patients…”

Section: Hepatitismentioning

confidence: 99%

Dental Implants in the Medically Compromised Patient Population

Akay¹,

Arısan²

2018

Clinical Trials in Vulnerable Populations

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As a result of the increase of the life expectancy, elder people live with diverse diseases or conditions like systemic disorders, immune-related disorders, and psychiatric issues. Consecutively, practicing clinicians are faced with serving dental implant treatments in such a population comprised of medical and demographic characteristics. Most commonly, implant therapy is performed among patients above middle ages; therefore, clinicians often encounter medically compromised patients. The patients are usually with adverse conditions like bleeding disorders, bone diseases, cardiovascular disease (CVD), and/or immunologic conditions like cancer therapy, steroid or immunosuppressive or antiresorptive medication, alcoholism, smoking, and many others. Nevertheless, only few conditions could be stated for contraindication to dental implant therapy. Besides the broad range of the mentioned dental implant comorbidities smoking seems less prevalent compared to the general population. Dental implants in smoking patients are certainly affected in relation to the failure rate, marginal bone loss, and some other risks of postoperative complications. Hence, smoking or other similar conditions could be accounted as a chronic systemic disorder just like diabetes mellitus or drug usage. Briefly, it seems that establishing the medical and demographic conditions prior to implant therapy along with controlling the systemic diseases or disorders may be more important than the presence of compromise.

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“…K-vitamin-antagonista (VKA) kezelésben ré-szesülő (például acenokumarol, phenokumarol), 3. az úgynevezett új típusú orális antikoagulánsokat szedő (az angol NOAC, novel anticoagulants szóból) betegek [2][3][4][5]. Ezen terápiák bármelyikében részesülő betegeknél a vérzéssel járó fogorvosi/szájsebészeti beavatkozások elvégzésére sokáig nem volt egységes hazai ajánlás.…”

Section: Dental and Oral Surgical Treatment Of Medication-induced Bleunclassified

A gyógyszer indukálta vérzékeny betegek fogorvosi, szájsebészeti ellátása: a 2015-ös hazai szakmai ajánlás alkalmazása és értékelése

et al. 2016

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Pécs 2 Semmelweis Egyetem, Fogorvostudományi Kar, Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika, BudapestBevezetés: A Magyar Arc-, Állcsont-és Szájsebészeti Társaság és a Magyar Fogorvosok Implantológiai Társasága által 2015-ben elfogadásra került "A gyógyszer indukálta vérzékeny betegek fogorvosi ellátása" szakmai ajánlás. Célkitű-zés: A szerzők célja volt az ajánlásban leírt lokális vérzéscsillapítási módszerek hatékonyságának, megbízhatóságának ellenőrzése. Módszer: Az orális antithromboticus kezelésben részesülő betegeiknél vizsgálták a fogorvosi, szájsebésze-ti ellátásukat követő utóvérzések előfordulását, retrospektív módon. Eredmények: 263, vérzéssel járó beavatkozás történt (186 betegnél), amelyből 138 K-vitamin-antagonista, 97 thrombocytaaggregáció-gátló és 6, úgynevezett új típusú orális antikoaguláns kezelésben részesülő betegeknél. Összesen 6 (2,3%) esetben tapasztaltak utóvérzést az egyórás kontrollnál, míg ügyeletbe 1 beteg jött vissza utóvérzés miatt (0,5%). Ezzel szemben 86-an jelentkeztek ügyeletükön, akiknél az ajánlást nem vették figyelembe, közülük K-vitamin-antagonista gyógyszert szedett 3 beteg, alacsony molekulasúlyú heparinkezelésben részesült 24 beteg, thrombocytaaggregáció-gátló szert szedett 30 beteg és új típusú orális antikoaguláns kezelésben részesült 1 beteg. Következtetések: A hazai szakmai ajánlás az ambuláns gyakorlatban biztonságosan alkalmazható az antithromboticus terápiában részesülő páciensek vérzéssel járó fogorvosi/szájsebészeti beavatkozásakor, habár a körzetes fogorvos ellátók sok esetben nincsenek ilyen jellegű ellátásra felké-szülve.

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

Cited by 56 publications

References 33 publications

World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis

World workshop on oral medicine VII: Direct anticoagulant agents management for invasive oral procedures: A systematic review and meta‐analysis

Dental Implants in the Medically Compromised Patient Population

A gyógyszer indukálta vérzékeny betegek fogorvosi, szájsebészeti ellátása: a 2015-ös hazai szakmai ajánlás alkalmazása és értékelése

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