The Effect of Anticoagulants on Early Implant Failure: A Retrospective Cohort Study

Abstract

Background: Anticoagulants (AC) are among the most often prescribed drugs in the world. Data regarding ACs’ effect on the osseointegration of dental implants is lacking. Purpose: The aim of the present retrospective cohort study was to evaluate the effect of anticoagulants (AC) on early implant failure (EIF). The null hypothesis was that the use of AC increases the incidence of EIF. Materials and Methods: The research included 687 patients who underwent 2971 dental implant placements in the department of oral and maxillofacial surgery in Rabin medical center, Beilinson hospital, by specialists in oral and maxillofacial surgery. The study group comprised 173 (25.2%) patients and 708 (23.8%) implants using AC. The rest of the cohort served as a control. A structured form was used to collect data at patient and implant level. EIF was defined as implant failure within a period of up to 12 months from loading. EIF was the primary outcome parameter. A logistic regression model was used to predict EIF. Results: Implants placed in individuals ≥ 80 (odds ratio (OR) = 0.34, p = 0.05), and ASA 2/3 vs. ASA 1 individuals (OR = 0.30, p = 0.02/OR = 0.33, p = 0.03, respectively) had decreased odds of EIF, and implants in those using anticoagulants (OR = 2.64, p = 0.01) had increased odds of EIF. At the patient level, the odds of EIF in ASA 3 (OR = 0.53, p = 0.02) and IHD (OR = 0.40, p = 0.02) individuals decreased. In AF/VF (OR = 2.95, p = 0.01) individuals, EIF odds increased. Conclusions: Within the limitations of the present study, the use of AC is significantly associated with an increased likelihood of EIF: the OR was 2.64. Future research is required to validate and examine the prospective impact of AC on the osseointegration phenomena.

Evaluation of the Hemostatic Effect of an Innovative Tissue Adhesive during Extraction Therapy under Rivaroxaban in a Rodent Model

“…Furthermore, over a period of 5 days, the hemostatic treatment of the biodegradable adhesive was evaluated and compared to the gold standard, GSP, which served as a control. Many studies have indicated that the risk of bleeding after dental extractions should not be reduced by the administration of OAT drugs [3,18,30]; however, the paradigm has existed for more than 10 years that the risk of postoperative bleeding should be reduced by local hemostatic measurements [18]. Although local measurements were taken, there was still a described risk of bleeding after the dental extractions under an anticoagulative medication of 3.63-27% [31,32].…”

“…Postoperative bleeding is one of the most common post-interventional complications in ambulant dental treatment [1], accounting for up to 31% of cases [2]. Anticoagulants are among the most widely prescribed medications worldwide [3], and patients receiving systemic anticoagulation are at a particularly high risk of postoperative bleeding after dental extractions [1,4]. Conditions such as atrial fibrillation and thromboembolic disease often require anticoagulant therapy [5][6][7][8].…”

“…When patients require oral surgical treatment with oral anticoagulants (OATs), modifications to OAT medications are discussed [3,13]. It is possible to reduce the risk of postoperative bleeding by pausing drug therapy during the procedure.…”

The effect of human periodontal pathogenic bacteria on immediate basal implant placement: A comparative study in beagle dogs

“…P. gingivalis and Tannerella forsythia, red complex periodontal pathogens, colonised several implants, although all implants were successfully osseointegrated (Jakobi et al, 2015). Such opinions could help to conclude the significance of the microbial role in postoperative infection in dental implantology (Esposito et al, 2013), a role that represents one of the possible reasons for implant failure whether early or late failure (Chaushu et al, 2023).…”