A systematic review of hemorrhage risk in patients on the new oral anticoagulant therapy postdental implant placement

Abstract

Aim: Dental implant placement is potentially invasive and hemorrhagic. Patients on the new oral anticoagulants (NOAC) have a potential risk of hemorrhage postoperative. The present study systematically reviews if NOAC medication presents the potential to increase the bleeding risk after dental implant placement. Materials and methods: A systematic review was conducted of randomized clinical trials evaluating the risk of hemorrhage after dental implants in patients taking NOAC medication. The literature search was conducted using Cochrane Central Register of Controlled Trials, PubMed, Science Direct without the restriction of language from June 2010 to December 2018. The inclusion criteria were: anticoagulant therapy, dental implant placement and postoperative incidence of bleeding follow-up. The reviewers performed data extraction, bias risk assessment, and determination of the overall quality of evidence for each of the outcomes using the Jadad scale. Review results: Two articles regarding the incidence of bleeding risk post dental implant placement were included in the review. The first article showed that one patient from the intervention group and two patients from the control group presented slight bleeding the day after the surgery, with the relative risk of 0.919 and the 95% confidence interval of 0.078–10.844. The second article showed that two patients from the intervention group and two patients from the control group presented slight bleeding the day after the surgery, with the relative risk of 0.675 and the 95% confidence interval of 0.090–5.088. Conclusion: The results suggested that continuing the intake of NOAC during and post procedure has not increased the hemorrhage risk. Hence, drugs modification or alteration was not necessary. Clinical significance: More well-designed studies are required for future research.