Title Anticoagulant Drugs Do Not Increase Risk of Postoperative Bleeding after Implant Placement
Clinical Question Will a patient on anticoagulant drugs who is receiving a dental implant have a higher risk of postoperative bleeding than a patient who discontinues the medication?
Clinical Bottom Line Discontinuation of oral anticoagulant drugs is “not recommended for minor oral surgery, such as ….implant placement, provided that this does not involve autogenous bone grafts, extensive flaps or osteotomy preparations extending outside the bony envelope.”
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
19663955Madrid/2009 19 Studies TotalSystematic Review
Key resultsIn this systemic review, the evidence “does not support that dental implant placement in patients on OAT [oral anticoagulant therapy] is contraindicated.” Also, it was found that topical hemostatic agents were adequate for patients who did not discontinue anticoagulant drugs.
Evidence Search "Dental Implantation"[Mesh] AND "Anticoagulants"[Mesh]
Comments on
The Evidence
In this systemic review by Madrid and Sanz, “five studies were randomized-controlled trials (RCTs), 11 were controlled clinical trials (CCTs) and three were prospective case series.” Because the protocols and management of patients were different for all the studies, especially in “terms of haemostatic measures for the management of bleeding were different…” it prevented the author from aggregating data and thus only a descriptive analysis of the different studies were possible.
Applicability Because the protocols and management of patients were different for all the studies the main comparison was between continuation and discontinuation of anticoagulants. Thus we cannot be confident that those patients who were in the studies are representative of our patient pool but no indications are there to suggest that the results are contrary to our patients.
Specialty (General Dentistry) (Oral Surgery) (Periodontics)
Keywords Dental Implants, Anticoagulants
ID# 2875
Date of submission 03/26/2015
E-mail josephv@livemail.uthscsa.edu
Author Varun P. Joseph
Co-author(s) e-mail
Faculty mentor Norma Olvera, DDS, MS
Faculty mentor e-mail OlveraN@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available