Dental implant surgery in patients in treatment with the anticoagulant oral rivaroxaban

Objectives: The aim of this study was to evaluate the incidence of bleeding complications after dental implant placement in patients in treatment by the anticoagulant oral rivaroxaban without interrupting its administration or modifying dosage. Materials and methods: About 57 patients were divided into two groups: 18 had been in treatment by rivaroxaban for over 6 month before implant surgery and a control group consisted of 39 healthy subjects. All subjects received dental implants in different positions, without interrupting or modifying rivaroxaban dosage. Patients were treated in an outpatient setting. Non-absorbable sutures were used, and all patients were given gauze impregnated with tranexamic acid 5%, to bite on for 30-60 min. Results: One rivaroxaban patient presented moderate bleeding the day after surgery, and two control patients presented moderate bleeding the day after and on the second day. Bleeding was managed with gauzes impregnated with tranexamic acid. No statistically significant differences (P = 0.688) were found in relation to bleeding episodes between the groups, with a relative risk = 0.919 based on the pooled groups and 95% confidence interval of 0.078-10.844. Conclusions: Dental implant surgery in patients taking the anticoagulant oral rivaroxaban can be performed safely in outpatients departments applying local hemostatic measures without the need to modify or interrupt anticoagulant medication.