Department of Surgical, Medical, Molecular and of Critical Area Pathologies, Complex Operative Unit of Stomatology and Oral Surgery, University-Hospital of Pisa, University of Pisa, 56126 Pisa, Italy.
Complex Operative Unit of Geriatrics, SS Filippo e Nicola Hospital, 67051 Avezzano, Italy.
Int J Environ Res Public Health. 2020 Jun 26;17(12):4607. doi: 10.3390/ijerph17124607.
The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient's physician.
接受直接口服抗凝剂（DOACs）治疗的患者的管理，使临床医生不得不应对两个临床问题，例如在不停用治疗的情况下出血风险，以及在停用治疗的情况下血栓栓塞风险。本回顾性研究的主要目的是评估接受利伐沙班治疗且接受牙种植体和即刻修复的患者围手术期出血事件和愈合并发症的发生率。选择接受利伐沙班（每日 20 毫克 Xarelto）治疗且需要植入物修复的患者。在下颌愈合部位或新鲜拔牙窝中放置四到六枚种植体。所有患者均根据医生的建议中断药物治疗 24 小时，并接受植入物和即刻修复。本研究共分析了 12 名患者和 57 枚种植体。未报告重大术后出血事件。有 3 名患者（25%）仅出现轻微的即刻术后出血，通过压迫即可控制。植入物和修复体的 1 年存活率均为 100%。在本研究的限制范围内，联合患者医生，在停用利伐沙班 24 小时的情况下，可进行无明显并发症的多枚种植体即刻负重。
