title: Dental implant surgery in patients in treatment with the anticoagulant oral rivaroxaban.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Director of Master in Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gómez-Moreno
authors.affiliation: Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Aguilar-Salvatierra
authors.affiliation: Department of Pharmacological Research in Dentistry Group, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Fernández-Cejas
authors.affiliation: School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Rafael Arcesio
authors.identifier: http://orcid.org/0000-0003-1721-0509
authors.initials: RA
authors.lastname: Delgado-Ruiz
authors.affiliation: Department of Clinic of Oral Surgery, Faculty of Stomatology, University of Belgrade, Belgrade, Serbia.
authors.forename: Aleksa
authors.initials: A
authors.lastname: Markovic
authors.affiliation: International Research Cathedra UCAM, Universidad Católica San Antonio, Murcia, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calvo-Guirado
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous; D065427:Factor Xa Inhibitors / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012307:Risk Factors; D000069552:Rivaroxaban / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban
keywords: bleeding; dental implants; rivaroxaban; tranexamic acid