title: Dental implant surgery in patients in treatment by dabigatran.
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 oral anticoagulant dabigatran following a specific protocol.
  
  
  METHODS
  Seventy-one patients were divided into two groups: 29 had been taking dabigatran for over 6 months (150 mg orally every 12 h) before implant surgery (dabigatran group) and a control group consisting of 42 healthy subjects. Patients were treated in an outpatient setting. All subjects received dental implants in different positions, dabigatran group patients 12 h after the last dose of dabigatran. Nonabsorbable sutures were used and patients were given gauzes impregnated with tranexamic acid 5% to bite on for 30-60 min. Dabigatran patients resumed medication 8 h after the procedure, resuming usual dosage (every 12 h) the day after surgery.
  
  
  RESULTS
  Two dabigatran patients and two control patients presented slight bleeding the day after surgery. Bleeding was managed with gauzes impregnated with tranexamic acid. No statistically significant differences (P = 0.542) were found in relation to bleeding episodes between the groups, with a relative risk of 0.675 based on the pooled groups and a 95% confidence interval of 0.090-5.088.
  
  
  CONCLUSIONS
  Dental implant surgery in patients taking dabigatran can be performed safely providing 12 h have passed since the last dose and local hemostatic measures are applied. Normal dosage can be resumed 8 h after implant surgery.
authors.affiliation: Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gómez-Moreno
authors.affiliation: International Research Cathedra in Dentistry, San Antonio Catholic University of Murcia, UCAM, Murcia, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Fernández-Cejas
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 Surgery and Medical-Surgical Specialities, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Oviedo, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: de Carlos
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: International Research Cathedra in Dentistry, San Antonio Catholic University of Murcia, UCAM, Murcia, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calvo-Guirado
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D000069604:Dabigatran / Q000009:adverse effects / Q000627:therapeutic use*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology
chemical_list: D000991:Antithrombins; D000069604:Dabigatran
keywords: bleeding; dabigatran; dental implants; tranexamic acid