Implant surgery and oral anticoagulant therapy: case report

Abstract

Objectives: This work aims to assess the risks both thromboembolic that bleeding of a management protocol "non-conservative" in patients on oral anticoagulant therapy (OAT) to be undergoing implant surgery.

Materials and methods: We decided to take a surgical "non-conservative" protocol, to insert four implants in the aesthetic zone, without using flapless surgery and the surgical template. In accordance with the hematologist, the value of INR is lowered and warfarin was replaced with heparin low molecular weight, to have a better coagulation's control.

Results: The modern guidelines impose a protocol of conservative management in patients with OAT, with minimally invasive surgery, flapless, and use of surgical template to reduce the risk of uncontrolled bleeding. This, thanks to the team-work between dentist and hematologist, thanks to careful adjustment of INR and the use of local haemostatic agents, were not encountered any problems with bleeding or intra or postoperative.

Conclusion: Surgical treatment of patients with OAT is a real problem for the oral surgeon, to treat every time in association with the hematologist. Applying this type of surgical procedure, different from today's guidelines, in our experience there were no post-operative complications (bleeding or bleeding); osseointegration has not been compromised and the prosthetic rehabilitation was completed successfully.

Keywords: OAT; implant surgery; oral pathology; protocol “non conservative”.

Figure 1

Rx Orthopanoramic before treatment.

Figure 2

Intraoral view before treatment.

Figure 3

The maxilla after extraction of residual root 1.3.

Figure 4

Crestal incision before the implants’ insertion.

Figure 5

Winsix implants and screws cap in position 1.3 and 1.4.

Figure 6

After 4 months the placement of the healing screws.

Figure 7

The provisional elements in reinforced resin before their fixing with screws.

Figure 8

Rx Orthopanoramic after treatment.