J Dent Anesth Pain Med.  2017 Jun;17(2):143-147. 10.17245/jdapm.2017.17.2.143.

Delayed bleeding after implant surgery in patients taking novel oral anticoagulants: a case report

• Kim C
• Dam C
• Jeong J
• Kwak EJ
• Park W

• KMID: 2384477
• DOI: http://doi.org/10.17245/jdapm.2017.17.2.143

Abstract

The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs. This article reports a case of a 74-year-old male patient who was taking rivaroxaban. The patient underwent a dental implant procedure after discontinuing rivaroxaban for one day and subsequently suffered delayed bleeding on postoperative day 6. Accordingly, this article also reports that the use of NOACs may also lead to delayed bleeding.

Keyword

Anticoagulants; Bleeding; Dental Implants; Emergencies; Rivaroxaban

MeSH Terms

Aged
Anticoagulants*
Atrial Fibrillation
Dental Implants
Drug Interactions
Emergencies
Hematologic Tests
Hemorrhage*
Humans
Male
Rivaroxaban
Thrombosis
Warfarin
Anticoagulants
Dental Implants
Rivaroxaban
Warfarin

Figure

• 

  Fig. 1 Panoramic image from the initial examination (red arrow: area of chief complaint during the initial examination; blue arrow: planned sites for implantation).

• 

  Fig. 2 (A) Panoramic image after the implant placement procedure (yellow arrow: implant placement sites), (B) Clinical photo during implant placement procedure (after flap elevation), (C) Clinical photo after implant placement and site of postoperative delayed bleeding (green arrow).

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