The International journal of oral & maxillofacial implants · 2022
Postoperative Bleeding in Patients Under Direct Oral Anticoagulation After Maxillary Sinus Floor Augmentation: A Case-Control Study.
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Capparè Paolo, Tetè Giulia, Alfieri Ottavio, Pantaleo Giuseppe, Montemezzi Pietro
Аннотация
PURPOSE: The aim of this case-control study was to investigate the occurrence of bleeding events related to maxillary sinus elevation with a lateral window in patients under direct oral anticogulant therapy.
MATERIALS AND METHODS: Seventyseven consecutive patients were scheduled for unilateral maxillary sinus floor elevation using a lateral window approach. Participants were divided into two groups: group A, formed by 37 patients who were under novel oral anticoagulation therapy (rivaroxaban/apixaban), and a control group, composed of 40 healthy subjects. Within group A, assumption of direct oral anticoagulants was not suspended nor modified before surgical procedures. Time (early/delayed) and site (intraoral/extraoral) of bleeding episodes were recorded in both groups of patients, in addition to bleeding severity (mild, moderate, or severe).
RESULTS: Maxillary sinus floor elevation was performed in all patients. One dropout happened due to intraoperative membrane perforation. Overall bleeding episodes were comparable in both groups, chi-square (1) = .68, P = .41. Early intraoral bleeding events were more common in absolute terms, but also occurred with approximately the same frequency in both group A and the control group (Fisher exact tests: P = 1.00 and P = .375, respectively). No severe bleeding was observed in any of the attended patients.
CONCLUSION: Within the limitations of this case-control study, maxillary sinus floor augmentation with a lateral window approach can be safely administered to patients who are under direct oral anticoagulation therapy when specific recommendations are instituted.
MATERIALS AND METHODS: Seventyseven consecutive patients were scheduled for unilateral maxillary sinus floor elevation using a lateral window approach. Participants were divided into two groups: group A, formed by 37 patients who were under novel oral anticoagulation therapy (rivaroxaban/apixaban), and a control group, composed of 40 healthy subjects. Within group A, assumption of direct oral anticoagulants was not suspended nor modified before surgical procedures. Time (early/delayed) and site (intraoral/extraoral) of bleeding episodes were recorded in both groups of patients, in addition to bleeding severity (mild, moderate, or severe).
RESULTS: Maxillary sinus floor elevation was performed in all patients. One dropout happened due to intraoperative membrane perforation. Overall bleeding episodes were comparable in both groups, chi-square (1) = .68, P = .41. Early intraoral bleeding events were more common in absolute terms, but also occurred with approximately the same frequency in both group A and the control group (Fisher exact tests: P = 1.00 and P = .375, respectively). No severe bleeding was observed in any of the attended patients.
CONCLUSION: Within the limitations of this case-control study, maxillary sinus floor augmentation with a lateral window approach can be safely administered to patients who are under direct oral anticoagulation therapy when specific recommendations are instituted.