Assessment of Bleeding in Patients on Antiplatelets Undergoing Dental Implants

Antiplatelet drugs are used for the secondary prevention of cardiac and cerebrovascular diseases. Clopidogrel and Aspirin are the most commonly prescribed drugs for these patients. Physicians and dentists have to weigh bleeding risks versus thrombotic risks in interrupting antiplatelet regimen. The balance of these risks for an individual patient is the primary consideration in management of dental patients who are taking antiplatelet drugs and require dental implants. The study was undertaken to assess the risk of bleeding in patients on single and dual antiplatelets undergoing dental implants.

65 patients were assessed for bleeding after placement of dental implants. They were divided into 2 groups: group I included 48 patients on single antiplatelets (Aspirin) and group II included 17 patients on dual antiplatelets (Aspirin and Clopidogrel) based upon the timing of coronary intervention. Bleeding was evaluated intra-operatively and post-operatively.

Significant difference in bleeding was noted between group I and group II based on the Visual Analog Scale (VAS) for bleeding severity after implant placement both intra-operatively (P = 0.000) and post-operatively (P = 0.004) within 24 h. However, post-operative complication after 24 h was non-significant (P = 0.277).

Dental implants can be safely placed in patients on single antiplatelet drugs without discontinuing them. In patients on dual antiplatelets, risk of bleeding is mild to moderate if the drugs are continued. Consultation with treating cardiologist is a must before any kind of dental invasive surgery in patients on antiplatelets.