Postoperative Bleeding in Patients Under Direct Oral Anticoagulation After Maxillary Sinus Floor Augmentation: A...

Area of Science:

• Oral and Maxillofacial Surgery
• Periodontology
• Dental Implantology

Background:

• Maxillary sinus floor elevation is a common procedure for dental implant placement.
• Patients on direct oral anticoagulants (DOACs) require careful management during surgical procedures.
• The safety of DOACs during sinus elevation has been a concern, necessitating further investigation.

Purpose of the Study:

• To investigate the occurrence and severity of bleeding events during maxillary sinus elevation with a lateral window approach in patients on DOAC therapy.
• To compare bleeding complications in patients on DOACs versus a control group of healthy subjects.
• To assess the safety of performing sinus floor elevation without suspending DOAC medication.

Main Methods:

• A case-control study involving 77 patients undergoing unilateral maxillary sinus floor elevation via a lateral window.
• Group A (37 patients) received DOACs (rivaroxaban/apixaban) without interruption.
• A control group (40 healthy subjects) was included for comparison. Bleeding events were recorded by time, site, and severity.

Main Results:

• Maxillary sinus floor elevation was successfully performed in all patients.
• Overall bleeding episodes were similar between the DOAC group and the control group (P = .41).
• Early intraoral bleeding occurred with similar frequency in both groups, and no severe bleeding events were reported.

Conclusions:

• Maxillary sinus floor augmentation with a lateral window can be safely performed in patients on DOAC therapy.
• Specific management recommendations are crucial for safe administration of this procedure to anticoagulated patients.
• DOAC therapy does not appear to significantly increase bleeding risk during this specific surgical procedure when managed appropriately.