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Management of Bleeding During Dental Implant Surgery using a Novel Implant

Now online in the Journal of Prosthodontics, a new clinical report co-authored by ACP member Mikhail Babayan, DMD, MBS and ACP Fellow Avinash S. Bidra, BDS, MS, FACP.

Coagulopathy is a well-recognized complication in dental surgery in patients who use oral anticoagulants. Management of bleeding during dental implant surgery commonly involves conventional methods such as discontinuation of anticoagulant use, compression, styptics, and local anesthetic administration containing vasoconstrictors. This clinical report describes the successful management of a patient with a history of coagulopathy who was rehabilitated with complete arch fixed implant-supported prostheses with immediate loading.

Before beginning treatment, a detailed medical consultation was done with his cardiologist, orthopedic surgeon, and primary care physician for management of systemic conditions during dental implant surgery. Recommendations for patient management included discontinuation of blood thinners for 3 days before the surgical procedure, limiting the number of local anesthetics containing epinephrine, and minimizing treatment time during dental surgery.

Due to the bleeding risk and requirement of decreasing treatment time, subsequent implant therapy involved the use of a single drill (‘osseodirector’), an implant-specific single-use bone shaping instrument (‘osseoshaper’), followed by placement of novel tri-oval implants in the maxilla and mandible which were immediately loaded and subsequently used to support a complete arch fixed implant-supported zirconia prosthesis.

This treatment plan successfully decreased the overall bleeding and significantly reduced the intraoperative time for the surgical procedure.

Babayan, M, Bidra, AS. Management of bleeding during dental implant surgery using a novel implant with an abbreviated drilling protocol: A clinical report. J Prosthodont. 2023; 1–6. https://doi.org/10.1111/jopr.13758

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