The number of patients using direct oral anticoagulants (DOACs) instead of vitamin K antagonists (VKA) is increasing and there is limited data on the safety of tooth extractions in patients taking DOACs. The aim of this study was to compare the amount of bleeding (AOB) and postoperative complications after tooth extractions between patients taking VKAs and patients taking DOACs without altering the anticoaguation therapy. The study consisted of four groups: Direct thrombin inhibitor group, factor Xa inhibitor group, warfarin group and a control group. A single tooth was extracted in each patient and routine coagulation test values were recorded prior to extraction. AOB was measured for 20 minutes after tooth extraction. The patients were evaluated on 2nd and 7th days after extraction for bleeding. Status of bleeding was classified as no bleeding, mild bleeding controlled by gauze pads, moderate bleeding controlled by hemostatic agents and severe bleeding required hospitalization. Analysis of variance, chi square test and correlation analysis were used for statistical analysis of data. A total of 84 patients (48 male, 36 female) were included in this study. The mean age of patients was 57 (38-87) years. Mean AOB was 1388.6±913.0, 1909.29±1063.1, 3673±1415.4, 1593.33±672.5 mg for direct thrombin inhibitor, factor Xa inhibitor, warfarin and control groups respectively. Mean AOB was significantly higher for warfarin group, compared to other groups (p<0.05). The number of patients showing mild and moderate bleeding was significantly higher in warfarin group compared to other groups on the 2nd postextraction day (p=0.001). No bleeding was occurred in control group on 2nd and 7th postextraction days and no bleeding was occurred in direct thrombin inhibitor group on 7th postextraction day. The number of bleeding events among groups was not statistically significant on 7th postextraction day (p=0.251). Patients taking warfarin had more bleeding compared to patients taking direct oral anticoagulants after tooth extractions. In patients taking direct oral anticoagulants simple tooth extractions can be safely carried out without altering the anticaogulant regimen with the use of local hemostatic agents.

Objective: To compare the clinical, radiographic, esthetic outcomes, and success and survival rates of dental implants placed after bone augmentation techniques.Methods: This retrospective study included a total of 764 patients receiving 764 dental implants between 2009 and 2019. Four hundred implants were placed without bone augmentation (control), and 364 were placed after bone augmentation. Bone augmentation techniques were guided bone regeneration (GBR), ridge split, and onlay bone grafting. Gingival index (GI), plaque index (PI), probing depth (PD), bleeding on probing (BOP), pink esthetic score (PES) and marginal bone loss (mm) and area (mm²) were measured. The study variables of the implants among augmentation groups were compared statistically.Results: The mean PI and GI scores, and BOP values of the implants in the augmentation and control groups were comparable (p = 0.365, p = 0.230, and p = 0.371 resp.) The mean PD scores of the implants were 2.82 ± 1.22 in the augmentation and 2.54 ± 1.29 in the control groups; the difference was significant (p = 0.002). The mean vertical bone loss of the implants was 0.78 ± 0.70 in augmentation and 0.82 ± 0.82 in the control groups, which was comparable (p = 0.461). The mean PES total values of the implants were 8.30 ± 1.55 in augmentation and 10.04 ± 2.43 in the control groups; the difference was significant (p < 0.001). There were no significant differences between the augmentation and control groups in implant survival (99.18% vs. 98%, p = 0.228) and success (82.97% vs. 85.50%, p = 0.389) rates. Significant differences in some study variables were observed among the augmentation groups. The survival and success rates of the implants in GBR (99.21% and 85.04%), ridge split (99.19% and 79.68%), onlay (99.12% and 84.21%), and control (98.00% and 85.50%) groups were similar (p = 0.630 and p = 0.479, resp.) in the 6‐year mean follow‐up.Conclusion: The implants placed in augmented bone showed similar cumulative success and survival rates compared to implants placed in natural bone with a 6‐year mean follow‐up. The augmentation group showed lower esthetic scores. There are some differences in clinical parameters among augmentation groups; however, all the augmentation groups showed similar success and survival rates.