Vojnosanitetski pregled 2014 Volume 71, Issue 12, Pages: 1097-1101
https://doi.org/10.2298/VSP1412097B
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Comparison of efficacy of local hemostatic modalities in anticoagulated patients undergoing tooth extractions
Bajkin Branislav V. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Selaković Srećko D. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Mirković Siniša M. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Šarčev Ivan N. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Tadić Ana J. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Milekić Bojana R. (Faculty of Medicine, Dental Clinic of Vojvodina, Novi Sad)
Background/Aim. Patients receiving long-term oral anticoagulant therapy pose
a clinical challenge during invasive dental procedures. The goal of this
study was to compare different local hemostatic modalities after tooth
extraction in patients receiving chronic Vitamin-K antagonist therapy.
Methods. Totally 90 patients with International Normalized Ratio (INR) ≤ 3.0
requiring simple extraction of one or two teeth were randomized into three
groups, 30 patients in each group. The patients with the mean INR value of
2.35 ± 0.37, in whom extraction wound was sutured comprised the group A. In
the group B with the mean INR of 2.43 ± 0.4, local hemostasis was achieved by
placing absorbable gelatin sponges into the wound without suturing. The group
C consisted of the patients with the mean INR of 2.36 ± 0.34 in whom neither
gelatin sponge nor suturing were used for providing local hemostasis.
Bleeding was registered as an event if other than initial hemostatic measure
was needed or additional oral surgeon intervention required. Results. The
obtainded results show that 1 (3.3%) patient in the group A, 2 (6.7%)
patients in the groups B and C manifested post-extraction bleeding. All cases
of hemorrhage were easily solved with local hemostatic measures and all,
except one case, were registered in the first two hours after the procedure
until the dismissal. A difference between the groups was not statistically
significant (χ2 = .42, p > 0.05). Conclusion. In therapeutically
anticoagulated patients tooth extractions can be safely performed without
altering the dose of anticoagulant medication if efficient local hemostasis
is provided. In most cases, in patients with INR ≤ 3.0 after extraction of
one or two teeth postoperative bleeding can be controlled with local
pressure, without any additional local hemostatic measures.
Keywords: tooth extraction, antiacoagulants, administration+ oral, drug therapy, hemostasis