Comparison of efficacy of local hemostatic modalities in anticoagulated patients undergoing tooth extractions

Bajkin, Branislav; Selaković, Srećko; Mirković, Siniša; Sarcev, Ivan; Tadić, Ana; Milekic, Bojana

doi:10.2298/vsp1412097b

Cited by 33 publications

(33 citation statements)

References 28 publications

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“…However, some obstacles exist that limit the use of those agents, for example, the high cost of fibrin glue [15, 16] and the complex technique of tranexamic acid usage [25]. On the other hand, a Serbian study showed that local pressure is sufficient for adequate hemostasis in most cases of teeth extraction if INR is less than or equal to 3 [26]. It is noteworthy that suturing is not always necessary and should be reserved for instances where local hemostasis fails or when there is extensive tissue damage [17].…”

Section: Introductionmentioning

confidence: 99%

Anticoagulation Use prior to Common Dental Procedures: A Systematic Review

Chahine

Khoudary

Nasr

2019

Cardiology Research and Practice

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Currently, the number of patients on oral anticoagulation is increasing. There is a paucity of data regarding maintaining oral anticoagulation (especially novel oral anticoagulants) around the time of specific dental procedures. A dentist has three options: either to stop anticoagulation, to continue it, or to bridge with heparin. A systematic review of 10 clinical trials was conducted to address this issue. It was found that continuing anticoagulation during dental procedures did not increase the risk of bleeding in most trials. Although none of the studies reported a thromboembolic event after interruption of anticoagulation, the follow-up periods were short and inconsistent, and the heightened thromboembolic risk when stopping anticoagulation is well known in the literature. Heparin bridging was associated with an increased bleeding incidence. We recommend maintaining oral anticoagulation with vitamin K antagonists and novel oral anticoagulants for the vast majority of dental procedures along with the use of local hemostatic agents.

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Section: Introductionmentioning

confidence: 99%

Anticoagulation Use prior to Common Dental Procedures: A Systematic Review

Chahine

Khoudary

Nasr

2019

Cardiology Research and Practice

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“…Despite the beneficial effect of these local hemostatic agents in preventing bleeding in dental surgery, available data comparing their effectiveness and efficiency is still scarce and inconclusive. Methodological heterogeneities, such as the lack of a standard therapy and comparable treatment regimens, are noticeable among studies, as well as the reduced number of randomized controlled trials [2,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70].…”

Section: Effectiveness Of Different Biosurgical Hemostatic Agents In mentioning

confidence: 99%

Bleeding in Dental Surgery

Campos¹,

Furlaneto²,

Buischi³

2019

Contemporary Applications of Biologic Hemostatic Agents Across Surgical Specialties - Volume 2 [Working Title]

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Excessive bleeding complicates surgery and may result in a higher risk of morbidity in dentistry. Although multiple evidence-based clinical guidelines regard dental interventions as minor procedures, with low risk of bleeding, patients on anticoagulation therapy are at elevated risk of bleeding complications, during and following dental surgeries. In many instances, discontinuation or altering of anticoagulation can be avoided through the use of local hemostatic agents during or after the procedure (or both), while patients are therapeutically continued on their prescribed anticoagulant doses. In addition, patients with diagnosis of hereditary bleeding disorders, such as von Willebrand disease and hemophilia, and individuals without any history of bleeding complications can present the need for the use of topical hemostatic agents. In this chapter, we discuss the mechanisms of action, practical applications, effectiveness, and potential negative effects of biosurgical topical hemostatic agents, such as gelatin sponges, collagen, oxidized regenerated cellulose (ORC) and oxidized cellulose, fibrin sealants, flowables, adhesives, and topical thrombin in dental surgery.

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“…The results of most studies show that dental extractions can be performed safely without discontinuing OAT if INR is within the therapeutic range (INR ≤ 4.0) and if appropriate local hemostatic measures are provided 14,[28][29][30][31][32][33][34][35][36][37][38] . The most commonly used local hemostatic agents and measures are: oxidized regenerated cellulose, absorbable gelatin or collagen sponges, fibrin glue, antifibrinolytics applied directly into the wound or in the form of a solution as a mouthwash and wound suturing [39][40][41] .…”

Section: Dental Treatment Of Patients Taking Oral Anticoagulant Drugsmentioning

confidence: 99%