Comparison of two hemostatic agents in patients receiving anticoagulants without altering medication dosage

Abstract

Background:Patients under anticoagulant therapy who need tooth extraction, face the problem of intraoperative and postoperative bleeding which may be difficult to control. Some surgeons use the option of stopping the medication or altering its dose for three to four days preoperatively to obtain adequate hemostasis; however, this may carry the risk of thromboembolism.

The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis

“…There was no significant difference between the hemostatic agents and the conventional methods in all studies. In contrast, when evaluating different agents, cyanoacrylate tissue adhesive resulted in significantly fewer bleeding events, as opposed to using a gelatin sponge 26 , while the latter demonstrated a statistical significance compared with chitosan 19 . Moreover, both fibrin and bismuth subgallate were significantly better than collagen 18 .…”

“…The hemostatic agents used were Chitosan dental dressing 19 , 30 , 31 , 33 – 37 , Oxidized regenerated cellulose 6 , 27 , 32 , Tranexamic acid 20 , 21 , 24 , 28 , 29 , 38 , Fibrin sponge or adhesive 18 , 27 , 38 , Collagen plug 18 , 34 , 37 , Bismuth subgallate 18 , Gelatin sponge 19 , 22 , 23 , 26 , Feracrylum 20 , Epsilon aminocaproic acid 7 , 29 , Ankaferd blood stopper 25 , and Cyanoacrylate tissue adhesive 26 .…”

“…Sixteen studies reported information related to postoperative bleeding events. Among these, five compared different agents 18 , 19 , 26 , 27 , 29 , while the rest compared one or more hemostatic agents to conventional methods 6 , 7 , 20 – 23 , 25 , 28 , 32 , 35 , 38 . The postoperative period to record bleeding events lasted up to 10 days 26 .…”

Efficacy of gelatamp in controlling the postoperative sequelae following mandibular posterior teeth extraction - A split-mouth study

“…This further demonstrates the efficacy of gelatamp in preventing dry sockets on the lines of studies conducted by previous authors. 5 , 11 , 17 , 18 …”

A Review on the Application of Silver Nanoparticles in Oral and Maxillofacial Surgery

“…The patients who used Gelatamp after tooth extraction achieved superior immediate postoperative hemostasis than the controls. 47 Likewise, the study by Piry et al determined that Gelatamp has the ability to promote hemostasis, with a significant reduction of pain symptoms between teeth with Gelatamp and control group. 48 This study interestingly implies that colloidal silvers in gelatin sponges are contributory to rapid hemostasis and wound healing, and might decrease the chances of other postoperative complications.…”