Use of local hemostatic modalities in oral anticoagulant dental patients

In patients who receive oral anticoagulantа, dental extractions are a common procedure. In the past, some authors have proposed that anticoagulant treatment be stopped for several days (2 to 6) oral surgery intervention; others have proposed reducing the dose of anticoagulant intake for several days before the interventions. AIM: The aim of this study was to compare the clinical hemostatic effect of tranexamic acid mouthwash and resorbable oxicellulose dressing after oral surgery interventions in patients receiving continuous oral anticoagulant therapy. MATERIAL AND METHOD: A first group was consisted of 25 patients with a preoperative international normalized ratio (INR) in the range of 1.8 to 3.0. After the interventions was used 5% tranexamic acid mouthwashing for 2 minutes, 4 time daily during a postoperative period of 4days. The second group of 25 patients with a comparable INR range of 1.9 to 2.9 had oral surgical interventions performed and the socket(s) dressed with a resorbable oxycellulose dressing and sutured with a resorbable suture. RESULTS: No discernible difference in the postoperative outcome with regard to hemorrhage was noted. Postoperative pain was reported more frequently in the group that used a resorbable oxycellulose dressing. Only 1 patient had significant postoperative bleeding. CONCLUSIONS: This study shows that in patients receiving oral anticoagulants whose INR is within the therapeutic range, the tranexamic acid mouthwash is as effective as the resorbable oxycellulose dressing in preventing post oral surgical hemorrhage