Objectives: Management of patients who are maintained on oral anticoagulant therapy represents a major challenge in the dental practice due to the significant risk of postoperative hemorrhagic complications and subsequent delayed wound healing. This study was performed to evaluate the local efficacy of Platelet Rich Fibrin (PRF), gelatin sponge and tranexamic acid following dental extraction in patients taking Warfarin.
Methods: Forty-five patients having an International Normalized Ratio (INR) < 3.5 underwent atraumatic extraction of 57 teeth under local anesthesia. Patients were allocated equally into 3 groups. Group A: the extraction sockets were packed with PRF, group B: the extraction sockets were packed with gelatin sponge, group C: a gauze soaked with tranexamic acid pressed over socket for 30 minutes. Immediate and delayed postoperative bleeding, socket healing and postoperative pain were assessed at different times of follow up.
Results: PRF significantly reduced postoperative bleeding after 5-, 30- and 60-minutes post extraction. No significant difference at 1 or 3 days postoperatively. Patients in group A recorded minimal postoperative pain and accelerated healing.
Conclusions: PRF has significant antihemorrhagic properties, increases tissue healing and wound closure and decrease postoperative pain. It is a promising autogenous, low cost, local hemostatic modality that can be used safely after dental extraction for patients under anticoagulant therapy.
Keywords: Anticoagulant therapy; Platelet rich fibrin; gelatin sponge; tranexamic acid; Dental extraction