[Effect of gelatin sponge and tranexamic acid M.rinses on prevention of bleeding after dental extraction in patients taking warfarin]

ABSTRACT

Management of postoperative bleeding in patients receiving warafin, has always been one of the most challenges for dentists. Cessation in using warafin 2-3 days before tooth extraction is one of the methods for preventing bleeding in these patients, but it may increase the risk of thromboembolism. The aim of this study was to use localized haemostatic drugs instead including gelatin sponge and tranexamic acid mouthwash. In this clinical trial study, 22 patients who were currently receiving warafin with INR range of 2-4 were selected. For each patient 3 teeth were extracted in several times. After extraction of each tooth, Gelatin sponge, Tranexamic acid 4.8% mouth wash and sterile gauze [without any haemostatic drug] were used. Tendency of bleeding in 66 teeth, 2 and 24 hours after extraction was checked. No suture was used for any patient. Data were analyzed with descriptive statistics [frequency and average] and Chi-square and Fisher's exact tests. Rate of bleeding in three groups were measured Gelatin sponge 9.1%, Tranexamic acid 4.8% mouthwash zero and sterile gauze [without any haemostatic drug] 27.3%. In patients treated with warafin, interruption in use of warfarin for tooth extraction is not needed. Local haemostasis with tranexamic acid, gelatin sponge, INR