Dental extractions in patients maintained on oral anticoagulant therapy: comparison of International Normalized Ratio [INR] value with occurrence of postoperative bleeding

ABSTRACT

The purpose of this study was to evaluate the incidence of postoperative bleeding in patients treated with oral anticoagulant medication undergone dental extraction without interruption of medication and to compare the incidence of postoperative bleeding with International Normalized Ratio [INR] value. This study was a cross sectional study and the data collecting method was direct observation. A total of 362 patients undergone 703 dental extractions without interruption of oral anticoagulant medication were studied. For all patients INR value was measured on the day of surgery and based on INR value, the patients were divided into three groups Group I with INR of 1.5-2.49, Group2 with INR of 2.5-3.49, and Group 3 with INR of> 3.5. Dental extraction was carried out by two surgeon and if necessary, local hemostatic agents were applied [gelfoam and multiple silk sutures]. The data were analyzed using SPSS 11.5 statistical software [Willcoxan and Mann-Whitney tests]. Of the 360 patients undergone oral anticoagulant medication, in 30 patients postoperative bleeding occurred. 11 patients [7.43%] in group one, 10 patients [8.62%] in group two and 9 patients [9.18%] in group three, developed postoperative bleeding. The incidence of postoperative bleeding was not significantly different in three groups. Thus simple dental extractions can be performed without modification of oral anticoagulant therapy. Local hemostasis using gelfoam and sutures would be sufficient to control postoperative bleeding