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Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study

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Abstract

Objectives

The present work is a controlled, blinded, and randomized clinical trial comparing hemostatic measures for the control of post-tooth extraction hemorrhage in patients on anticoagulation therapy with warfarin.

Materials and methods

The sample consisted of 37 patients (37.8% male and 62.2% female) with a mean age of 45.5 years. After randomization, 20 patients were allocated to the control group (conventional hemostasis measures) and 17 to the study group (addition of local tranexamic acid). All variables that could influence the outcome were similar between the groups and no significant difference was seen (p > 0.05).

Results

In the assessment of immediate hemostasis, for the control group, the time to achieve cessation of bleeding was 9.1 (± 3.6) minutes. For the study group this was much lower, and this difference (6.018 / confidence interval of 95%, 4.677 to 7.359) was statistically significant (p < 0.001). In evaluating the control of intermediate hemorrhage, the use of tranexamic acid was more significantly associated with the absence of bleeding, especially in the first 24 h.

Conclusions and clinical relevance

Thus, this measure of local hemostasis in topical form with gauze compression and irrigation was shown to be more effective in reducing the time to attain immediate hemostasis, and in preventing intermediate hemorrhage.

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Funding

The work was supported by the Department of Oral & Maxillofacial Surgery of UFRN in Natal/RN, the Brazil and Hemonorte of Rio Grande do Norte, Dalton Cunha.

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Authors and Affiliations

  1. Departamento de Odontologia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil

    Salomão Israel Monteiro Lourenço Queiroz, Valeria Damasceno Silvestre, Giordano Bruno Paiva Campos, Adriano Rocha Germano & José Sandro Pereira da Silva

  2. Hemocentro Dalton Cunha (Hemonorte), Natal, Brazil

    Renata Monteiro Soares

Authors
  1. Salomão Israel Monteiro Lourenço Queiroz
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  2. Valeria Damasceno Silvestre
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  3. Renata Monteiro Soares
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  4. Giordano Bruno Paiva Campos
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  5. Adriano Rocha Germano
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  6. José Sandro Pereira da Silva
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Correspondence to Salomão Israel Monteiro Lourenço Queiroz or José Sandro Pereira da Silva.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Queiroz, S.I.M.L., Silvestre, V.D., Soares, R.M. et al. Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study. Clin Oral Invest 22, 2281–2289 (2018). https://doi.org/10.1007/s00784-017-2327-4

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  • DOI: https://doi.org/10.1007/s00784-017-2327-4

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