Usefulness of platelet-rich fibrin as a hemostatic agent after dental extractions in patients receiving anticoagulant therapy with factor Xa inhibitors: a case series
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To evaluate the clinical outcomes of platelet-rich fibrin (PRF) application for hemostasis after dental extraction in patients receiving anticoagulant therapy with factor Xa inhibitors.
In total, 25 patients receiving anticoagulant therapy with rivaroxaban or apixaban who required routine dental extraction were evaluated. In all patients, PRF was used for hemostasis in addition to adapting sutures. Bleeding was subjectively assessed using a sterilize gauze pad at 24, 48, and 72 h after the procedure.
All invited participants (n = 25) consented to participate. The PRF clots successfully arrested bleeding after extraction in all patients, with no complications at any time point after the procedure. Favorable soft tissue healing was observed during suture removal at 10 days after the procedure in all patients, with no signs of infection or late healing.
The results of this case series indicate that PRF is a promising natural hemostatic agent for the management of bleeding after dental extraction in patients receiving factor Xa inhibitor therapy. Further controlled clinical studies with larger patient samples are necessary to clarify the findings of this case series.
KeywordsPlatelet-rich fibrin Anticoagulant therapy Clot stability Hemostasis Dental extraction
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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.
Informed consent was obtained from all individual participants included in the study.
- 6.O’Connell JE, Stassen LF (2014) New oral anticoagulants and their implications for dental patients. J Go Dent Assoc 60:137–143Google Scholar
- 7.Carter G, Goss A (2003) Tranexamic acid mouthwash : a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions. Int J Oral Maxillofac Surg 32:504–507Google Scholar
- 14.Riley DS, Barber MS, Kienle GS, Aronson JK, von Schoen-Angerer T, Tugwell P, Kiene H, Helfand M, Altman DG, Sox H, Werthmann PG, Moher D, Rison RA, Shamseer L, Koch CA, Sun GH, Hanaway P, Sudak NL, Kaszkin-Bettag M, Carpenter JE, Gagnier JJ (2017) CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 89:218–235CrossRefGoogle Scholar
- 19.Queiroz SIML, Alves HS, de Assis GM, Conceicao TS, Germano AR, da Silva JS (2016) An evaluation of the efficacy of local hemostatic measures in dental patients taking oral anticoagulants: a critical review of the literature over the past two decades. Curr Clin Pharmacol 11:230–240CrossRefGoogle Scholar
- 22.Eshghpour M, Danaeifar N, Kermani H, Nejat AH (2018) Does intra-alveolar application of chlorhexidine gel in combination with platelet-rich fibrin have an advantage over application of platelet-rich fibrin in decreasing alveolar osteitis after mandibular third molar surgery? A double-blinded randomized clinical trial. J Oral Maxillofac Surg 76:939.e1–939.e7CrossRefGoogle Scholar
- 23.Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G (2018) Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: a split-mouth randomized clinical trial. Quintessence Int 49:377–388Google Scholar
- 28.Castro AB, Meschi N, Temmerman A, Pinto N, Lambrechts P, Teughels W, Quirynen M (2017) Regenerative potential of leucocyte- and platelet-rich fibrin. Part B: sinus floor elevation, alveolar ridge preservation, and implant therapy. A systematic review. J Clin Periodontol 44:225–234CrossRefGoogle Scholar
- 30.Velier M, Magalon J, Daumas A, Cassar M, Francois P, Ghazouane A, Philandrianos C, Bertrand B, Frere C, Bernot D, Villani P, George FD, Sabatier F (2018) Production of platelet-rich plasma gel from elderly patients under antithrombotic drugs: perspectives in chronic wounds care. Platelets 29:496–503CrossRefGoogle Scholar
- 31.Weisel JW, Rustem-Litvinov I (2017) Fibrin formation, structure and properties subcell. Biochem 82:405–456Google Scholar
- 32.Caliskan M, Tükel HC, Benlidayi ME, Deniz A (2017) Is it necessary to alter anticoagulation therapy for tooth extraction in patients taking direct oral anticoagulants? Med Oral Patol Oral Cir Bucal 22:e767–e773Google Scholar