Usefulness of platelet-rich fibrin as a hemostatic agent after dental extractions in patients receiving anticoagulant therapy with factor Xa inhibitors: a case series

Oral Maxillofac Surg. 2019 Sep;23(3):381-386. doi: 10.1007/s10006-019-00769-y. Epub 2019 May 17.

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Anticoagulant therapy; Clot stability; Dental extraction; Hemostasis; Platelet-rich fibrin.

MeSH terms

  • Anticoagulants
  • Factor Xa Inhibitors
  • Hemostatics*
  • Humans
  • Platelet-Rich Fibrin*
  • Tooth Extraction

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Hemostatics