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Randomized, prospective trial comparing bridging therapy using low-molecular-weight heparin with maintenance of oral
Branislav V Bajkin1, Stevan L Popovic, Srecko D J Selakovic
1Department of Oral Surgery, Dental Clinic of Vojvodina, Medical Faculty, University of Novi Sad, Novi Sad, Serbia. bajkinb@eunet.yu
Purpose:
To evaluate postoperative bleeding and thromboembolic complications during dental extractions in anticoagulated patients, using 2 different protocols.
Patients And Methods:
In total, 214 anticoagulated patients in need of simple dental extractions were randomized into 2 groups. Group A consisted of 109 patients on continuous oral anticoagulation therapy (OAT), with a mean international normalized ratio (INR) of 2.45 +/- 0.54. Local hemostasis in these patients was achieved with resorbable collagen sponges, without wound suturing. Group B consisted of 105 patients on bridging therapy with low-molecular-weight heparin (nadroparin-calcium), with a mean INR of 1.26 +/- 0.11 on the day of the procedure. Neither local hemostatic agents nor suturing of the wound was used in these patients.
Results:
Eight (7.34%) patients in group A and 5 (4.76%) patients in group B manifested postextractional bleeding, without statistical significance (chi(2), Yates' = 0.253, P > .05). All cases of hemorrhage were mild and easily controlled using local hemostatic measures. None of the participants in either group experienced thromboembolic complications.
Conclusions:
In patients receiving OAT with an INR
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