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E-mail: aa_hs_88@yahoo.com
Effect of Gelatin Sponge and Tranexamic Acid M.rinses on Prevention of Bleeding after
Dental Extraction in Patients Taking Warfarin
Ali Peymani Mojaver*, Maryam Soltani**#, Hamid Bakhshi***
* Assistant Professor, Dept of Oral & Maxillofacial Surgery, School of Dentistry, Rafsanjan University of Medical Sciences,
Rafsanjan, Iran.
** Student of Dental School, Rafsanjan, Iran.
*** Instructor, Dept of Medical Education Center (EDC), Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Received: 20 September 2010; Accepted: 19 January 2011
Introduction: Management of postoperative bleeding in patients receiving warfarin, has always been one of the most
challenges for dentists. Cessation in using warfarin 2-3 days before tooth extraction is one of the methods for preventing
bleeding in these patients, but it may increase the risk of thromboembolism. The aim of this study was to use localized
haemostatic drugs instead including gelatin sponge and tranexamic acid mouthwash.
Materials & Methods: In this clinical trial study, 22 patients who were currently receiving warfarin with INR range of 2-
4 were selected. For each patient 3 teeth were extracted in several times. After extraction of each tooth, Gelatin sponge,
Tranexamic acid 4/8% mouth wash and sterile gauze (without any haemostatic drug) were used.Tendency of bleeding in 66
teeth, 2 and 24 hours after extraction was checked. No suture was used for any patient. Data were analyzed with descriptive
statistics (frequency and average) and Chi-square and Fisher's exact tests.
Results: Rate of bleeding in three groups were measured: Gelatin sponge: 9.1%, Tranexamic acid 4.8% mouthwash: zero
and sterile gauze (without any haemostatic drug): 27.3% .
Conclusions: In patients treated with warfarin, interruption in use of warfarin for tooth extraction is not needed. Local
haemostasis with tranexamic acid 4.8% mouthwash without any suture is sufficient.
Key words: Warfarin, tranexamic acid, gelatin sponge, INR.
# Corresponding Author: aa_hs_88@yahoo.com
J Mash Dent Sch 2011; 35(1): 17-22.