title: Hemostatic management for periodontal treatments in patients on oral antithrombotic therapy: a retrospective study.
abstract: OBJECTIVE
  We retrospectively investigated hemostatic management for periodontal treatments in patients on oral antithrombotic therapy.
  
  
  METHODS
  A total of 155 periodontal treatment procedures were performed in 139 patients who continued taking conventional antithrombotic drugs. Insertion of oxidized cellulose, compression, and suturing were used as local hemostatic measures. When hemostasis was difficult, hemorrhage was stopped using electrocautery and/or splint.
  
  
  RESULTS
  For the warfarin patients, 49 scaling procedures were performed in patients with INR of 4.82 or less, and 52 periodontal surgeries were performed in patients with INR of 2.97 or less. As for periodontal surgeries, electrocautery and splint were used in 30% and 70% of cases, respectively. In the entire patient population, posttreatment hemorrhage was seen in 2 (1.3%) of the 155 periodontal treatment procedures.
  
  
  CONCLUSIONS
  Scaling can be safely performed in patients on warfarin (INR <4.0) and/or antiplatelet therapy. Periodontal surgery can be performed in patients with INR less than 3.0 with proper local hemostatic procedures.
authors.affiliation: Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka Japan. ysn-mori@dent.osaka-u.ac.jp
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Niwa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003777:Dental Prophylaxis / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D005881:Gingiva / Q000601:surgery; D005884:Gingival Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D014859:Warfarin / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin