title: [Local haemostasis with an adhesive cyanoacrylate-coated membrane following tooth extraction in patients under anticoagulant or anti-platelet therapy].
abstract: OBJECTIVE
  Assessment of a local hemostasis with a compressive, extemporaneous gutter glued to the alveolar crest after tooth avulsion in patients under anticoagulant and/or platelet aggregation inhibitors, and economical impact of this technique.
  
  
  METHODS
  Ninety-seven tooth extractions were performed in patients under AVK and/or anti-platelet drugs. The interventions were consecutive and concerned 251 teeth (138 different alveolar sites). The extraction alveolus was protected by an absorbable oxycellulose membrane coated with sterilized cyanoacrylate adhesive for medical use. This procedure was used with all patients, whatever the hemorrhagic risk (the only inclusion criterion was INR less than 4 for patients under AVK). All procedures were performed under local anesthesia.
  
  
  RESULTS
  There was one hemorrhagic complication (0.72%) due to mechanical gutter destruction by an antagonist tooth. The adhesive did not run, there was no tissue necrosis, and no wound infection requiring gutter removal.
  
  
  CONCLUSIONS
  This local hemostasis procedure is reliable. It may be an alternative to substitution of heparin, without or with hospitalization. This procedure, requiring modification of treatment, greatly decreases healthcare costs. Contra-indications include the presence of an antagonist tooth harmful for the gutter, and patients with impaired consciousness or tongue dyspraxia.
authors.affiliation: Service de Stomatologie et Chirurgie Maxillo-Faciale, Hôpital André-Mignot, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay cedex, France. CLESCA@ch-versailles.fr
authors.forename: C
authors.initials: C
authors.lastname: Lesca
authors.forename: S
authors.initials: S
authors.lastname: Boumendjel
authors.forename: M
authors.initials: M
authors.lastname: Boumendjel
authors.forename: M
authors.initials: M
authors.lastname: Hefied
authors.forename: S
authors.initials: S
authors.lastname: Ben Ismail
authors.forename: D
authors.initials: D
authors.lastname: Bonnefous
mesh_terms: D015110:4-Hydroxycoumarins / Q000627:therapeutic use; D000287:Administration, Topical; D000925:Anticoagulants / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000453:epidemiology / Q000628:therapy*; D020099:Coated Materials, Biocompatible / Q000737:chemistry / Q000627:therapeutic use; D003487:Cyanoacrylates / Q000008:administration & dosage* / Q000737:chemistry; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007192:Indenes / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000008:administration & dosage / Q000737:chemistry; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D014812:Vitamin K / Q000037:antagonists & inhibitors / Q000627:therapeutic use
chemical_list: D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D003487:Cyanoacrylates; D007192:Indenes; D010975:Platelet Aggregation Inhibitors; D014014:Tissue Adhesives; C011664:antivitamins K; D014812:Vitamin K