title: The effectiveness of a new method using an extra-alveolar hemostatic agent after dental extractions in older patients on oral anticoagulation treatment: an intrapatient study.
abstract: OBJECTIVE
  The present study aimed to evaluate the effectiveness of a new adhesive agent, HemCon Dental Dressing (HDD), in patients receiving oral anticoagulant treatment (OAT), who were undergoing nonsurgical tooth extractions without interruption or reduction of OAT, compared with that of a common local hemostatic agent.
  
  
  METHODS
  Twenty patients on OAT with an international normalized ratio (INR) ranging between 1.6 and 3.5 were recruited. In the same session, each patient was subjected to the extraction of two teeth: In the test site the HDD was applied, and in the control site, a common hemostatic sponge (CollaPlug, Zimmer Dental) was used.
  
  
  RESULTS
  The mean application time was significantly lower in the test group than in the control group, and this difference is statistically significant. The mean postoperative pain was significantly lower in the test group than in the control group the morning after surgery and at the time of suture removal. Post-extraction socket healing was significantly better in the test group than in the control group.
  
  
  CONCLUSIONS
  Tooth extraction in patients receiving OAT and have an INR lower than 3.5 is a safe procedure without discontinuation of the OA regimen. The HDD seems to reduce postoperative side effects and obtain rapid soft tissue healing.
authors: Associate Professor, Sapienza University of Rome, Department of Odontostomatological and Maxillofacial Sciences, Via Caserta 6, 00161 Rome, Italy. Electronic address: roberto.pippi@uniroma1.it.
authors: Roberto
authors: R
authors: Pippi
authors: Oral Surgery postgraduate student, Sapienza University of Rome, Department of Odontostomatological and Maxillofacial Sciences, Rome, Italy.
authors: Marcello
authors: M
authors: Santoro
authors: Sapienza University of Rome, Department of Cell Biotechnology and Hematology, Rome, Italy.
authors: Arturo
authors: A
authors: Cafolla
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D017742:Dental Care for Chronically Ill; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D013997:Time Factors; D014081:Tooth Extraction; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000925:Anticoagulants; D006490:Hemostatics