Journal of Dental Research, Vol 71, 387-390, Copyright © 1992 by International & American Associations for Dental Research Online Journals
Influence of anticoagulation on blood loss following dental extractions
D. DeClerck, F. Vinckier and J. Vermylen
Catholic University of Leuven, School for Dentistry, Oral Pathology and Maxillofacial Surgery, Belgium.
The coagulation activity level at which oral surgery procedures can be
performed in anticoagulated patients without triggering bleeding
complications and without enhancing the risk of developing thrombo-embolic
events remains controversial. The objective of the present study was to
evaluate blood loss following dental extractions at different levels of
anticoagulation and to determine its effect on wound closure rates. Blood
loss was measured following the removal of four front teeth in warfarinized
rabbits. Immediate blood loss was evaluated by determining the tooth socket
bleeding times and by using a technique based on hemoglobin determinations.
Long-term blood loss was assessed by comparison of labeled red-blood-cell
disappearance curves. The results showed that blood loss following dental
extractions was significantly greater in animals anticoagulated at a
therapeutic level than in non-anticoagulated control animals. Determination
of blood loss at different levels of anticoagulation clearly demonstrated
that complete correction of the coagulation activity was unnecessary.
Partial correction (INR values of 1.6-1.8) allowed extractions to be
performed without extensive blood loss. With this technique of partial
correction, the period of interruption of the anticoagulation could be kept
very short, and the risk of postoperative bleeding complications was
minimal. Wound closure rates were negatively influenced in anticoagulated
animals.
