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Original Article
Year :  |  Volume : 7   |  Issue :1   |  Page :5-8  


P. Kiruthika, M. Dhanraj, Ashish R. Jain

Correspondence Address:Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India

Source of Support: None , Conflict of Interest: None


DOI: 10.4103/2231-4040.197331

  Abstract  
How to cite this article:

Kiruthika P, Dhanraj M, Jain AR, Varma ACU. Effectiveness of local hemostatic agents following dental extraction: A systematic review. J Adv Pharm Edu Res 2017;7(1):5-8.


  Introduction   Top

Anticoagulant drugs are involved in the prevention and management of cardiac valve disease, cardiac arrhythmia, prosthetic heart valve, pulmonary embolus, and cerebrovascular accident.[1] Patients who receive oral anticoagulant therapy (OAT), dental extractions is a common procedure. In the past, it was controversial that dental extractions in patients under anticoagulant therapy pose the problem between stopping or carrying on treatment as there is serious risk of post-operative hemorrhage and thromboembolism.[2] The postoperative bleeding time and hemostasis using local hemostatic agents in patients who were undergoing or stopped anticoagulant intake during dental extraction were calculated by means of the international normalized ratio (INR).[3] Various hemostatic agents have been found successful in controlling post-operative bleeding in patients undergoing anticoagulant therapy which includes histoacryl glue,[2] gelatin sponge,[4] collagen sponge[5] tranexamic acid, and autologous fibrin glue.[6] Cyanoacrylate glues are biocompatible, bactericidal and quick healing.[7] Tranexamic acid has antifibrinolytic activity and effective mouthwash in patients taking oral anticoagulants.[8] Gelatin sponge has excellent hemostatic properties and biocompatibility.[9] Fibrin glue is effective tissue adhesive, biodegradable, produces hemostasis, and reduced complications.[10] Hence, this systematic review is composed with the following aims and objectives.

Aim

To evaluate the effectiveness of local hemostatic agents in the management of bleeding in dental extraction sockets. To evaluate the difference between various local hemostatic agents in causing hemostasis in patients undergoing dental extraction.

  Materials and methods   Top

Sources used

An electronic search was initiated for scholarly articles on local hemostatic agents, OAT, and dental extraction. The search was PubMed based. The search methodology applied was a combination of MESH terms and suitable keywords based on PICO formulated for the review.

Search methodology

The search methodology applied was a combination of MESH terms and suitable keywords (Chart 2a).

PICO analysis

Population: Patients are undergoing extraction, patients under OAT, antithrombotic therapy, antiplatelet therapy, thrombocytopenia, hemophilia, scurvy, purpura, von willebrand disease, and vitamin K deficiency.

Intervention: Local hemostatic agents, hemostatic collagen, bone wax, cellulose, tranexamic acid, fibrin glue, gelatin sponge, histoacryl glue, collagen flees, and local antifibrinolytic solutions.

Comparison: Dental suture.

Outcome: Hemostasis, coagulation of blood, cessation of bleeding.

Selection of studies: The review process comprises two phases. In the first phase, the title and abstracts of the articles obtained through PubMed search were examined for relevance. The full text of relevant articles was obtained and accessed. In the second phase, relevant articles were isolated based on inclusion and exclusion criteria, for further data extraction and statistical analysis.

Inclusion criteria

• Clinical trials

• Patients undergoing anticoagulant therapy

• Patients undergoing dental extraction

• Use of local hemostatic agents.

Exclusion criteria

• Genetic disorders

• Animal study

• Reviews.

 

  Results   Top

Discussion   Top

Conclusion   Top

References   Top

Figures

 

 

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