Hemostatic management for periodontal treatments in patients on oral antithrombotic therapy: A retrospective study

Purpose We retrospectively investigated hemostatic management for periodontal treatments in patients on oral antithrombotic therapy. Patients and 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. We retrospectively investigated hemostatic management for periodontal treatments in patients on oral antithrombotic therapy. 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. 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. 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.