Key result
Platelet-rich fibrin shows identical hemostatic efficacy to gelatine sponge in patients on factor Xa inhibitors.
Why the study?
The study evaluated whether platelet-rich fibrin provides effective local hemostasis compared to a hemostatic gelatine sponge after tooth extraction in patients maintained on factor Xa inhibitors.
Does platelet-rich fibrin prevent postoperative bleeding compared to gelatine sponge in patients taking factor Xa inhibitors undergoing single-tooth extraction?
RCT (n=21)
Double-blind
Split-mouth design
No
Does platelet-rich fibrin prevent postoperative bleeding compared to gelatine sponge in patients taking factor Xa inhibitors undergoing single-tooth extraction?
Platelet-rich fibrin and gelatine sponges provide comparable and reliable hemostasis after single-tooth extraction in patients on factor Xa inhibitors, supporting the continuation of anticoagulation during such procedures.
Answers are grounded in this paper and cite their sources.
Supports continuing factor Xa inhibitors for tooth extraction; confirms PRF equivalence to gelatine sponge.
OBJECTIVES: In this prospective, double-blinded, randomized split-mouth study, the local hemostatic effect of platelet-rich fibrin (PRF) inserted into the extraction socket in patients taking factor Xa (FXa) inhibitors (apixaban, rivaroxaban, edoxaban) was compared to a hemostatic gelatine sponge (GS) as the "therapeutic gold standard" without withdrawal of oral anticoagulant therapy. MATERIALS AND METHODS: Single-tooth extraction was conducted under local anesthesia in n = 21 patients using a split-mouth design (42 teeth). Using a double-blind approach, the extraction socket on one side of the jaw was filled with PRF and on the other with a GS. Bleeding was assessed immediately after surgery, in 30 min, 1 h, 1.5 h, and on follow-up appointments in 24 h and on the 7th day. RESULTS: In 67% of cases, mild postoperative oozing could be stopped 30-90 min after tooth extraction via gauze pressure without any delayed bleeding. Concerning bleeding events, there was no difference among the PRF and GS groups and no significant difference among rivaroxaban, apixaban, and edoxaban (all p > 0.15). CONCLUSION: PRF and GS are reliable hemostatic methods in postextraction sockets of patients taking FXa inhibitors. CLINICAL RELEVANCE: Consequently, there is no need to discontinue FXa inhibitors because of a single-tooth removal, eliminating the risk of thrombus formation.
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Kyyak et al. (2023) conducted an RCT in Patients taking factor Xa inhibitors requiring single-tooth extraction (n=21). Platelet-rich fibrin (PRF) vs. Hemostatic gelatine sponge (GS) was evaluated on Postoperative bleeding/oozing events (p=>0.05). Platelet-rich fibrin and gelatine sponge demonstrated identical hemostatic efficacy, with 67% of cases experiencing mild oozing that stopped within 90 minutes, in patients taking factor Xa inhibitors.
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