Key result
Local hemostatic measures enable low-risk dental extractions without interrupting antithrombotic therapy.
Why the study?
Does local hemostatic management (including conventional methods, tranexamic acid, chitosan-based dressings, and platelet-rich fibrin) safely control postoperative bleeding without routine antithrombotic interruption in patients receiving antiplatelet and anticoagulant therapy undergoing simple and surgical dental extractions?
Does local hemostatic management (including conventional methods, tranexamic acid, chitosan-based dressings, and platelet-rich fibrin) safely control postoperative bleeding without routine antithrombotic interruption in patients receiving antiplatelet and anticoagulant therapy undergoing simple and surgical dental extractions?
Most low-risk dental extractions in patients on antithrombotic therapy can be safely performed without interrupting medication if meticulous conventional local hemostasis is applied, supplemented by adjunctive agents like tranexamic acid, chitosan, or platelet-rich fibrin when indicated.
Answers are grounded in this paper and cite their sources.
Supports local hemostasis without interruption in low-risk cases; extends consensus yet leaves open need for prospective trials.
Background: Antithrombotic therapy is increasingly common in dental patients and creates a practical need to balance postoperative bleeding against potentially severe thromboembolic events associated with inappropriate medication interruption. Objective: To critically review perioperative assessment, antithrombotic drug classes, conventional local hemostasis, tranexamic acid, chitosan-based dressings and platelet-rich fibrin (PRF) for simple and surgical extractions. Review Approach: This expanded narrative review integrates major dental guidance and selected clinical trials and systematic reviews. It is not a systematic review; no exhaustive search, formal risk-of-bias grading or meta-analysis was conducted. Synthesis: Most low-risk dental extractions can be performed without routine antithrombotic interruption when meticulous local hemostasis is available. Higher-bleeding-risk procedures require drug-specific planning. Tranexamic acid may reduce selected delayed bleeding outcomes; chitosan is promising for rapid local control; PRF offers a biological scaffold with possible healing benefits, although heterogeneous methods limit comparative conclusions. Conclusion: Risk-stratified treatment, atraumatic surgery, pressure, socket packing, sutures and appropriate follow-up remain the foundation of safe care. Newer agents should be viewed as adjuncts rather than substitutes for clinical judgment.
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Jusufi et al. (2026) conducted a review in Simple and surgical dental extractions in patients receiving antiplatelet and anticoagulant therapy. Local hemostatic measures (tranexamic acid, chitosan-based dressings, platelet-rich fibrin, and conventional measures) vs. Conventional local hemostasis (direct pressure, socket packing, and suturing) or placebo was evaluated. Local hemostatic measures allow most low-risk dental extractions to proceed without interrupting antithrombotic therapy, with tranexamic acid, chitosan, and PRF serving as useful adjuncts.
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