Platelet rich fibrin versus Hemcon dental dressing following dental extraction in patients under anticoagulant therapy

Objectives: Dental extractions in heart surgery patients treated with artificial mechanical heart valves under anticoagulant oral therapy can be difficult as these patients present a significant risk for postoperative hemorrhagic complications. This study was performed to evaluate the use of Platelet Rich Fibrin (PRF) and Hemcon dental dressing (HDD) in cardiac patients takingWarfarin following dental extraction. Methods: 20 patients were involved in this study with an age range of 36-62 years. Patients having an International Normalized Ratio (INR) 3.5 were excluded. Extraction was performed under local anesthesia and as atraumatic as possible. Patients were allocated equally in two groups; group A: where PRF was inserted into the extraction socket, while group B: the extraction socket was packed by HDD. Results: Complete hemostasis was achieved in all cases with no delayed bleeding. Patients in group A showed minimal pain and accelerated healing, while those in group B showed extreme to moderate pain on the first few days following extraction and retarded healing. Four patients developed alveolar osteitis. Conclusions: PRF has good antihemorrhagic properties and increases tissue healing and wound closure, thus allowing for a quick recovery without significant painful events. HDD has excellent hemostatic properties and can be used safely in such patients but with small amounts.