Evaluation of local hemostatic efficacy after dental extractions in patients taking antiplatelet drugs: a randomized clinical trial

Objectives The purpose of this study was to evaluate clinical efficacy of four different local hemostatics in patients taking oral antiplatelet therapy, after multiple dental extractions without discontinuing drugs. Materials and methods Study sample included 102 patients (mean age 64.1 +/- 17.4 years) in treatment with oral antiplatelet agents needing multiple dental extractions. After surgery, the sockets were randomly sealing with suture alone (control group), hemostatic plug (HEM), advanced platelet-rich fibrin (A-PRF+), and leukocyte-platelet-rich fibrin (L-PRF). Primary outcomes were post-operative bleeding, wound healing index, and possible complications. Secondary outcomes were correlation between primary outcomes and patient's comorbidities and voluptuous habits. Descriptive statistics, bivariate comparisons, and logistic regression analysis were performed (p< 0.05). Results Both A-PRF+ and L-PRF showed a reduced bleeding risk when compared with suture alone (OR = 0.09,p= 0.001 for A-PRF+; OR = 0.09,p= 0.005 for L-PRF). Only L-PRF showed a reduced risk for incomplete wound healing when compared with the control site (OR = 0.43,p= 0.019). Patients affected by hypertension (OR 3.91,p= 0.015) and diabetes (OR 3.24,p= 0.026) had the highest bleeding risk. Smoking (OR 4.30,p= 0.016) and diabetes (OR 3.79,p= 0.007) interfered with healing process. Conclusion L-PRF and A-PRF represent a valid alternative to the traditional hemostatics, reducing post-surgical bleeding and promoting wound healing.

Automated summary

Both A-PRF+ and L-PRF showed reduced bleeding risk compared to suture alone (OR = 0.09, p = 0.001 for A-PRF+; OR = 0.09, p = 0.005 for L-PRF). Only L-PRF reduced the risk of incomplete wound healing compared to the control site (OR = 0.43, p = 0.019). Patients with hypertension (OR 3.91, p = 0.015) and diabetes (OR 3.24, p = 0.026) had the highest bleeding risk, while smoking (OR 4.30, p = 0.016) and diabetes (OR 3.79, p = 0.007) impacted the healing process. Overall, L-PRF and A-PRF represent effective alternatives to traditional hemostatics for reducing bleeding and promoting wound healing.