warfarin and Gingivitis

Ligneous gingivitis is a rare condition characterized by inflammation and nodular gingival enlargement secondary to fibrin deposits in the gingival that results from plasminogen deficiency. Several therapeutic approaches have been used with limited success. We report a case of a patient with homozygous plasminogen deficiency and ligneous gingivitis that was initially refractory to local care and systemic antibiotics, but later improved with the addition of warfarin.

Topics: Anticoagulants; Coagulation Protein Disorders; Female; Gingivitis; Homozygote; Humans; Middle Aged; Plasminogen; Uterine Cervicitis; Warfarin

The purpose of the present work was to observe local hemostatic function during dental surgery in patients under oral anticoagulant therapy with an INR between 1.7 and 2.5. Thirty seven dental treatments were performed in 15 patients. Group A: nineteen dental treatments (13 scalings, 1 root canal therapy and 5 dental extractions), treated with oral rinse with tranexamic acid (250 mg dissolved in 10 ml of water). Group B: eighteen dental procedures (13 scaling, 1 root canal therapy and 14 dental extractions), in which oral rinse was utilized. Antibiotics were indicated for those patients with root canal therapy or with signs of infection. A cool soft diet was recommended to all patients during the three days following the surgical procedure. Only in five (13.5%) dental extractions (1 from group A and 4 from B) bleeding prolonged was observed, however periodontal disease was also present in those patients hone of them required blood products or withdrawal of the anticoagulant. The results suggest that mouth washing with tranexamic acid prevents excessive oral bleeding in patients treated with oral anticoagulants with an INR between 1.7 and 2.5.

Topics: Anticoagulants; Antifibrinolytic Agents; Blood Coagulation Disorders; Blood Loss, Surgical; Dental Scaling; Drug Evaluation; Gingival Hemorrhage; Gingivitis; Hemostasis, Surgical; Humans; Mouthwashes; Periapical Abscess; Periodontitis; Postoperative Hemorrhage; Root Canal Therapy; Tooth Extraction; Tranexamic Acid; Warfarin