Perioperative Management Of Anticaogulated Patients In Oral Surgery: Tranexamic Acid

Managing anticoagulated patients in oral surgery requires balancing bleeding risk with thromboembolic prevention. Discontinuing anticoagulants increases thrombotic risk, while maintaining them may lead to excessive bleeding. Topical 4.8% tranexamic acid (TXA), an antifibrinolytic agent, stabilizes clot formation without affecting systemic coagulation. This case highlights the use of TXA as a local hemostatic measure in an anticoagulated patient undergoing tooth extraction for implant placement. A male patient on anticoagulants required extraction before dental implant placement. • Preoperative: No anticoagulation adjustment; TXA rinse (4.8%, 2 min). • Intraoperative: Atraumatic extraction, Gentle irrigation with TXA, TXA-soaked gauze applied. • Postoperative: TXA mouth rinses (10 mL, 2 min, 4×/day for 2 days). Follow-ups at 24 hours, 1 week, and 2 weeks. Hemostasis was achieved without excessive bleeding or complications. Topical TXA effectively controlled bleeding while allowing continuous anticoagulation, aligning with current evidence-based guidelines. Studies support TXA’s role in reducing oral surgery bleeding without systemic risks. 4.8% TXA is a safe, effective hemostatic adjunct for anticoagulated patients undergoing oral surgery. Its use eliminates the need for anticoagulant discontinuation, minimizing both thrombotic and bleeding risks. This case supports TXA as a standard hemostatic strategy in oral surgery, warranting further study.