J Korean Dent Soc Anesthesiol.  2012 Jun;12(2):99-104. 10.17245/jkdsa.2012.12.2.99.

Oral Surgery Using Low-molecular-weight Heparin in the Anticoagulated Patients

• Hwang SY
• Yun HJ
• Pang NS
• Jung BY
• Kim KD
• Kim HJ
• Park W

• KMID: 2345048
• DOI: http://doi.org/10.17245/jkdsa.2012.12.2.99

Abstract

Anticoagulation therapy with warfarin sodium is used to reduce the risk of thromboembolic events in patients with valvular heart disease, prosthetic heart valve, recurrent myocardiac infarction, etc. To keep anticoagulation state and minimize bleeding risk, patients with high risk of thromboembolism have been usually hospitalized for heparinization before oral surgery like extraction. However, this protocol requires time and high expense because of the long period of hospitalization and this is why low-molecular-weight heparin (LMWH) therapy is receiving attention in medical field as well as dentistry. LMWH has several advantages over unfractionated heparin (UFH) including predictable anticoagulant response which makes coagulation monitoring unnecessary in most patients and longer half-life than heparin which enables the patients to give themselves a subcutaneous injection once or twice daily. These advantages of LMWH make patients get oral surgery on an outpatient basis so that they can save time and cost. This case report introduces the use of LMWH in dental surgery and suggests proper use of LMWH. Though LMWH bridging therapy is widely used most of the previous studies are observational studies. Therefore randomized controlled trials are necessary to evaluate the safety and efficacy of LMWH bridging therapy.

Keyword

Low-molecular-weight heparin; Anticoagulation therapy; Oral surgery; Anticoagulant bridging therapy

MeSH Terms

Dentistry
Half-Life
Heart Valve Diseases
Heart Valves
Hemorrhage
Heparin
Heparin, Low-Molecular-Weight*
Hospitalization
Humans
Infarction
Injections, Subcutaneous
Outpatients
Surgery, Oral*
Thromboembolism
Warfarin
Heparin
Heparin, Low-Molecular-Weight
Warfarin