Abstract: Objective: To evaluate the differences of bleeding and thromboembolic complications after tooth extraction in long-term anticoagulant patients with maintenance of anticoagulation or low molecular weight heparin bridging. Methods: A total of 215 anticoagulant patients were included in the study, and 98 patients were included in the maintaining anticoagulant group, with the average preoperative international normalized ratio (INR) of 2.56±0.45. There were 117 patients in the low-molecular weight heparin bridging group, with an INR average of 1.52±0.21 on the day of operation. Each patient had no more than three teeth extracted. Local hemostatic agents (Avitene ©) and suturing of the wound were used in both groups. Results: There were 7 patients (7.14%) in the maintaining anticoagulation group and 5 patients (4.27%) in the low-molecular weight heparin bridging group who had mild to moderate postoperative bleeding (P=0.361). Patients with mild bleeding were controlled by local compression and local hemostatic agents. For patients with uncontrolled bleeding, vitamin K could be injected or fresh frozen plasma could be infused. None of the participants in either group experienced thromboembolic complications within a month after operation. Conclusion: For patients received anticoagulant therapy with simple tooth extraction, there is no obvious difference in the incidence of postoperative bleeding and postoperative thromboembolic events on maintaining anticoagulation and low molecular heparin bridge. In view of the consequences of thromboembolic complications, such patients can safely keep anticoagulant therapy and no need for low molecular heparin bridging therapy during tooth extraction.

Key words: anticoagulation therapy, tooth extraction, bridging therapy