Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study.

OBJECTIVES: The present work is a controlled, blinded, and randomized clinical trial comparing hemostatic measures for the control of post-tooth extraction hemorrhage in patients on anticoagulation therapy with warfarin. MATERIALS AND METHODS: The sample consisted of 37 patients (37.8% male and 62.2% female) with a mean age of 45.5 years. After randomization, 20 patients were allocated to the control group (conventional hemostasis measures) and 17 to the study group (addition of local tranexamic acid). All variables that could influence the outcome were similar between the groups and no significant difference was seen (p > 0.05). RESULTS: In the assessment of immediate hemostasis, for the control group, the time to achieve cessation of bleeding was 9.1 (± 3.6) minutes. For the study group this was much lower, and this difference (6.018 / confidence interval of 95%, 4.677 to 7.359) was statistically significant (p < 0.001). In evaluating the control of intermediate hemorrhage, the use of tranexamic acid was more significantly associated with the absence of bleeding, especially in the first 24 h. CONCLUSIONS AND CLINICAL RELEVANCE: Thus, this measure of local hemostasis in topical form with gauze compression and irrigation was shown to be more effective in reducing the time to attain immediate hemostasis, and in preventing intermediate hemorrhage.

Efficacy of a pit and fissure sealant in arresting dentin non-cavitated caries: a 1-year follow-up, randomized, single-blind, controlled clinical trial.

PURPOSE: To evaluate the efficacy of conservative treatment of dentin non-cavitated caries using a resin-based fluoride-containing pit and fissure sealant. METHODS: In this controlled clinical trial, 60 teeth with clinically non-cavitated occlusal caries radiographically located beneath the enamel-dentin junction (radiolucent area) were selected among patients presenting a moderate to high caries risk. The teeth were randomly divided into two groups of 30 teeth each: an experimental group receiving an application of Fluorshield (Dentsply) sealant and a control group not submitted to any clinical intervention. Caries progression was monitored by clinical and radiographic examination at 4-month intervals over a period of 1 year. In addition, marginal integrity of the sealant was evaluated in the experimental group. RESULTS: Clinical and radiographic caries progression was significantly more frequent in control teeth when compared to the experimental group (P < 0.05).