HEMOSTASIA AFTER DENTAL EXTRACTIONS IN LEUKEMIC AND ANTICOAGULATED PATIENT

Onco-hematological diseases have complex management, including dentistry. Patients taking anticoagulants need to be correctly evaluated. A 36-year-old female patient, with chronic myeloid leukemia, using 5 mg daily warfarin for risk of venous thrombosis, looked for an outpatient dentistry clinic, reporting pain in the region of the teeth 27 and 28. At first, expectant treatment was performed. The pain increased and the patient opted for exodontia instead of endodontic treatment. After discussion with the medical team, warfarin was replaced by heparin as anticoagulant. The surgical procedure was performed without any complications. Occlusive sutures were performed but, on the fifth postoperative day, the blood clot ruptured and detached from the mucosa, causing hemorrhage. The bleeding was contained with local hemostatic methods. On the following 2 days, there was new clot formation. The extra alveolar clot was removed under local anesthesia. A new suture was performed and healing occurred without further complications.