Surgical Rehabilitation of Maxillary and Mandibular Bone Using L-PRF in Cardiac Patients Under Antithrombotic Therapy

Frederico Buhatem Medeiros; Raquel D’Aquino Garcia Caminha; Tiago Carvalho Santos; Gustavo Hashida; Gabriel Peres & Paulo Sergio da Silva Santos

The risk of perioperative and postoperative hemorrhage makes oral surgery involving bone tissue in patients receiving antithrombotic therapy difficult, and for the best clinical management, physicians and dentists must always beuptospeed.Inordertopreventbleeding,lessinvasivetechniqueswerelongconsideredprohibited.Thisraisedconcerns about the increased risk of thromboembolic events and the possibility of stopping antithrombotic medication. Leukocyte- and platelet-rich fibrin (L-PRF) is a new local hemostatic measure that shows promise for reducing bleeding and speeding up healing following exodontia in individuals receiving antithrombotic medication. In order to improve repair, bone regeneration, and control of the local hemostatic process, this case series, which includes an integrative literature review, attempts to demonstrate evidence for the use of fibrin derivatives as a surgical option in the management of patients with heart disease receiving anticoagulant and/or antiplatelet therapy. Oral surgery AND platelet-rich fibrin AND oral anticoagulant were the descriptors used to identify papers for an integrative review that was conducted by scanning the PUBMED/MEDLINE®, SCOPUS®, and BVS databases. In this series of cases we present: Case 1: A person who had a balloon catheter valvuloplasty, a heart murmur, and an unidentified cardiac arrhythmia who also took acetylsalicylic acid every day. Case 2: a patient with a history of rheumatic fever, diabetes, hypertension, a mechanical heart valve prosthesis, several teeth extractions, and a sinus lift who is also on oral anticoagulants. In both cases, L-PRF was used to complete the surgery. Dental surgical operations using platelet aggregate concentrates can be performed safely, with no need to suspend or adjust therapy due to the risk of increased post-operative bleeding. L-PRF has been shown to aid healing and regeneration of soft tissues and bone in the maxillary and mandible areas. KEY WORDS: platelet-rich fibrin, anticoagulants, platelet aggregation inhibitors, oral surgery, hemostatic techniques.

MEDEIROS, F. B.; CAMINHA, R. D. G.; SANTOS, T. C.; HASHIDA, G.; PERES, G. & SANTOS, P. S. S. Surgical rehabilitation of maxillary and mandibular bone using L-PRF in cardiac patients under antithrombotic therapy. Int. J. Odontostomat., 19(3):304-314, 2025.