Abstract
Objective. This study evaluated the effectiveness of a protocol to prevent bleeding after dental
extraction in patients with hemophilia, von Willebrand's disease (VWD), or platelet
disorders. Study Design. Replacement therapy was used in cases involving general anesthesia, and nerve trunk
infiltration was used in patients with severe bleeding disorders (severe-to-moderate
hemophilia or type 2-3 VWD). Desmopressin was used in good responders with mild hemophilia
A, type 1 VWD, and platelet disorders. Local hemostatic measures and antifibrinolytic
treatment were used systematically. Results. Ninety-three patients underwent 103 dental extractions; 2 of these patients had secondary
bleeding requiring surgical hemostasis. Conclusion. The indication for replacement therapy depended on the type of anesthesia that was
used. Coagulation factor concentrates or desmopressin were necessary to avoid upper
airway hematoma with general anesthesia or nerve trunk infiltration. With local anesthesia,
substitutive treatment was indicated in patients with severe-to-moderate hemophilia
and type 2-3 VWD. Inexpensive desmopressin was effective in those who responded well.
Local hemostatic measures and antifibrinolytic treatment were performed systematically.
(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:247-50)
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References
- Dental extractions in hemophilia: reflections on 10 years' experience.Oral Surg Oral Med Oral Pathol. 1985; 59: 6-9
- Management of von Willebrand's disease with desmopressin.J Oral Maxillofac Surg. 1988; 46: 313-314
- 1-deamino-8-D-arginine vasopressin: a new pharmacological approach to the management of haemophilia and von Willebrand's disease.Lancet. 1977; 1: 869-872
- Evaluation of desmopressin for dental extractions in patients with hemostatic disorders.Oral Surg Oral Med Oral Pathol. 1994; 77: 6-12
- Shortening of bleeding time by 1-deamino-8-D-arginine vasopressin in various bleeding disorders.Lancet. 1984; 1: 1145-1148
- Dental extraction for patients on oral anticoagulant therapy.Oral Surg Oral Med Oral Pathol. 1990; 70: 274-277
- Dental extractions in patients with bleeding disorders. The use of fibrin glue.Oral Surg Oral Med Oral Pathol. 1993; 75: 280-282
- Proposal of a standard approach to dental extraction in haemophilia patients. A case-control study with good results.Haemophilia. 2000; 6: 533-536
- Haemophilia and advanced fibrin sealant technologies.Haemophilia. 1998; 4: 449-455
- Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy.Oral Surg Oral Med Oral Pathol. 1993; 75: 29-31
- Characterization of plasminogen activators in unstimulated and stimulated human whole saliva.J Dental Res. 1987; 66: 1199-1203
- Effect of local antifibrinolytic treatment with tranexamic acid in hemophiliacs undergoing oral surgery.J Oral Maxillofac Surg. 1986; 44: 703-707
- Evaluation of the effectiveness of DDAVP in surgery and in bleeding episodes in hemophilia and von Willebrand disease. A study on 43 patients.Clin Lab Haematol. 1984; 6: 229-238
Article info
Publication history
Accepted:
October 29,
2001
Received in revised form:
August 2,
2001
Received:
May 31,
2001
Footnotes
*Reprint requests:Benoit Piot, MD, PhD, Clinique de Stomatologie et Chirurgie Maxillo-faciale, Centre Hospitalier Régional et Universitaire de Nantes, 44093 Nantes cedex 1, France [email protected]
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
