Tooth extractions are quite common surgical procedures in patients with haemophilia, in particular in older age or in countries with restricted resources. Uptodate, the optimal management of replacement therapy (RT, dosage and duration of treatment) are scant and only low levels of evidence are available. A recent article has reviewed the haematological treatment protocols and assessed their effectiveness in prevention of bleeding complications during and after tooth extractions in people with haemophilia. Overall, only two randomized studies have been conducted on this issue. The overall reported bleeding rate in case of both pre‐ and postoperative RT or single dose RT preoperative is similar, thus suggesting that minimizing the use of clotting factor concentrate is possible if proper local haemostatic measures are provided. Strictly designed prospective studies with higher number of patients are necessary to get firm conclusions about optimal RT required to prevent bleeding complications during and after oral surgery in patients with haemophilia.
Fonte: https://doi.org/10.1111/hae.13928