Dental extractions in patients with bleeding disorders. The use of fibrin glue.
Eighty patients with various bleeding disorders underwent 135 extractions without preventive replacement hematologic therapy. The local hemostatic control involved the use of fibrin glue Beriplast. Secondary bleeding occurred in 9 of 12 patients with severe hemophilia when the concentration of the aprotinin in the fibrin glue was 1,000 KIU/ml. When it was increased to 10,000 KIU/ml and swish and swallow rinses of tranexamic acid before and after the dental extractions were added, only 3 of 25 hemophilia patients suffered from secondary bleeding. Local use of fibrin glue is a safe and cost-effective tool to treat patients with severe bleeding disorders. None of the 43 patients with coagulopathies other than severe hemophilia suffered bleeding after extractions.
Rakocz
M
M
Division of Pediatric and Hospital Dentistry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Mazar
A
A
Varon
D
D
Spierer
S
S
Blinder
D
D
Martinowitz
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003730:Dental Care for Persons with Disabilities; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D014081:Tooth Extraction
D015718:Fibrin Tissue Adhesive