Dental extraction in congenital hemorrhagic patients.

125 dental extractions were performed in patients with hemophilia A, B, von Willebrand disease and rare coagulopathies. The missing factor was brought to a level of 15-40% according to the degree of surgical trauma. In the majority of cases a single pre-extraction administration of concentrate was sufficient. Antifibrinolytics were administered to the patients (tranexamic acid, 60 mg/kg/day) for 8-10 days. After tooth extraction, a fibrin sponge was positioned using anti-traumatic cross suture. In 90% of cases there was no bleeding, in the others modest easily controllable hemorrhagic episodes. Our results show that it is sufficient in hemophilia A and B to use low doses of antihemophilic concentrate (10-20 U/kg) and frequently a single pre-extraction administration. In rare coagulopathies the hemostatic procedure and dental management have also to be similar to those used in hemophilia A and B.