The combined local/systemic use of antifibrinolytics in hemophiliacs undergoing dental extractions

Abstract

A total of 185 permanent teeth were extracted in 43 hemophiliacs. The patient material is divided into 3 groups with respect to antifibrinolytic therapy. Patients in group 1 were given antifibrinolytics systemically. In group 2, antifibrinolytics were applied locally, and in group 3 they were used both locally and systemically. The results of the treatment were evaluated using the number of units per kilogram of F VIII administered per patient and the Coagulum Index (CoI). It is shown that local use of antifibrinolytics can reduce the amount of F VIII required for the control of bleeding, but regarding the high values of the CoI, the therapeutic effects are unsatisfactory. Approximately 20 U/kg of F VIII per patient, given in single infusion prior to intervention, were required in group 1 as well as in group 3. However, with respect to the CoI, a statistically significant difference is found between groups 3 and 1. On this basis, it is concluded that antifibrinolytics, used both locally and systemically, appear to show distinct advantages in the treatment of hemophiliacs undergoing dental extractions and also receiving F VIII therapy.