Graduate Program in Dentistry, Federal University of Pelotas (UFPEL), Pelotas, RS, Brazil.
Graduate Program in Dentistry, Meridional University (IMED), Passo Fundo, RS, Brazil.
Aust Dent J. 2021 Jun;66(2):150-158. doi: 10.1111/adj.12813. Epub 2021 Jan 27.
This scoping review aimed to map available evidence regarding minor/major oral procedures in patients with inherited bleeding disorders (IBDs).
Studies in medicine or dentistry that reported minor and major oral procedures in individuals presenting IBDs (e.g. haemophilia A or B, von Willebrand disease) were selected. Search and screening were performed in PubMed/Medline, Scopus, Web of Science and Cochrane Library by two independent researchers.
Initial search yielded 4152 citations, of which 257 were included in the final analysis. Most of the evidence for prophylaxis use was derived from observational studies and the most-commonly reported prophylactic protocols were fresh frozen plasma and factor VIII concentrate. A considerable number of studies reported postoperative complications and hospitalizations.
The present study identified that (1) there is room for new studies to assess the use of antifibrinolytic agents with no factor replacement; (2) to date, the use of factor replacement therapy is the most indicated approach when treating patients with IBDs with adjunct systemic or local antifibrinolytic agents to reduce post-operative complications; and (3) there is a critical need for high-quality evidence studies since much of the conclusions of the included studies are not supported by statistical analysis.
本范围综述旨在绘制有关遗传性出血性疾病（IBD）患者进行口腔小/大手术的现有证据图谱。
选择了报告 IBD 患者（如血友病 A 或 B、血管性血友病）进行口腔小/大手术的医学或牙科研究。由两名独立研究人员在 PubMed/Medline、Scopus、Web of Science 和 Cochrane Library 中进行搜索和筛选。
初步搜索产生了 4152 条引文，其中 257 条被纳入最终分析。预防使用的证据主要来自观察性研究，最常报告的预防方案是新鲜冷冻血浆和因子 VIII 浓缩物。相当多的研究报告了术后并发症和住院治疗。
本研究确定了：（1）有新的研究空间来评估无因子替代的抗纤维蛋白溶解剂的使用；（2）迄今为止，在治疗伴有附加全身性或局部抗纤维蛋白溶解剂的 IBD 患者时，使用因子替代疗法是最有指征的方法，以减少术后并发症；（3）高质量证据研究的需求非常迫切，因为纳入研究的大部分结论都没有得到统计分析的支持。
