Vujkov Sanja, Bajkin Branislav, Blagojević Duška, Nešković Isidora, Komšić Jelena, Tadić Ana, Petrović Bojan
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
J Clin Med. 2024 Dec 18;13(24):7743. doi: 10.3390/jcm13247743.
: This systematic review evaluates the effectiveness of various hematological treatment protocols and local hemostatic measures in preventing oral bleeding and other complications during and after dental treatments in children with inherited bleeding disorders and inhibitors. : This study was registered in the PROSPERO database. The comprehensive search strategy for this systematic review was conducted across five databases, namely, PubMed, Google Scholar, Web of Science, Scopus, and Cochrane Library. The search was aimed at identifying relevant literature published from January 2000 up to February 2024. Eligible studies included those with various designs, such as randomized controlled trials (RCTs), observational studies, cohort studies, case-control studies, and cross-sectional studies. Data extraction was carried out systematically, and relevant information on study characteristics, interventions, treatment protocols, local measures, complications, and outcomes was collected. : The systematic review included a total of five studies, encompassing participants ranging from ages of 2 to 18 years. These studies varied in their scope, with some focusing on hemophilia A with inhibitors while others addressed broader inherited bleeding disorders. The interventions examined included various prophylactic and treatment measures such as Emicizumab, recombinant factor VIIa, and local hemostatic measures. The study outcomes primarily assessed the efficacy of these interventions in preventing postoperative bleeding and improving quality of life. Emicizumab has significantly shifted the treatment paradigm for children with inherited bleeding disorders and inhibitors. This prophylactic treatment has been associated with a marked reduction in the frequency of bleeding episodes, fewer hospital admissions for bleeding management, and enhanced participation in daily activities. : This review highlights gaps in the management of dental care in children with inherited bleeding disorders and inhibitors. It underscores the need for standardized protocols that integrate new prophylactic treatments such as Emicizumab. Our findings suggest that adopting updated protocols can significantly reduce bleeding complications during dental procedures.
本系统评价评估了各种血液学治疗方案和局部止血措施在预防遗传性出血性疾病及抑制剂患儿牙科治疗期间及之后口腔出血和其他并发症方面的有效性。本研究已在国际前瞻性系统评价注册库(PROSPERO)数据库中登记。针对本系统评价开展了全面的检索策略,检索了五个数据库,即PubMed、谷歌学术、科学网、Scopus和考克兰图书馆。检索旨在识别2000年1月至2024年2月发表的相关文献。符合条件的研究包括各种设计的研究,如随机对照试验(RCT)、观察性研究、队列研究、病例对照研究和横断面研究。系统地进行了数据提取,并收集了有关研究特征、干预措施、治疗方案、局部措施、并发症和结果的相关信息。本系统评价共纳入五项研究,参与者年龄在2至18岁之间。这些研究范围各异,一些聚焦于伴有抑制剂的甲型血友病,而其他研究则涉及更广泛的遗传性出血性疾病。所考察的干预措施包括各种预防和治疗措施,如艾美赛珠单抗、重组凝血因子VIIa和局部止血措施。研究结果主要评估了这些干预措施在预防术后出血和改善生活质量方面的疗效。艾美赛珠单抗显著改变了遗传性出血性疾病及抑制剂患儿的治疗模式。这种预防性治疗与出血事件频率显著降低、因出血管理而住院的次数减少以及日常活动参与度提高有关。本综述突出了遗传性出血性疾病及抑制剂患儿牙科护理管理方面的差距。强调了需要整合诸如艾美赛珠单抗等新的预防性治疗方法的标准化方案。我们的研究结果表明,采用更新后的方案可显著减少牙科手术期间的出血并发症。