Surgical management of the patient with hemophilia undergoing oral surgery: A case report

Abstract

Introduction: Hemophilia is a congenital deficiency of a coagulation factor, associated to a recessive pattern
located in the X chromosome, which induces a lower or even absent functional activity of that factor. Objective:
To provide a narrative review of the literature about haemophiliac patients, as well as a case report of a patient.
Methods: Female patient, 18 years old, attended in the postgraduate of Maxillofacial Surgery of the Andrés Bello
University to Santiago, Chile, derived to perform extractions of wisdom teeth due to the end of its orthodontic
mechanics. At the anamnesis, the patient reports to suffer from mild hemophilia A, and 6 months ago she
had 38% VIII factor. Prior to surgical treatment, a complete blood count with a coagulation test was requested to measure TTPA. In addition, an interconsultation was made with the treating hematologist to perform a hicorrect
management to assess of her pathology and recommendations to carry out it with the least amount of
intrasurgical and post-surgical risks. Suggested the administration of factor of freeze-dried VIII factor before
and after surgery. Local hemostasis measures were also applied for better control and proper post-surgical pain
management. Conclusion Hemophilia, requires the dentist to perform a thorough management pre, intra and
postoperatory, in which complementary tests, communication with the hematologist, atraumatic procedure and a
precise management of hemostasis, are key for the treatment’s success.