Dental management of people with congenital hemophilia: An integrative review of case reports and case series from a global scenario.

Abstract

Objective: To analyze the various dental management strategies adopted to manage patients with hemophilia in a dental clinical setup.

Methods: An electronic database search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Web of Science, and EMBASE databases from January 2000 to August 2023 for case reports and case series published in English language. Case reports addressing the dental treatments for people with hemophilia A/hemophilia B were included. Cases of acquired hemophilia and cases of hemophilia who are inhibitor positive were excluded.

Results: There was a total of 286 articles that were identified of which 24 reports were included for the review. This included 20 case reports and four case series which addressed various dental treatment procedures performed on people with mild/moderate/severe hemophilia A or hemophilia B. A total of 28 patients were presented with a mean age of 20.4 years. The pre-treatment factor ranged from 200 to 2500 IU and the post-treatment factor range was 1000-3000 IU.

Conclusions: There was a wide range of variation in the utilization of prophylactic factors for dental treatment procedures among people with hemophilia. This variation highlights the need for larger prospective clinical studies that address the rationale for using clotting factor concentrate and its impact on dental treatment outcomes for individuals with mild, moderate, or severe hemophilia.