Management of surgical third lower molar extraction and post-operative progress in patients with factor VII deficiency: a clinical protocol and a focus on this rare pathology

Publication date: Available online 14 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Pier Carmine Passarelli, Guido Pasquantonio, Antonio D'Addona
PurposeThe purpose of this study was to analyze the management of surgical third molar extraction and postoperative progress in patients with a diagnosis of factor VII deficiency. Close collaboration between the oral-maxillofacial surgeon and hematologist allows the team to categorize the risk and to operate safely, thereby minimizing intraoperative and postoperative complications.Materials and methodsThis retrospective study includes 7 patients with factor VII deficiency who underwent third lower molar surgery. Their factor VII deficiency was in the range of 10.5–21.0%.Recombinant activated factor VII (rFVIIa) (NovoSeven) was transfused intravenously in a single dose of 25 μg/kg body weight, 30 min before surgical extractions. After the surgery, betamethasone, an analgesic, and an ice pack were administered.ResultsPretreatment with recombinant activated factor VII resulted in excellent hemostasis. No hemorrhagic complications and no postoperative major bleeding were observed.ConclusionThe extraction of the third lower molar appears to be a safe procedure in patients with factor VII deficiency when appropriate prophylaxis with rFVIIa is used.



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