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The mean total dose of factor VIII or IX was 45.8 U\/kg for 11 procedures with preoperative replacement therapy and 34.5 U\/kg for the 8 without. Four patients received no replacement therapy at all.<\/jats:p><jats:p>Our results compared favorably to published studies employing factor replacement alone or in combination with antifibrinolytic agents such as epsilon\u2010amino\u2010caproic acid (EACA), with respect to blood products utilized and duration of hospitalization. However, our patients received less factor replacement than usually suggested. General anesthesia with intubation, a common recommendation, was not required in any patients.<\/jats:p><jats:p>Dental extractions can be carried out in hemophiliacs using less replacement therapy than currently recommended. In some circumstances, no replacement therapy may be necessary. The reported efficacy of antifibrinolytic agents in reducing the requirement for replacement therapy is difficult to assess because of the relatively large amount of prophylactic factor replacement used in conjunction with these agents.<\/jats:p>","DOI":"10.1002\/ajh.2830160102","type":"journal-article","created":{"date-parts":[[2007,2,21]],"date-time":"2007-02-21T09:38:38Z","timestamp":1172050718000},"page":"1-13","source":"Crossref","is-referenced-by-count":16,"title":["Evidence that less replacement therapy is required for dental extractions in hemophiliacs"],"prefix":"10.1002","volume":"16","author":[{"given":"Stephen E.","family":"Steinberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William R.","family":"Bell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,7,11]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(65)91213-4"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.214.9.1673"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1963.tb05459.x"},{"key":"e_1_2_1_5_2","first-page":"1333","article-title":"Surgery in congenital disorders of blood coagulation","volume":"123","author":"Britten AF","year":"1966","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_1_6_2","first-page":"1193","volume-title":"Hematology","author":"Hougie C","year":"1972"},{"key":"e_1_2_1_7_2","first-page":"1404","volume-title":"Hematology","author":"Hougie C","year":"1977"},{"key":"e_1_2_1_8_2","first-page":"1329","volume-title":"Hematology","author":"Johnson AJ","year":"1972"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(66)90006-4"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(64)91332-7"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(67)90063-X"},{"key":"e_1_2_1_12_2","first-page":"39","volume-title":"Treatment of Hemophilia and other Coagulation Disorders","author":"Ratnoff OD","year":"1966"},{"key":"e_1_2_1_13_2","first-page":"139","volume-title":"The Hemophiliac and His World","author":"Webster WP","year":"1970"},{"key":"e_1_2_1_14_2","first-page":"1188","volume-title":"Clinical Hematology","author":"Wintrobe MM","year":"1974"},{"key":"e_1_2_1_15_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0065-3101(22)00522-9","article-title":"The management of bleeding in hemophilia","volume":"16","author":"Abildgaard CF","year":"1969","journal-title":"Adv Pediatr"},{"key":"e_1_2_1_16_2","first-page":"223","article-title":"Current concepts in the management of hemophilia","volume":"12","author":"Abildgaard CF","year":"1975","journal-title":"Semin Hematol"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5530.1633"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(72)80471-2"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5809.311"},{"key":"e_1_2_1_20_2","first-page":"151","volume-title":"Hemophilia in Children","author":"Hilgartner MW","year":"1976"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1973.0608"},{"key":"e_1_2_1_22_2","first-page":"158","article-title":"Management of the hereditary coagulation disorders","volume":"8","author":"Mason DY","year":"1971","journal-title":"Semin Hematol"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-196408000-00007"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.47.253.451"},{"key":"e_1_2_1_25_2","first-page":"238","volume-title":"Dental extraction in haemophilia","author":"Safinia F","year":"1973"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5809.314"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1971.03180240074027"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1975.tb53359.x"},{"key":"e_1_2_1_29_2","unstructured":"WebsterWP McMillanCW LucasON RobertsHR:Dental management of the bleeder patient. 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