{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T12:15:48Z","timestamp":1776341748799,"version":"3.51.2"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>The use of emicizumab prophylaxis among persons with haemophilia A (PwHA), both with and without inhibitors, has been increasing significantly in recent years. Nevertheless, clear recommendations remain lacking regarding the necessity and extent of perioperative adjunctive systemic haemostatic therapy for surgical procedures. Given the high frequency of dental interventions, minor oral surgical procedures, are of particular clinical relevance for these persons.<\/jats:p>\n                    <jats:p>This paper provides a review of the literature along with a retrospective analysis of a case series involving 10 PwHA who underwent invasive dental procedures across three centres. In cases involving permanent tooth extraction a single preoperative dose of rFVIII (for PwHA without inhibitors) or rFVIIa (for those with inhibitors) were used. The analysis indicated that extraction of primary teeth in children receiving emicizumab prophylaxis can be successfully performed without the concomitant use of systemic haemostatic agents. Only one postoperative bleeding event was observed, following a periodontal procedure, suggesting that type of procedure may pose a greater challenge in achieving adequate hemostasis due to larger bleeding area and limited possibility for the use of local haemostatic measures.<\/jats:p>\n                    <jats:p>A review of the literature showed that for minor oral surgical procedures, such as tooth extraction, either preoperative administration of haemostatic factor infusions or performing the procedure without factor use may be recommended. However, evidence\u2010based data and recommendations regarding the safest management strategies remain insufficient. A multidisciplinary and individualized approach, incorporating assessment of the procedural bleeding risk, the patient's bleeding history, and strict use of local haemostatic measures remains essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70237","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:36:22Z","timestamp":1776339382000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dental Management of Persons With Haemophilia Receiving Emicizumab Prophylaxis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2189-6769","authenticated-orcid":false,"given":"Branislav V.","family":"Bajkin","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Novi Sad, Dentistry Clinic of Vojvodina  Novi Sad Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7891-5465","authenticated-orcid":false,"given":"Miryam E.","family":"Parreira","sequence":"additional","affiliation":[{"name":"Foundation of Hemophilia of Buenos Aires Faculty of Dentistry \u2010 University of Buenos Aires  Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zikra A.","family":"Alkhayal","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"issue":"9","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1056\/NEJMoa1703068","article-title":"Emicizumab Prophylaxis in Hemophilia A With Inhibitors","volume":"377","author":"Oldenburg J.","year":"2017","journal-title":"New England Journal of Medicine"},{"issue":"23","key":"e_1_2_9_3_1","first-page":"1972","article-title":"Emicizumab, a Bispecific Antibody Recognizing Coagulation Factors IXa and X: How Does It Compare to Factor VIII?","volume":"134","author":"Pipe S. W.","year":"2019","journal-title":"Blood"},{"issue":"2","key":"e_1_2_9_4_1","first-page":"313","article-title":"Emicizumab: A Novel Hemostatic Therapy for Hemophilia A","volume":"19","author":"Mancuso M. E.","year":"2021","journal-title":"Journal of Thrombosis and Haemostasis"},{"issue":"9","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1056\/NEJMoa1803550","article-title":"Emicizumab Prophylaxis in Patients Who Have Hemophilia A Without Inhibitors","volume":"379","author":"Mahlangu J.","year":"2018","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"e_1_2_9_6_1","first-page":"1","article-title":"Long\u2010Term Safety and Efficacy of Emicizumab in Persons With Hemophilia A and Inhibitors","volume":"13","author":"Shapiro A. D.","year":"2020","journal-title":"Expert Review of Hematology"},{"issue":"1","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.rpth.2025.102693","article-title":"Major Surgery in Persons With Hemophilia A Without Inhibitors Receiving Emicizumab Prophylaxis","volume":"9","author":"Castaman G.","year":"2025","journal-title":"Research and Practice in Thrombosis and Haemostasis"},{"issue":"1","key":"e_1_2_9_8_1","first-page":"533","article-title":"Toward Optimal Therapy for Inhibitors in Hemophilia","volume":"2021","author":"Kempton C. L.","year":"2021","journal-title":"Hematology, the American Society of Hematology Education Program"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hae.14046","article-title":"WFH Guidelines for the Management of Hemophilia","volume":"26","author":"Srivastava A.","year":"2020","journal-title":"Haemophilia"},{"issue":"12","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1080\/17474086.2024.2429606","article-title":"Global Prophylaxis Trends in Hemophilia: A Macroeconomic Analysis and Its Association With World Development Indicators","volume":"17","author":"John M. J.","year":"2024","journal-title":"Expert Rev Hematol"},{"issue":"2","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00431-023-05270-z","article-title":"Oral Health Status of Children and Adolescents With Hemophilia","volume":"183","author":"Li Y.","year":"2024","journal-title":"European Journal of Pediatrics"},{"issue":"5","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1111\/hae.70104","article-title":"Dental Management for People with Congenital Haemophilia: A Systematic Review of the Existing Dental Recommendations","volume":"31","author":"Kumar M.","year":"2025","journal-title":"Haemophilia"},{"issue":"4","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"e338","DOI":"10.1111\/hae.12434","article-title":"Oral Health in Children With Hemophilia\u2014an Educational Intervention Study","volume":"20","author":"Gaddam K. R.","year":"2014","journal-title":"Haemophilia"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"6","article-title":"Evolving Treatment Landscape of Hemophilia A","volume":"27","author":"Jim\u00e9nez\u2010Yuste V.","year":"2021","journal-title":"Haemophilia"},{"issue":"1","key":"e_1_2_9_15_1","first-page":"1","article-title":"Practical Aspects of Managing Dental Procedures in Patients With Hemophilia A Receiving Emicizumab Prophylaxis","volume":"19","author":"Zanon E.","year":"2021","journal-title":"Blood Transfusion"},{"issue":"24","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"6140","DOI":"10.1182\/bloodadvances.2022007458","article-title":"Surgical Outcomes in People With Hemophilia A Taking Emicizumab Prophylaxis: Experience From the HAVEN 1\u20134 Studies","volume":"6","author":"Kruse\u2010Jarres R.","year":"2022","journal-title":"Blood Advances"},{"issue":"3","key":"e_1_2_9_17_1","first-page":"266","article-title":"Emicizumab: The First\u2010in\u2010Class Bispecific Antibody for Hemophilia A","volume":"39","author":"Mahlangu J. N.","year":"2019","journal-title":"Hamostaseologie"},{"issue":"1","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/hae.14667","article-title":"Peri\u2010operative Hemostatic Management of Tooth Extraction in Patients With Hemophilia A, With and Without Inhibitors, Receiving Emicizumab Prophylaxis","volume":"29","author":"Yagyuu T.","year":"2023","journal-title":"Haemophilia"},{"issue":"1","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4103\/0976-237X.128663","article-title":"Efficacy of Tranexamic Acid Mouthwash in Gingival Bleeding During Dental Scaling in Hemophilia","volume":"5","author":"Nuvvula S.","year":"2014","journal-title":"Contemporary Clinical Dentistry"},{"issue":"1","key":"e_1_2_9_20_1","first-page":"1","article-title":"Emicizumab for the Treatment of Hemophilia A: A Narrative Review","volume":"19","author":"Franchini M.","year":"2021","journal-title":"Blood Transfusion"},{"issue":"23","key":"e_1_2_9_21_1","first-page":"2272","article-title":"Thrombotic Microangiopathy Associated With aPCC and Emicizumab","volume":"134","author":"Callaghan M. U.","year":"2019","journal-title":"Blood"},{"issue":"1","key":"e_1_2_9_22_1","first-page":"1","article-title":"Clinical Management of Hemophilia A and B: A Review","volume":"19","author":"Coppola A.","year":"2021","journal-title":"Blood Transfusion"},{"key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/1076029617715117","article-title":"Major and minor Classifications for Surgery in People With Hemophilia: A Literature Review","volume":"24","author":"Solimeno L. P.","year":"2018","journal-title":"Clinical and Applied Thrombosis\/Hemostasis"},{"issue":"2","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/hae.13928","article-title":"Current state of Play Regarding Dental Extractions in Patients With Haemophilia: Consensus or Evidence\u2010based Practice? A Review of the Literature","volume":"26","author":"Bajkin B.","year":"2020","journal-title":"Haemophilia"},{"key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/hae.15005","article-title":"Dental Management of People With Complex or Rare Inherited Bleeding Disorders","volume":"30","author":"Nanayakkara L.","year":"2024","journal-title":"Haemophilia"},{"issue":"1","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.1055\/s-0043-1777766","article-title":"Surgical Experience From the STASEY Study of Emicizumab Prophylaxis in People With Hemophilia A With Factor VIII Inhibitors","volume":"8","author":"Castaman G.","year":"2024","journal-title":"TH Open"},{"key":"e_1_2_9_27_1","doi-asserted-by":"crossref","DOI":"10.1155\/crid\/8128415","article-title":"A Unique Comparison of Tooth Extraction before and after Emicizumab Prophylaxis in a Patient with Haemophilia A and Inhibitors","volume":"2025","author":"Zaizen M.","year":"2025","journal-title":"Case Reports in Dentistry"},{"key":"e_1_2_9_28_1","first-page":"592","article-title":"Dental Extractions on a Patient With Severe Haemophilia A and Inhibitors Taking Emicizumab Prophylaxis","volume":"15","author":"Hamid A. A. N.","year":"2022","journal-title":"Case Reports and Reviews in Oral Surgery"},{"issue":"4","key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/hae.14005","article-title":"Real\u2010world Use of Emicizumab in Patients With Haemophilia A: Bleeding Outcomes and Surgical Procedures","volume":"26","author":"McCary I.","year":"2020","journal-title":"Haemophilia"},{"issue":"5","key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"e620","DOI":"10.1111\/hae.14358","article-title":"Management and Outcomes of Paediatric Patients on Emicizumab Prophylaxis Undergoing Surgical Procedures: Experience From a Large Haemophilia Centre in the UK","volume":"27","author":"Hassan E.","year":"2021","journal-title":"Haemophilia"},{"issue":"2","key":"e_1_2_9_31_1","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1097\/MPH.0000000000002997","article-title":"A 5\u2010Year Single\u2010Center Experience on the Use of Emicizumab Prophylaxis in Children With Severe Hemophilia A With and Without Factor VIII Inhibitors","volume":"47","author":"Ahmed Hasan E. M.","year":"2025","journal-title":"Journal of Pediatric Hematology\/Oncology"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2023.1155853","article-title":"Management of Children With Hemophilia A on emicizumab Who Need Surgery","volume":"11","author":"Belletrutti M.","year":"2023","journal-title":"Frontiers in Pediatrics"},{"issue":"24","key":"e_1_2_9_33_1","doi-asserted-by":"crossref","first-page":"7743","DOI":"10.3390\/jcm13247743","article-title":"Dental Considerations in Children With Inherited Bleeding Disorders and Inhibitors: a Systematic Review","volume":"13","author":"Vujkov S.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"4","key":"e_1_2_9_34_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/hae.14322","article-title":"Concomitant Use of Bypassing Agents With emicizumab for People With Haemophilia A and Inhibitors Undergoing Surgery","volume":"27","author":"Jim\u00e9nez\u2010Yuste V.","year":"2021","journal-title":"Haemophilia"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70237","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hae.70237","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:36:26Z","timestamp":1776339386000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.70237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":33,"alternative-id":["10.1111\/hae.70237"],"URL":"https:\/\/doi.org\/10.1111\/hae.70237","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"assertion":[{"value":"2025-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hae.70237"}}