Oral surgery with fibrin sealants in patients with bleeding disorders: a case report.

Surgical treatment of patients with bleeding disorders requires careful planning. The use of fibrin sealants following a dental extraction in a patient with von Willebrand's disease is presented in this report. A female patient with von Willebrand's disease had an extraction of a maxillary right third molar. After evaluation by the surgeon and the hematologist, the surgery was performed with a topical application of fibrin sealant and systemic administration of antifibrinolytic drugs. Hemostasis was obtained without replacement of plasma clotting factor. New techniques of achieving hemostasis in patients with bleeding disorders using fibrin sealants have been successfully used in oral surgery without replacement of plasma clotting factors or changes in anticoagulant therapy.