E. González, G. Sottilotta
Abstract
These rare disorder scan significantly increase the risk of perioperative and postoperative bleeding, especially indental surgery. Although often underdiagnosed, they must be considered in patients with abnormal coagulation tests or unexplained bleeding history.
Types: afibrinogenemia (complete absence), hypofibrinogenemia (reduced levels), and dysfibrinogenemia (functional defect). Manifestations: mucosal bleeding, poor clot formation, surgical hemorrhage. Key labs: plasma fibrinogen <150mg/dL; severe deficiency may prolong PT and aPTT. Dental management: all surgical procedures contraindicated unless factor replacement is pre-arranged. In some cases of mild hypofibrinogenemia, if the dental procedures are at low risk of bleeding, tranexamic acid alone may be used. Urgent referral to hematologist is mandatory.
