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Karasneh J, Christoforou J, Walker JS, Dios PD, Lockhart PB, Patton LL. World Workshop on Oral Medicine VII: Bleeding control interventions for invasive dental procedures in patients with inherited functional platelet disorders: A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:412-431. [PMID: 34758941 DOI: 10.1016/j.oooo.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The objective of this study was to determine bleeding control interventions (BCIs) that were reported to be effective in controlling postoperative bleeding in patients with inherited functional platelet disorders (IFPDs) undergoing invasive dental procedures. STUDY DESIGN We searched MEDLINE/PubMed, Embase, Cochrane Library (Wiley), and Scopus from 1960 through April 2020 for studies on patients with IFPD undergoing invasive dental procedures. Two reviewers conducted assessments independently. RESULTS We found a total of 620 nonduplicate published articles, of which 32 studies met our inclusion criteria. Management with BCI in patients with IFPD included in this systematic review was effective in 80.7% of treatment sessions. Local measures used intraoperatively were found to be effective. Three different protocols of BCI were noted; the most effective protocol consisted of antifibrinolytics, scaffold/matrix agents, and sutures (P < .01). An adjunct protocol consisting of a tissue sealant was also effective (P < .01). A third protocol of platelet transfusion and antifibrinolytics was ineffective in controlling postoperative bleeding in 4 of 6 dental sessions. CONCLUSIONS This systematic review supports the use of local measures intraoperatively and antifibrinolytics postoperatively. It also supports making decision regarding platelet transfusion based on the clinician's clinical judgment and medical history of the individual patient.
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Affiliation(s)
- Jumana Karasneh
- Department of Oral Medicine and Oral Surgery; School of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
| | - Janina Christoforou
- Faculty of Health and Medical Sciences, Dental School, University of Western Australia, Perth, Australia
| | - Jennifer S Walker
- Health Sciences Library, University of North Carolina at Chapel Hill, NC, USA
| | - Pedro Diz Dios
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Peter B Lockhart
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Lauren L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
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Bellot A, Curien R, Derache A, Delaître B, Longo R, Zevering Y, Guillet J, Phulpin B. Oral management in a patient with Gardner-Diamond Syndrome: A case report. Int J Surg Case Rep 2020; 75:367-371. [PMID: 32980710 PMCID: PMC7522574 DOI: 10.1016/j.ijscr.2020.09.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022] Open
Abstract
Gardner-Diamond Syndrome is a rare but potentially life-threatening disease. Oral surgery in Gardner-Diamond Syndrome can induce intraoral-facial skin lesions. Concomitant systemic manifestations may also arise. Oral surgery guidelines for Gardner-Diamond syndrome are needed.
Introduction Gardner-Diamond Syndrome (GDS) is rare. It is characterized by the spontaneous formation of painful erythematous skin lesions that develop into ecchymoses within 24 h and then disappear progressively over days to weeks. The complications can be serious. Presentation of case A 35-year-old man with GDS was admitted to the oral surgery department for dental infectious focus eradication. Clinical and radiological examinations indicated extraction of tooth 17. It was performed with local anaesthesia, cardiac monitoring, and verbal reassurance therapy. After delivering anaesthesia, two intra-oral hematomas and a bruise quickly developed. Cardiovascular manifestations and a spontaneous painful right temporal erythematous skin lesion appeared in the next 24 h. The patient was briefly hospitalized in the cardiovascular medicine department. Over the next 21 days, some haematomas regressed, another expanded, and a new cervico-thoracic ecchymosis developed. Discussion The surgical and post-surgical complications in this clinical case raise several points concerning the oral management of patients with GDS. We propose to apply: verbal reassurance therapy during surgery; presurgical haematological evaluation and postsurgical daily haematological follow-up; and atraumatic surgery with intra- and post-surgical haemostatic precautions. Systematic antibiotic prophylaxis and non-steroidal anti-inflammatory drugs may also be useful. Other possibilities include desmopressin acetate, corticosteroids, antihistamines, plasmapheresis, and immunosuppressive agents; however, few cases have been treated with these strategies. Conclusion This case highlights the difficult management of patients with GDS who require oral surgery. Further studies are needed to improve the oral surgical procedures in these patients and to establish a systematic management algorithm.
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Affiliation(s)
- Ambre Bellot
- Department of Oral Surgery, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France; Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France.
| | - Rémi Curien
- Department of Oral Surgery, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Anaïs Derache
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France
| | - Bruno Delaître
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
| | - Raffaele Longo
- Department of Oncology, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France; Clinical Research Support Unit, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Yinka Zevering
- Clinical Research Support Unit, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Julie Guillet
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
| | - Bérengère Phulpin
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
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Fiorillo L, De Stefano R, Cervino G, Crimi S, Bianchi A, Campagna P, Herford AS, Laino L, Cicciù M. Oral and Psychological Alterations in Haemophiliac Patients. Biomedicines 2019; 7:biomedicines7020033. [PMID: 31010003 PMCID: PMC6631232 DOI: 10.3390/biomedicines7020033] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 02/04/2023] Open
Abstract
Haemophiliacs are hereditary coagulopathies whose basic anomaly consists of the quantitative or qualitative alteration of one or more plasma proteins in the coagulation system. The objective of this review is to analyse all risk factors, predispositions and alterations to the oral-maxillofacial district in patients with haemophilia. The broader assessment also includes the psychological aspects that could affect the treatment and maintenance of oral conditions. The study takes into consideration all the works in the literature in the last 10 years. Works that present oral, dental and psychological changes in haemophilia patients have been combined. A total of 16 studies were analysed carefully evaluating and explaining all the alterations and risk factors that this disease provides. The aim of the review is to report all the anomalies reported in the literature for these patients, and to direct and update the clinician in the treatment of haemophilia patients.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
| | - Salvatore Crimi
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Alberto Bianchi
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Paola Campagna
- Department of Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy.
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Glanzmann's Thrombastenia: The Role of Tranexamic Acid in Oral Surgery. Case Rep Dent 2018; 2018:9370212. [PMID: 30254767 PMCID: PMC6145161 DOI: 10.1155/2018/9370212] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/04/2018] [Accepted: 08/13/2018] [Indexed: 11/17/2022] Open
Abstract
Glanzmann's thrombastenia (GT) is the most frequent inherited condition. GT is a genetic autosomal recessive disease caused by the alteration of the genes ITGA2B and ITGB3, located on the chromosome 17. The incidence of GT is calculated in 1 on 1000000. The patients, during their life, show episodes of mucocutaneous bleeding, epistaxis, and gingival bleeding. Some subjects required continuous bleeding transfusion. The aim of this case report is to demonstrate that oral assumption of tranexamic acid is a gold standard to prevent excessive bleeding. The patient GM of 36 years old with GT type 1 needs dental extractions of the teeth 4.7 and 4.8 at the "Tor Vergata" University Hospital in Rome. The specialist suggests that 3 days before surgery, the patient must take 6 vials every day of tranexamic acid that is used in obstetrics and gynecology. The teeth were extracted and applied suture. The patient is observed and is recommended mouth rinse with tranexamic acid. No bleeding complications were observed.
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Choi MS, Lee JH, Lim YC. Glanzmann Thrombasthenia in a Korean Patient: A Postoperative Intracranial Hemorrhagic Diasthesis in a Patient with a Rupture of a Cerebral Aneurysm. JOURNAL OF NEUROCRITICAL CARE 2017. [DOI: 10.18700/jnc.170025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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