Oral vascular malformation in a patient with hereditary hemorrhagic telangiectasia: a case report

Oral manifestations and dental considerations of patients with hereditary hemorrhagic telangiectasia: a scoping review

OBJECTIVE

We examined the range, nature, and extent of research conducted regarding the oral and dental implications of hereditary hemorrhagic telangiectasia (HHT) to identify gaps in the research and knowledge of the field.

STUDY DESIGN

We performed a scoping review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and 2017 Guidance for the Conduct of Joanna Briggs Institute Scoping Reviews. We searched the MEDLINE and Web of Science databases for all full-text articles published in English from December 1946 to October 2022.

RESULTS

We identified 103 articles describing oral and dental considerations of patients with HHT, primarily case reports. Most reported oral telangiectasias of the tongue, lips, and palate. Many reported management of bleeding and the use or recommendation of prophylactic antibiotics before dental procedures.

CONCLUSIONS

Oral telangiectasias are commonly found in patients with hereditary hemorrhagic telangiectasia, and dental professionals may be the first to diagnose it in their patients. Early detection and diagnosis are important to prevent potentially fatal outcomes, and prophylactic antibiotics before procedures may be warranted.

Hereditary haemorrhagic telangiectasia in a patient taking anticoagulant drugs who has sustained facial trauma

The authors present the case of a 41-year-old patient with hereditary hemorrhagic telangiectasia (HHT), who in the past had an aortic valve replacement surgery, currently takes anticoagulant drugs and has sustained an extensive trauma to the nose as a result of a dog bite. The HHT is diagnosed basing on the presence of at least three out of four symptoms or signs: spontaneous epistaxis, vascular lesions in the internal organs, skin telangiectasias and a family history of the disease. The presented patient showed hepatic angioma, history of recurrent bleeding from the tongue and spontaneous epistaxis as well as numerous skin telangiectasias. In his case, HHT coincided with chronic treatment with coagulants implemented after an implantation of the artificial aortic replacement valve, what substantially modified the clinical picture and course of treatment.