Management of dental patients with bleeding disorders: Review and update

Johnson, William T.; Leary, James M.

doi:10.1016/0030-4220(88)90235-6

Cited by 40 publications

(19 citation statements)

References 11 publications

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“…Oxidised cellulose tranexamic acid rinses, [29][30][31] astringents (eg aluminum chloride), microfibrillar collagen, thrombin-soaked gauze, 32 fibrin sealant and adhesive, 2,33 electrocautery, 32 absorbable gelatin sponges, and aminocaproic acid (EACA) to prevent clot lysis, have all been suggested as aids to haemostasis in this setting. 3,[34][35][36][37][38][39] Many of these methods are based on studies with flawed designs and therefore lack scientific validity. A study of 69 patients undergoing oral surgical procedures, with varying INR values from warfarin had no cases of clinically significant prolonged or excessive bleeding with the use of both absorbable gelatin sponges and fibrin sealant.…”

Section: Fundamentals In Patient Managementmentioning

confidence: 99%

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Lockhart

Gibson²,

Pond³

et al. 2003

Br Dent J

115

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Section: Fundamentals In Patient Managementmentioning

confidence: 99%

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Lockhart

Gibson²,

Pond³

et al. 2003

Br Dent J

115

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“…Elles ont été réalisées avec une alvéolectomie fine en « gouttière » et séparation de racine, respectant les tables alvéolaires, garantes de la protection du caillot [6]. D'autre part, le type d'anesthésie, toujours locale et non locorégionale (foramen mandibulaire, foramen mentonnier, anesthésie tubérositaire), ces dernières étant à risque d'hématome, notamment latéro pharyngé, potentiellement asphyxiant, déjà rapporté sous AAS [16][17][18].…”

Section: Discussionunclassified

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

Baranes

Princ

Spaulding

et al. 2016

Med Buccale Chir Buccale

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Résumé -Introduction :Le clopidogrel est un agent antiplaquettaire (AAP) indiqué dans la prévention de l'athé-rothrombose et des thromboses de stents coronaires. Il augmente le risque hémorragique lors des actes chirurgicaux. Son arrêt, même transitoire, peut entraîner un accident thrombotique aigu potentiellement grave. Sujets et méthodes : Une étude prospective bicentrique était réalisée. L'objectif était d'évaluer le risque hémorragique postavulsionnel chez des patients des deux sexes, sans limite d'âge, sous clopidogrel en monothérapie ou bithérapie, bénéficiant d'une hémostase à base de colle chirurgicale. Les critères de non-inclusion étaient les patients ayant bénéficié d'un relais (héparine, flubiprofène) ou ayant arrêté leur traitement anti-agrégant. Quatre-vingt-neuf patients étaient inclus, 128 interventions réalisées, 284 dents extraites. Résultats : Douze épisodes hémorra-giques post-opératoires (9,5 %) étaient constatés dont 11 stoppés par le patient à domicile par compressions avec de l'acide tranexamique à 10 %. Deux tiers des hémorragies (8/12) concernaient des patients sous bithérapie antiagrégante. Un patient présentait une hémorragie persistante ayant nécessité une reprise de l'hémostase au fauteuil. Discussion : Cette étude confirme qu'un protocole d'hémostase locale adapté permet de réaliser les avulsions avec maintien du clopidogrel qu'il soit ou non associé à un autre AAP. En cas de bithérapie, les procédures d'hémos-tase doivent être renforcées. Conclusion : Ces résultats confirment les recommandations de la Société française de chirurgie orale (SFCO).Abstract -Dental avulsions in patients receiving clopidogrel: prospective bicentric study. Introduction: Clopidogrel is an antiplatelet drug used in the prevention of atherothrombosis and thrombosis after coronary stent implantation. It increases the risk of bleeding during surgical procedures. In 2015, the French Society of Oral Surgery (SFCO) published a practice guideline which clearly stated that "interruption of clopidogrel before a surgical procedure is not justified". However, there is limited data on tooth avulsions in patients receiving clopidogrel. Subjects and Methods: A prospective bicentric study was performed. The objective was to evaluate the risk of bleeding after tooth avulsion with an hemostatic procedure including surgical glue, in patients treated with clopidogrel alone or associated with aspirin. Patients under switch treatment (heparine, flurbiprofen) or who interrupted their treatment were not included in this study. 99 patients were included, 128 surgical procedures performed and 284 teeth extracted (2 ± 1 per intervention). Results: 12 post-surgical haemorrhages, 11 of which stopped by patient at home by compression with 10% tranexamic acid where noted. 2/3 of these haemorrhage concerned occurred in patients receiving dual antiplatelet therapy. Only one patient required a new local hemostasis procedure at hospital without transfusion or hospitalisation. Discussion: According to these results discontinuation of clopi...

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“…Finally, in the control of the fourth month, a suspected ulcer below the disjunctor due to the inflammation of the edges of it, a decision was made to extract the device before the time was ideally indicated. Before extracting the disjunctor we valuated the risk of bleeding (12) with a prior determination by the haematologist of the activity Factor VIII (13,14), which decided that four hours before going to the dental hospital, at hospital level he was administered for 20 minutes 0.3 mg / kg of intravenous desmopressin. Confirming the suspicions, large swelling and an ulcerated area below the acrylic of the disjunctor was found (Fig.…”

Section: E465mentioning

confidence: 99%

Orthodontic management in patients with haemophilia. About two clinical cases

Cañete-Sánchez¹,

Guardia²,

Castillo-Naveros³

et al. 2010

Med Oral

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The most common congenital bleeding disorder is haemophilia. It is a pathology inherited and caused by a defective or an absence of the coagulation factors, so that haemophiliacs cannot form an efficient clot. These patients have been treated with fear in the dental profession without having achieved the goals and ideals most appropriate according to the requirements of each case, which is demonstrated in the little existing literature available. However, they are currently treated as healthy orthodontic patients thanks to the advances in orthodontics. We present the cases of two brothers with mild classical haemophilia, who were treated by Mc Namara's disjunctor. The emphasis is on importance of interconsultation with the haematologist, prevention and oral hygiene, and that of the beneficial effect of orthodontic.

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Management of dental patients with bleeding disorders: Review and update

Cited by 40 publications

References 11 publications

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease

Avulsions dentaires chez les patients sous clopidogrel : étude prospective bi-centrique

Orthodontic management in patients with haemophilia. About two clinical cases

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