817 results on '"Oral Hemorrhage etiology"'
Search Results
2. A Mouthful: Recurrent Oropharyngeal Bleeding in a Child.
- Author
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Chan L, Neeley M, Whigham A, and Wolf R
- Subjects
- Humans, Male, Child, Oral Hemorrhage etiology, Oral Hemorrhage diagnosis, Oropharynx, Female, Diagnosis, Differential, Recurrence
- Published
- 2024
- Full Text
- View/download PDF
3. Effect of different anticoagulants and antiplatelets on intraoral bleeding time during professional oral hygiene session.
- Author
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Pesce P, Pin L, Pin D, Bagnasco F, Ball L, Isola G, Nicolini P, and Menini M
- Subjects
- Humans, Female, Male, Middle Aged, Bleeding Time, Oral Hemorrhage prevention & control, Oral Hemorrhage etiology, Aged, Adult, Oral Hygiene, Dabigatran therapeutic use, Dabigatran adverse effects, Factor Xa Inhibitors therapeutic use, Warfarin therapeutic use, Warfarin adverse effects, Clopidogrel therapeutic use, Clopidogrel adverse effects, Pyrazoles therapeutic use, Aspirin adverse effects, Aspirin therapeutic use, Rivaroxaban therapeutic use, Rivaroxaban adverse effects, Anticoagulants therapeutic use, Platelet Aggregation Inhibitors therapeutic use, Platelet Aggregation Inhibitors adverse effects
- Abstract
Objective: Patients with thromboembolic problems, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to examine the bleeding durations associated with various anticoagulants and antiplatelets during professional dental hygiene sessions, utilizing a modified Ivy test adapted for the oral context., Materials and Methods: Ninety-three consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn's post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; RESULTS: Control patients presented the lowest bleeding time 50 s, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p = 0.004), VKA (p < 0.001), DAPT (p < 0.001)., Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT., Clinical Significance: bleeding did not interfere with the oral hygiene session The optimal period for dental treatment of these patients should be 2-3 h before the next dose, without the need to temporarily suspend the medication., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
4. Ethanol embolotherapy of mandibular arteriovenous malformation-induced acute oral hemorrhage after tooth extraction.
- Author
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Shen Y, Wang D, Su L, Fan X, and Yang X
- Subjects
- Humans, Female, Adult, Angiography, Embolization, Therapeutic methods, Arteriovenous Malformations therapy, Arteriovenous Malformations complications, Ethanol administration & dosage, Tooth Extraction adverse effects, Oral Hemorrhage etiology, Oral Hemorrhage therapy, Mandible blood supply
- Abstract
Background: Mandibular arteriovenous malformation (AVM) is rare. Our work aims to introduce the ethanol embolization of a patient suffering from acute oral hemorrhage induced by mandibular AVM., Methods: A 35-year-old woman without coagulopathy underwent tooth extraction, and the acute oral bleeding occurred intraoperatively. Imaging examinations indicated the enhancement of vascular mass with bone destruction inside the mandible. Angiography finally confirmed the high blood flow nature and the diagnosis of AVM., Results: During the interventional procedure, the coils were first applied into the dilated outflowing vein to slow down the blood flow rate of mandibular AVM. Absolute ethanol was injected in a multi-bolus modality to destroy the nidus of AVM. Her mandibular lesion had been stable in the 12-month re-examined angiography, no further bleeding occurred during the period., Conclusions: Ethanol embolotherapy was a less invasive, more precise, and quick-action approach managing AVM of the jaw and related emergency medicine., (© 2024 Wiley Periodicals LLC.)
- Published
- 2024
- Full Text
- View/download PDF
5. Intraoral hemorrhagic bullae as the first sign of immunoglobulin light chain amyloidosis.
- Author
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Dominguez-Lopez RM and Naharro-Rodriguez J
- Subjects
- Humans, Immunoglobulin Light Chains, Immunoglobulin Light-chain Amyloidosis diagnosis, Immunoglobulin Light-chain Amyloidosis complications, Oral Hemorrhage etiology, Oral Hemorrhage diagnosis, Amyloidosis diagnosis, Amyloidosis complications, Blister etiology, Blister diagnosis
- Abstract
Competing Interests: Competing interests:: None declared.
- Published
- 2024
- Full Text
- View/download PDF
6. The effect of different hemostatic agents following dental extraction in patients under oral antithrombotic therapy: a network meta-analysis.
- Author
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Mahardawi B, Jiaranuchart S, Arunjaroensuk S, Tompkins KA, Somboonsavatdee A, and Pimkhaokham A
- Subjects
- Humans, Fibrinolytic Agents adverse effects, Network Meta-Analysis, Oral Hemorrhage drug therapy, Oral Hemorrhage etiology, Tooth Extraction adverse effects, Postoperative Hemorrhage etiology, Collagen, Cyanoacrylates, Tranexamic Acid therapeutic use, Chitosan, Tissue Adhesives, Hemostatics therapeutic use
- Abstract
This network meta-analysis was done to thoroughly evaluate the available literature on the use of different hemostatic agents for dental extraction in patients under oral antithrombotic therapy, aiming to identify the agent with the best/worst performance in bleeding control. Considering that such patients have a higher risk of bleeding, choosing the right hemostatic is essential. Twenty-three randomized clinical trials articles were included after completing the literature search. Cyanoacrylate tissue adhesive showed a reduction in the odds of postoperative bleeding events compared with conventional methods (i.e., gauze/cotton pressure, sutures), with a tendency toward a statistical significance (OR 0.03, P = 0.051). Tranexamic acid was the only agent that demonstrated a significantly lower risk of developing postoperative bleeding events (OR 0.27, P = 0.007). Interestingly, chitosan dental dressing and collagen plug had the shortest time to reach hemostasis. However, they ranked last among all hemostatic agents, regarding bleeding events, revealing higher odds than conventional measures. Therefore, it is concluded that the use of cyanoacrylate tissue adhesive and tranexamic acid gives favorable results in reducing postoperative bleeding events following dental extractions. Although chitosan dental dressing and collagen exhibited a faster time to reach hemostasis, they led to a higher occurrence of bleeding events., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
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7. Angina bullosa hemorrhagica: report of two cases.
- Author
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Alotaiby F, Al-Homaid M, Islam MN, Bhattacharyya I, and Alramadhan SA
- Subjects
- Blister diagnosis, Diagnosis, Differential, Humans, Mouth Diseases diagnosis, Oral Hemorrhage diagnosis, Oral Hemorrhage etiology
- Abstract
Angina bullosa hemorrhagica (ABH) is a rare benign condition that affects the oral and oropharyngeal mucosa. It is characterized by a rapid eruption of one or more red or magenta blood-filled bullae, which typically involves the soft palate. ABH is a self-limiting condition that heals spontaneously usually within 2 weeks without scarring. ABH is not related to any dermatologic, hematologic, systemic disorders, or other known causes. The etiopathogeneses of ABH are unknown, though several theories have been proposed. Trauma has been suggested as a potential cause for the development of ABH in susceptible individuals. Two cases are presented of ABH, and the differential diagnoses of oral vesiculobullous conditions is discussed. Cognizance and identification of this benign condition is important to prevent misdiagnosis and eventual unwarranted treatment.
- Published
- 2022
- Full Text
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8. Uncontrolled bleeding during tooth extraction from an undiagnosed arteriovenous malformation.
- Author
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Nilesh K, Shah S, Gautam A, and Thorat S
- Subjects
- Adult, Female, Humans, Mandible diagnostic imaging, Mandible surgery, Oral Hemorrhage etiology, Tooth Extraction adverse effects, Arteriovenous Malformations complications, Arteriovenous Malformations diagnostic imaging, Arteriovenous Malformations surgery
- Abstract
Arteriovenous malformations (AVMs) are rare congenital disorders of vascular morphogenesis. These lesions are characterised by high vascular flow with risk of severe bleeding from accidental trauma or surgical manipulation. Although infrequent, potentially life-threatening and fatal oral bleeding has been reported during extraction of tooth associated with AVM. This paper presents a case of uncontrolled bleeding in an adult female patient undergoing mandibular anterior tooth extraction. The bleeding was related to undiagnosed soft tissue AVM in gingivobuccal space. Management of the case with review of previously reported similar cases is presented., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
- Full Text
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9. Acute Immune Thrombocytopenia following administration of Shingrix recombinant zoster vaccine.
- Author
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Schmidt N and Maitland H
- Subjects
- Dexamethasone therapeutic use, Humans, Immunoglobulins, Intravenous therapeutic use, Male, Middle Aged, Purpura etiology, Purpura, Thrombocytopenic, Idiopathic blood, Purpura, Thrombocytopenic, Idiopathic drug therapy, Purpura, Thrombocytopenic, Idiopathic therapy, Thrombocytopenia blood, Thrombocytopenia etiology, Vaccines, Synthetic adverse effects, Blister etiology, Herpes Zoster Vaccine adverse effects, Oral Hemorrhage etiology, Purpura, Thrombocytopenic, Idiopathic etiology
- Published
- 2021
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10. Tongue arteriovenous malformation with oral haemorrhage treated by embolisation.
- Author
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Hendriks T, Pollaers K, Phillips T, and Kuthubutheen J
- Subjects
- Humans, Male, Oral Hemorrhage etiology, Tongue blood supply, Young Adult, Arteriovenous Malformations pathology, Carotid Artery, External abnormalities, Embolization, Therapeutic methods, Oral Hemorrhage therapy
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2020
- Full Text
- View/download PDF
11. Controlling oral hemorrhages in Steven-Johnson syndrome/toxic epidermal necrolysis.
- Author
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Adams L and Creamer D
- Subjects
- Administration, Topical, Hospitals, University, Humans, Mouth Mucosa drug effects, Patient Safety, Stevens-Johnson Syndrome diagnosis, Treatment Outcome, United Kingdom, Antifibrinolytic Agents therapeutic use, Oral Hemorrhage drug therapy, Oral Hemorrhage etiology, Stevens-Johnson Syndrome complications, Tranexamic Acid therapeutic use
- Published
- 2020
- Full Text
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12. The incidence of airway haemorrhage in manual versus mechanical cardiopulmonary resuscitation.
- Author
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Asha SE, Doyle S, Paull G, and Hsieh V
- Subjects
- Airway Obstruction mortality, Airway Obstruction physiopathology, Australia, Cardiopulmonary Resuscitation adverse effects, Cardiopulmonary Resuscitation methods, Emergency Medical Services, Equipment Design, Female, Humans, Incidence, Male, Middle Aged, Oral Hemorrhage mortality, Oral Hemorrhage physiopathology, Out-of-Hospital Cardiac Arrest mortality, Retrospective Studies, Survival Rate, Treatment Outcome, Airway Obstruction etiology, Cardiopulmonary Resuscitation instrumentation, Oral Hemorrhage etiology, Out-of-Hospital Cardiac Arrest therapy
- Abstract
Objective: The aim of this study was to compare the incidence of airway haemorrhage between participants who received manual cardiopulmonary resuscitation (CPR) and those who had received mechanical CPR using the LUCAS device., Methods: A retrospective cohort study was conducted by means of a medical chart review. All non-traumatic cardiac arrest patients that presented to the ED, from May 2014 to February 2018, were recruited. The groups were stratified according to those who had the majority of CPR performed using the LUCAS and those who had the majority of CPR performed manually. The primary outcome was the proportion of participants with airway haemorrhage, defined as blood observed in the endotracheal tube, pharynx, trachea or mouth, and documented in the doctor or nursing notes. Logistic regression analysis was performed to adjust for confounders., Results: 12 of 54 (22%) participants in the majority LUCAS CPR group had airway haemorrhage, compared with 20 of 215 (9%) participants in the majority manual CPR group, a difference of 13% (95% CI 3% to 26%, p=0.02). The unadjusted odds for developing airway haemorrhage in the majority LUCAS CPR group was 2.8 (95% CI 1.3 to 6.1). After adjusting for confounders, the odds for developing airway haemorrhage in the majority LUCAS CPR group was 2.5 (95% CI 1.1 to 5.7)., Conclusions: The LUCAS mechanical CPR device is associated with a higher incidence of airway haemorrhage compared with manual CPR. Limitations in the study design mean this conclusion is not robust., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
- Full Text
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13. Esophagogastroduodenoscopy-Induced Angina Bullosa Hemorrhagica of the Aryepiglottic Folds and Arytenoid.
- Author
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Hamada K, Yoshida A, and Okada H
- Subjects
- Aged, Blister etiology, Female, Humans, Oral Hemorrhage etiology, Blister diagnostic imaging, Endoscopy, Digestive System adverse effects, Laryngeal Mucosa diagnostic imaging, Laryngeal Muscles diagnostic imaging, Oral Hemorrhage diagnostic imaging
- Published
- 2019
- Full Text
- View/download PDF
14. A rare case of angina bullosa hemorrhagica of the esophagus.
- Author
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Cavallaro F, Tontini GE, Leggieri E, Lagoussis P, Prada A, Bonavina L, and Pastorelli L
- Subjects
- Diagnosis, Differential, Female, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Humans, Middle Aged, Mouth Mucosa pathology, Oral Hemorrhage diagnosis, Oral Hemorrhage etiology, Blister complications, Blister diagnosis, Blister physiopathology, Chest Pain diagnosis, Chest Pain etiology, Endoscopy, Digestive System methods, Epidermolysis Bullosa diagnosis, Esophagus diagnostic imaging, Esophagus pathology, Lichen Planus, Oral diagnosis, Pemphigoid, Benign Mucous Membrane diagnosis
- Abstract
Competing Interests: None
- Published
- 2019
- Full Text
- View/download PDF
15. [A woman with a swelling in the mouth].
- Author
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van Kempen PMW, Peters HPM, and Thomeer HGXM
- Subjects
- Adult, Blister diagnosis, Edema etiology, Face, Female, Gastrointestinal Hemorrhage diagnosis, Humans, Mouth Mucosa pathology, Blister etiology, Gastrointestinal Hemorrhage etiology, Mouth Diseases diagnosis, Mouth Diseases etiology, Oral Hemorrhage etiology
- Abstract
A 35-year-old woman developed acute swallowing problems caused by a big oral blood blister after eating nuts. The blister ruptured 32 hours later and healed without scarring. 'Angina bullosa haemorrhagica' was diagnosed after ruling out bleeding disorders.
- Published
- 2019
16. Oral Manifestation Like Forchheimer Spots of Dengue Fever.
- Author
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Yamamoto K
- Subjects
- Child, Humans, Male, Dengue complications, Oral Hemorrhage etiology, Palate pathology
- Published
- 2019
- Full Text
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17. U.K. hemophilia treaters' knowledge of risk assessment for prolonged bleeding associated with dental procedures.
- Author
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Rahman A, Nizarali N, Dougall A, and Daly B
- Subjects
- Adult, Cross-Sectional Studies, Female, Guideline Adherence, Hemostasis, Humans, Male, Risk Assessment, Risk Factors, Surveys and Questionnaires, United Kingdom, Dental Care for Chronically Ill adverse effects, Health Knowledge, Attitudes, Practice, Hemophilia A complications, Oral Hemorrhage etiology, Oral Hemorrhage prevention & control, Physicians
- Abstract
Introduction: Optimal delivery of dental care for adults with congenital bleeding disorders (CBD) requires close collaboration between hemophilia treaters and dentists., Aim: To explore U.K. hemophilia treaters' knowledge of dental procedures and associated hemostatic management in adults with CBD., Method: Staff (N = 180) from N = 60 hemophilia facilities in the United Kingdom were invited to participate in a questionnaire-based study using a web-based tool. The questionnaire assessed participants' knowledge, adherence and appropriateness of application of U.K. guidance on hemostatic management of common dental procedures., Results: The response rate was 23% of treaters (n = 41) from 62% (n = 32) hemophilia facilities. Individual participants (87%; n = 34) reported they adhered to guidelines, though knowledge of guidance was poor with only 36% (n = 15) applying guidance appropriately in 3 common dental scenarios. There was a tendency for participants to assign the use of systemic hemostatic measures independent of the agreed bleeding risk associated with the proposed dental procedure., Conclusion and Recommendations: While hemophilia treaters were aware of current guidelines, their knowledge of the guidelines and ability to risk assess dental procedures was poor. There was a tendency to overprescribe systemic hemostatic measures for dental procedures. Education initiatives to aid decision making are needed., (© 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.)
- Published
- 2019
- Full Text
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18. Dental Emergencies.
- Author
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Hammel JM and Fischel J
- Subjects
- Emergencies, Focal Infection, Dental diagnosis, Focal Infection, Dental therapy, Humans, Mouth injuries, Oral Hemorrhage etiology, Pain etiology, Stomatognathic Diseases pathology, Stomatognathic Diseases therapy, Tooth Avulsion diagnosis, Tooth Avulsion therapy, Tooth Injuries diagnosis, Tooth Injuries therapy, Stomatognathic Diseases diagnosis
- Abstract
Dental emergencies present frequently to the emergency department and urgent care centers. Trauma to the teeth includes fractures, luxations, and avulsions, which can be reduced in most cases. Avulsed primary teeth should never be replaced. Mouthguards should be worn in most youth sports to prevent many dental injuries. Dental caries can progress to worsening infection and should be diagnosed and promptly referred. More severe infections may require antibiotics, imaging, or incision and drainage. Dental blocks can assist with analgesia and patient comfort during other procedures., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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19. Tracheostomy Emergencies.
- Author
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Bontempo LJ and Manning SL
- Subjects
- Humans, Oral Hemorrhage etiology, Oral Hemorrhage therapy, Emergencies, Tracheostomy adverse effects, Tracheostomy methods
- Abstract
Tracheostomy is a common procedure for long-term airway management. Although the overall complication rate is greater than 50%, the incidence of serious complications is low. These serious complications can, however, lead to significant morbidity and mortality and it is incumbent on the emergency provider to be prepared to deal with such tracheostomy-related emergencies. The greatest life threats to the tracheostomy patient are decannulation, obstruction, and hemorrhage. Other important but lower-acuity complications include tracheoesophageal fistula formation, tracheal stenosis, infection, and tracheocutaneous fistula formation., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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20. Angina bullosa haemorrhagica: a systematic review and proposal for diagnostic criteria.
- Author
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Ordioni U, Hadj Saïd M, Thiery G, Campana F, Catherine JH, and Lan R
- Subjects
- Biopsy, Diagnosis, Differential, Humans, Recurrence, Risk Factors, Blister diagnosis, Blister epidemiology, Blister etiology, Blister therapy, Oral Hemorrhage diagnosis, Oral Hemorrhage epidemiology, Oral Hemorrhage etiology, Oral Hemorrhage therapy
- Abstract
The aim of this study was to perform a critical review of published data on the epidemiological, aetiological, clinical, histological, biological, and therapeutic characteristics of patients with angina bullosa haemorrhagica (ABH). A literature search was conducted in the PubMed, Science Direct, Web of Science, and Cochrane Library databases. All publications fulfilling the selection criteria were included in the eligibility assessment according to the PRISMA statement. The full texts of 54 retrieved articles were screened. Forty articles published between 1985 and 2016 describing 225 cases of ABH were finally selected. The mean age of the patients was 55.4 years; the male to female ratio was 0.7. The predominant localization was the palate (66%). A third of patients had no medical history. When specified, a triggering event or promoting factor was frequently found (82%). Biological tests were normal. A biopsy was performed on 35% of the patients. Treatment was symptomatic with a favourable outcome. Recurrences were frequent (62%). In conclusion, ABH is poorly documented and only by studies of low-level evidence. This review did not allow any aetiopathogenic association to be made with a general pathology or treatment. On the basis of this systematic review of the literature, diagnostic criteria aiming to improve the care of patients presenting with ABH are proposed., (Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2019
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21. Embolization of Hemorrhagic Hepatocellular Carcinoma to the Mandible.
- Author
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Sidhar V and Kelly P
- Subjects
- Carcinoma, Hepatocellular complications, Carcinoma, Hepatocellular diagnostic imaging, Computed Tomography Angiography, Humans, Male, Mandibular Neoplasms complications, Mandibular Neoplasms diagnostic imaging, Middle Aged, Oral Hemorrhage diagnostic imaging, Particle Size, Treatment Outcome, Acrylic Resins administration & dosage, Carcinoma, Hepatocellular secondary, Carcinoma, Hepatocellular therapy, Embolization, Therapeutic methods, Gelatin administration & dosage, Liver Neoplasms pathology, Mandibular Neoplasms secondary, Mandibular Neoplasms therapy, Oral Hemorrhage etiology
- Published
- 2018
- Full Text
- View/download PDF
22. Dental treatment in the era of new anti-thrombotic agents.
- Author
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Sahar-Helft S, Chackartchi T, Polak D, and Findler M
- Subjects
- Clinical Protocols, Fibrinolytic Agents pharmacology, Hemostatic Techniques, Humans, Pharmaceutical Research, Practice Guidelines as Topic, Dental Care adverse effects, Dental Care methods, Fibrinolytic Agents adverse effects, Fibrinolytic Agents therapeutic use, Oral Hemorrhage etiology, Oral Hemorrhage prevention & control
- Abstract
Background: In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry., Methods: An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines., Results: In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications., Clinical Implications: Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis., (© 2017 FDI World Dental Federation.)
- Published
- 2018
- Full Text
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23. Interventions for treating post-extraction bleeding.
- Author
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Kumbargere Nagraj S, Prashanti E, Aggarwal H, Lingappa A, Muthu MS, Kiran Kumar Krishanappa S, and Hassan H
- Subjects
- Female, Humans, Male, Oral Hemorrhage etiology, Postoperative Hemorrhage etiology, Oral Hemorrhage therapy, Postoperative Hemorrhage therapy, Tooth Extraction adverse effects
- Abstract
Background: Post-extraction bleeding (PEB) is a recognised, frequently encountered complication in dental practice, which is defined as bleeding that continues beyond 8 to 12 hours after dental extraction. The incidence of post-extraction bleeding varies from 0% to 26%. If post-extraction bleeding is not managed, complications can range from soft tissue haematomas to severe blood loss. Local causes of bleeding include soft tissue and bone bleeding. Systemic causes include platelet problems, coagulation disorders or excessive fibrinolysis, and inherited or acquired problems (medication induced). There is a wide array of techniques suggested for the treatment of post-extraction bleeding, which include interventions aimed at both local and systemic causes. This is an update of a review published in June 2016., Objectives: To assess the effects of interventions for treating different types of post-extraction bleeding., Search Methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 24 January 2018), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 12), MEDLINE Ovid (1946 to 24 January 2018), Embase Ovid (1 May 2015 to 24 January 2018) and CINAHL EBSCO (1937 to 24 January 2018). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. We searched the reference lists of relevant systematic reviews., Selection Criteria: We considered randomised controlled trials (RCTs) that evaluated any intervention for treating PEB, with male or female participants of any age, regardless of type of teeth (anterior or posterior, mandibular or maxillary). Trials could compare one type of intervention with another, with placebo, or with no treatment., Data Collection and Analysis: Three pairs of review authors independently screened search records. We obtained full papers for potentially relevant trials. If data had been extracted, we would have followed the methods described in the Cochrane Handbook for Systematic Reviews of Interventions for the statistical analysis., Main Results: We did not find any randomised controlled trial suitable for inclusion in this review., Authors' Conclusions: We were unable to identify any reports of randomised controlled trials that evaluated the effects of different interventions for the treatment of post-extraction bleeding. In view of the lack of reliable evidence on this topic, clinicians must use their clinical experience to determine the most appropriate means of treating this condition, depending on patient-related factors. There is a need for well designed and appropriately conducted clinical trials on this topic, which conform to the CONSORT statement (www.consort-statement.org/).
- Published
- 2018
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24. Diagnosis of Hypofibrinogenemia After Dental Treatment Under General Anesthesia.
- Author
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Kim T, Yeroshalmi F, Margulis KS, Badner V, and Rivlin K
- Subjects
- Child, Preschool, Female, Hemostatic Techniques, Humans, Oral Hemorrhage therapy, Afibrinogenemia diagnosis, Anesthesia, Dental, Anesthesia, General, Crowns adverse effects, Dental Caries therapy, Dental Restoration, Permanent adverse effects, Oral Hemorrhage etiology
- Abstract
Congenital hypofibrinogenemia is a rare coagulation disorder characterized by a deficiency in fibrinogen protein, which is critical to the normal coagulation process. This hematological disorder can go undiagnosed until an event leads to prolonged bleeding. The purposes of this report were to describe an incidental diagnosis of congenital hypofibrinogenemia after a dental procedure, discuss the importance of recognizing coagulopathies on the delivery of dental care, examine the multi-disciplinary clinical management of prolonged bleeding after a dental procedure, and evaluate the challenges health care practitioners may encounter when obtaining a thorough medical history.
- Published
- 2018
25. Does Achievement of Hemostasis After Pulp Exposure Provide an Accurate Assessment of Pulp Inflammation?
- Author
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Mutluay M, Arıkan V, Sarı S, and Kısa Ü
- Subjects
- Biomarkers blood, Child, Child, Preschool, Cytokines blood, Dental Caries complications, Dental Caries physiopathology, Dental Pulp Cavity physiopathology, Dental Pulp Exposure complications, Dental Pulp Exposure physiopathology, Female, Humans, Interleukin-6 blood, Male, Molar, Oral Hemorrhage etiology, Risk Factors, Tooth, Deciduous, Dental Caries therapy, Dental Pulp Exposure therapy, Hemostatic Techniques, Oral Hemorrhage therapy, Pulpitis physiopathology
- Abstract
Purpose: The purpose of this study was to determine in primary molars with carious exposures whether hemostasis at the exposure site and pulp orifice reflected inflammatory status of the pulp at the canal orifice based on cytokine levels., Methods: Forty mandibular primary molars with deep caries were included in the study. Teeth were divided into two groups: group A had teeth where hemostasis at the exposure site was achieved within five minutes, and group B had teeth where hemostasis at the exposure site could not be achieved within five minutes. Blood samples were harvested from the exposure sites and canal orifices. Cytokine levels for IL-1β, IL-2, IL-6, IL-8, IL-10, TNF-α, and PGE2 were measured using ELISA for all sample sites., Results: The IL-6 levels at the exposure sites were found to be significantly higher in group A when compared to group B, but there was no statistically significant differences in any of the cytokine levels at the canal orifices between the two groups., Conclusions: Controlling bleeding at the exposure site or canal orifices does not provide accurate assessment of inflammation at the canal orifice and may be misleading for diagnosing vital pulp treatment in primary teeth with a carious pulp exposure.
- Published
- 2018
26. Oral surgery in patients under antithrombotic therapy: perioperative bleeding as a significant risk factor for postoperative hemorrhage.
- Author
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Rocha AL, Souza AF, Martins MAP, Fraga MG, Travassos DV, Oliveira ACB, Ribeiro DD, and Silva TA
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Perioperative Period, Risk Factors, Fibrinolytic Agents adverse effects, Mouth surgery, Oral Hemorrhage etiology, Postoperative Hemorrhage etiology
- Abstract
: To investigate perioperative and postoperative bleeding, complications in patients under therapy with anticoagulant or antiplatelet drugs submitted to oral surgery. To evaluate the risk of bleeding and safety for dental surgery, a retrospective chart review was performed. Medical and dental records of patients taking oral antithrombotic drugs undergoing dental surgery between 2010 and 2015 were reviewed. Results were statistically analyzed using Fisher's exact test, t test or the χ test. One hundred and seventy-nine patients underwent 293 surgical procedures. A total of eight cases of perioperative and 12 episodes of postoperative bleeding were documented. The complications were generally managed with local measures and did not require hospitalization. We found significant association of postoperative hemorrhage with increased perioperative bleeding (P = 0.043) and combination of anticoagulant and antiplatelet therapy (P < 0.001). The chance of postoperative hemorrhage for procedures with increased perioperative bleeding is 8.8 times bigger than procedures without perioperative bleeding. Dental surgery in patients under antithrombotic therapy might be carried out without altering the regimen because of low risk of perioperative and postoperative bleeding. However, patients with increased perioperative bleeding should be closely followed up because of postoperative complications risk.
- Published
- 2018
- Full Text
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27. Unplanned readmission following transoral robotic surgery.
- Author
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Topf MC, Vo A, Tassone P, Shumrick C, Luginbuhl A, Cognetti DM, and Curry JM
- Subjects
- Carcinoma, Squamous Cell pathology, Clopidogrel, Dehydration etiology, Dehydration therapy, Female, Humans, Male, Middle Aged, Mouth Neoplasms pathology, Oral Hemorrhage drug therapy, Oral Hemorrhage etiology, Pain, Postoperative etiology, Pain, Postoperative therapy, Platelet Aggregation Inhibitors therapeutic use, Retrospective Studies, Risk Factors, Robotic Surgical Procedures adverse effects, Ticlopidine analogs & derivatives, Ticlopidine therapeutic use, Carcinoma, Squamous Cell surgery, Mouth surgery, Mouth Neoplasms surgery, Patient Readmission, Postoperative Complications, Robotic Surgical Procedures methods
- Abstract
Objectives: To determine the rate of unplanned readmission after transoral robotic surgery (TORS), and to determine which patient or surgical factors increase the likelihood of readmission., Materials and Methods: Retrospective chart review of all patients who underwent TORS for squamous cell carcinoma at our institution from March 2010 through July 2016. Primary outcome was unplanned readmission to the hospital within 30 days of discharge. Univariable and multivariable logistic regression were performed to identify risk factors for unplanned readmission., Results: 297 patients met eligibility criteria. 23 patients (7.7%) had unplanned readmissions within 30 days. Most common reasons for readmission were oropharyngeal bleed (n = 13) and pain/dehydration (n = 10). Average time to unplanned readmission was 6.52 days (range 0-25 days). Discharge on clopidogrel was the only variable independently associated with an increased risk of 30-day unplanned readmission on multivariable analysis with an OR = 6.85 (95% CI 1.59-26.36). Unplanned return to the operating room during initial hospitalization (OR = 7.55, 95% CI 1.26-38.50) and discharge on clopidogrel (OR = 10.45, 95% CI 1.06-82.69) were associated with increased risk of postoperative bleeding. Bilateral neck dissection (OR = 5.17, 95% CI 1.15-23.08) was associated with significantly increased odds of unplanned readmission secondary to pain and dehydration., Conclusion: Unplanned readmission following TORS occurs in a small but significant number of patients. Oropharyngeal bleeding and dehydration were the most common reasons for unplanned readmission following TORS., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
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- 2017
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28. High-flow paediatric mandibular arteriovenous malformations: case reports and a review of current management.
- Author
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Kaderbhai J, Breik O, Heggie AA, and Penington AJ
- Subjects
- Adolescent, Arteriovenous Malformations diagnostic imaging, Biopsy adverse effects, Child, Child, Preschool, Diagnosis, Differential, Embolization, Therapeutic, Female, Humans, Male, Mandibular Diseases diagnostic imaging, Oral Hemorrhage diagnostic imaging, Tooth Extraction adverse effects, Arteriovenous Malformations complications, Arteriovenous Malformations therapy, Mandible blood supply, Mandibular Diseases complications, Mandibular Diseases therapy, Oral Hemorrhage etiology, Oral Hemorrhage therapy
- Abstract
High-flow vascular malformations in the paediatric population are potentially life-threatening and are challenging to treat. This paper describes the management of three cases of mandibular arteriovenous malformations and reviews the contemporary management options for these serious lesions., (Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
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- 2017
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29. Oral bleeding associated with palatine erosion in the cat.
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Whitley NT, McCann TM, and Doyle RS
- Subjects
- Animals, Cat Diseases etiology, Cat Diseases surgery, Cats, Electrocoagulation veterinary, Female, Oral Hemorrhage diagnosis, Oral Hemorrhage etiology, Oral Ulcer surgery, Palate surgery, Prednisolone therapeutic use, Pruritus drug therapy, Pruritus veterinary, Cat Diseases diagnosis, Oral Hemorrhage veterinary, Oral Ulcer veterinary, Palate pathology
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- 2017
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30. Lupus anticoagulant hypoprothrombinemia syndrome associated with severe thrombocytopenia in a child.
- Author
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Foord A, Baca N, Buchbinder D, and Mahajerin A
- Subjects
- Child, Humans, Male, Severity of Illness Index, Syndrome, Autoimmune Diseases blood, Autoimmune Diseases complications, Autoimmune Diseases therapy, Hypoprothrombinemias blood, Hypoprothrombinemias complications, Hypoprothrombinemias therapy, Lupus Coagulation Inhibitor blood, Oral Hemorrhage blood, Oral Hemorrhage etiology, Oral Hemorrhage therapy, Thrombocytopenia blood, Thrombocytopenia etiology, Thrombocytopenia therapy
- Abstract
Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) comprises lupus anticoagulant, acquired hypoprothrombinemia, and often mild thrombocytopenia or normal platelets. It is usually associated with autoimmunity or postviral illness. We describe a case of a 10-year-old boy with oral bleeding and severe thrombocytopenia initially suggestive of immune thrombocytopenia. Secondary to bleeding, evaluation demonstrated prolonged coagulation tests and subsequently revealed the presence of lupus anticoagulant and hypoprothrombinemia, along with marked autoimmunity, suggestive of LAHPS. He was treated with intravenous immunoglobulin and hydroxychloroquine. This case report and discussion highlight the diagnostic and therapeutic challenges associated with LAHPS and coincident severe thrombocytopenia., (© 2016 Wiley Periodicals, Inc.)
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- 2017
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31. Successful tracheal intubation with the McGRATH™ MAC during chest compression in a difficult airway patient.
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Kurahashi N, Komasawa N, Watanabe N, and Minami T
- Subjects
- Aged, Continuous Positive Airway Pressure, Heart Arrest etiology, Humans, Hypoxia etiology, Intubation, Intratracheal adverse effects, Intubation, Intratracheal instrumentation, Male, Mouth injuries, Mouth Neoplasms complications, Mouth Neoplasms therapy, Oral Hemorrhage etiology, Sleep Apnea Syndromes complications, Sleep Apnea Syndromes therapy, Supine Position, Treatment Outcome, Cardiopulmonary Resuscitation methods, Heart Arrest therapy, Hypoxia therapy, Intubation, Intratracheal methods, Laryngoscopes adverse effects, Mouth Neoplasms diagnostic imaging, Sleep Apnea Syndromes diagnostic imaging, Tomography, X-Ray Computed adverse effects
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- 2017
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32. Angina bullosa hemorrhagica: report of 7 cases and analysis of 199 cases from the literature.
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Dias KB, Flores AP, Oliveira MG, Carrard VC, Hildebrand LC, and Sant'Ana Filho M
- Subjects
- Adult, Diagnosis, Differential, Female, Humans, Middle Aged, Risk Factors, Blister diagnosis, Blister etiology, Oral Hemorrhage diagnosis, Oral Hemorrhage etiology
- Abstract
Angina bullosa hemorrhagica (ABH) is a condition characterized by blood blisters in the oral or oropharyngeal mucosa. Typically, the first presentation of ABH is acute, and rupture of the blisters occurs after a few hours or days. Although its etiology is unclear, ABH is assumed to be associated with predisposing factors such as local trauma or chronic use of inhaled steroids. The diagnosis is defined clinically, based on the presentation and evolution of the lesions. The recommended treatment is symptomatic, but extensive lesions may present a risk of airway obstruction and may require surgical excision. This case series reports 7 cases of ABH and reviews 199 cases published in the English-language literature. The possible etiologic factors, predisposing factors, and differential diagnoses are discussed.
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- 2017
33. Contemporary management of carotid blowout syndrome utilizing endovascular techniques.
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Manzoor NF, Rezaee RP, Ray A, Wick CC, Blackham K, Stepnick D, Lavertu P, and Zender CA
- Subjects
- Aged, Algorithms, Carcinoma, Squamous Cell mortality, Carotid Artery Diseases mortality, Combined Modality Therapy, Computed Tomography Angiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local complications, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local therapy, Oral Hemorrhage mortality, Otorhinolaryngologic Neoplasms mortality, Platelet Aggregation Inhibitors administration & dosage, Risk Factors, Surgical Flaps, Survival Rate, Veins transplantation, Carcinoma, Squamous Cell complications, Carcinoma, Squamous Cell therapy, Carotid Artery Diseases etiology, Carotid Artery Diseases therapy, Carotid Artery, External, Carotid Artery, Internal, Embolization, Therapeutic methods, Endovascular Procedures methods, Interdisciplinary Communication, Intersectoral Collaboration, Oral Hemorrhage etiology, Oral Hemorrhage therapy, Otorhinolaryngologic Neoplasms complications, Otorhinolaryngologic Neoplasms therapy, Septal Occluder Device, Stents
- Abstract
Objectives/hypothesis: To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS)., Study Designs: Retrospective chart review., Methods: Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied., Results: Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means. Of these, 23 were localized to the external carotid artery (ECA) branches and five localized to the ECA main trunk; nine were related to the common carotid artery (CCA) or internal carotid artery (ICA), and one event was related to the innominate artery. Seven events related to the CCA/ICA or innominate artery were managed with endovascular sacrifice, whereas three cases were managed with a flow-preserving approach (covered stent). Only one patient developed permanent hemiparesis. In two of the three cases where the flow-preserving approach was used, the covered stent eventually became exposed via the overlying soft tissue defect, and definitive management using carotid revascularization or resection was employed to prevent further hemorrhage. In cases of soft tissue necrosis, vascularized tissues were used to cover the great vessels as applicable., Conclusions: The use of modern endovascular approaches for management of acute CBS yields optimal results and should be employed in a coordinated manner by the head and neck surgeon and the neurointerventionalist., Level of Evidence: 4. Laryngoscope, 2016 127:383-390, 2017., (© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)
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- 2017
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34. Prolonged Bleeding in a 34-Year-Old Man following Oral Surgery.
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Olson NJ, Shajani-Yi Z, Cervinski MA, and Ornstein DL
- Subjects
- Adult, Blood Coagulation Tests, Cautery, Humans, Male, Oral Hemorrhage therapy, Postoperative Complications etiology, Postoperative Complications therapy, Recurrence, Sutures, Oral Hemorrhage etiology, Oral Surgical Procedures adverse effects, von Willebrand Disease, Type 2 complications, von Willebrand Disease, Type 2 diagnosis
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- 2016
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35. The Occurrence Rate and Diameter of Arteries Traveling Near the Mandible and an Assessment of the Relative Hemorrhage Risk in Implant Surgery.
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Katsumi Y, Takagi R, and Ohshima H
- Subjects
- Aged, Aged, 80 and over, Arteries anatomy & histology, Cadaver, Female, Humans, Male, Middle Aged, Mouth Floor, Risk Assessment, Arteries injuries, Dental Implants, Intraoperative Complications etiology, Mandible, Oral Hemorrhage etiology
- Abstract
Background: Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space., Purpose: This study aimed to assess the relative hemorrhage risk during implant surgery., Materials and Methods: We investigated the occurrence rate and diameter of submental and sublingual arteries with special reference to their relationship with the course patterns of these arteries using 26 human cadavers., Results: Three types of arteries were distinguished: main duct (MD), mucoperiosteal branches (MB), and cortical branches (CB). The occurrence rate of MB and CB was significantly high at the central incisor region in the upper part of the mylohyoid muscle, whereas the diameter of the MB and CB was significantly smaller than the occurrence rate of MD at the incisor regions. The occurrence rate of MD in the submental artery was significantly higher at the lateral incisor, canine, and premolar regions in the lower parts, whereas the occurrence rate of MD was significantly lower at the second and third molars in the upper parts., Conclusion: The susceptibility of the submental artery to injury is suggested at the incisors, canine, premolars, and first molar regions during implant surgery., (© 2015 Wiley Periodicals, Inc.)
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- 2016
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36. Overcoming the oral aspects of -self-mutilation: description of a method.
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Shapira J, Birenboim R, Shoshani M, Abdel-Kader A, Behar O, Moskovitz M, Ben-Attar Y, Chaushu S, and Becker A
- Subjects
- Child, Preschool, Dental Prosthesis Design, Humans, Lesch-Nyhan Syndrome complications, Lip injuries, Mouth Protectors, Oral Hemorrhage etiology, Oral Hemorrhage prevention & control, Self Mutilation etiology, Self Mutilation prevention & control, Tongue injuries
- Abstract
Background/aim: Self-injurious behavior (SIB) is a serious and chronic condition frequently seen in special needs populations, affecting 10% to 17% of individuals diagnosed with intellectual and/or developmental disabilities. A 2.5-year-old infant with SIB, whose presenting symptoms were severe tongue and lip lacerations accompanied by much hemorrhage, is presented here to illustrate the problem and to show how this may be prevented., Materials and Methods: An appliance is described which effectively limits the damage caused by SIB and permits rapid healing of existing injuries., Results: The method provides for a stable, retentive, and comfortable device on the infant's undererupted and largely nonretentive crowns of the deciduous teeth as well as for all permanent teeth in children, adolescents, and adults., Conclusions: The appliance has been successfully employed for the past 10 years in patients with SIB who have attended for treatment in the Special Needs Clinic in our Department., (© 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.)
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- 2016
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37. Epithelioid hemangioendothelioma of tongue presenting as a papilloangioma in a pregnant woman.
- Author
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Dutta M and Roy K
- Subjects
- Diagnosis, Differential, Female, Hemangioendothelioma, Epithelioid complications, Hemangioendothelioma, Epithelioid surgery, Hemangioma diagnosis, Humans, Oral Hemorrhage etiology, Papilloma diagnosis, Pregnancy, Pregnancy Complications, Neoplastic surgery, Tongue, Tongue Neoplasms complications, Tongue Neoplasms surgery, Young Adult, Hemangioendothelioma, Epithelioid diagnosis, Pregnancy Complications, Neoplastic diagnosis, Tongue Neoplasms diagnosis
- Published
- 2016
38. Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications.
- Author
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Helenius-Hietala J, Åberg F, Meurman JH, Nordin A, and Isoniemi H
- Subjects
- Blood Transfusion, Female, Finland, Hemostasis, Surgical, Hemostatics therapeutic use, Humans, International Normalized Ratio, Male, Middle Aged, Oral Hemorrhage prevention & control, Platelet Count, Postoperative Hemorrhage prevention & control, Predictive Value of Tests, Retrospective Studies, Risk Factors, Time Factors, Liver Transplantation, Oral Hemorrhage etiology, Oral Surgical Procedures, Postoperative Hemorrhage etiology, Tooth Extraction
- Abstract
Objective: Untreated dental infections pose a threat for immunocompromised liver transplant (LT) recipients. Therefore, pretransplant dental evaluations are recommended. However, risk of bleeding should be considered among patients with end-stage liver disease, and prophylactic blood transfusions may be used to prevent bleeding. We performed a retrospective study of the incidence of and risk factors for oral surgery-related bleeding in candidates for LT and hypothesized that complications may occur despite preoperative and perioperative hemostatic actions., Study Design: One hundred thirty-four patients who had tooth extractions performed by oral and maxillofacial surgeons before LT were studied. The primary endpoint was bleeding between 24 hours and 2 weeks after extraction. Bleeding risk was analyzed by preoperative platelet (PLT) count and international normalized ratio (INR). Invasiveness of procedures, severity of liver disease, PLT, INR, prophylactic transfusions of PLT, fresh frozen plasma, and tranexamic acid (TA) were included in univariate and multivariate logistic regression analyses to further assess risk., Results: Twelve patients exhibited minor bleeding; four despite PLT >100 × 10(9)/L and INR <1.5. Increased bleeding associated with INR and prophylactic transfusions by univariate analysis; by multivariate analyses, prophylactic TA (odds ratio [OR] = 8.0; 95% confidence interval [CI] 1.7-37.0), and PLT (OR = 8.3; 95% CI 1.1-62.7) remained significant., Conclusions: Most extractions were safe, but prophylactic transfusions did not ensure adequate hemostasis. Local hemostatic measures and close follow-up are warranted., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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39. Massive oral bleeding after full-mouth extraction in a patient with B-cell lymphocytic leukemia/small lymphocytic lymphoma reversed with recombinant activated factor VII.
- Author
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Sprenker C, Omar HR, Powless RA, Mangar D, and Camporesi E
- Subjects
- Aged, Humans, Male, Oral Hemorrhage drug therapy, Postoperative Hemorrhage drug therapy, Recombinant Proteins therapeutic use, Coagulants therapeutic use, Factor VIIa therapeutic use, Leukemia, Lymphocytic, Chronic, B-Cell complications, Oral Hemorrhage etiology, Postoperative Hemorrhage etiology, Tooth Extraction adverse effects
- Abstract
Background and Overview: Full-mouth extraction can be associated with intraoral bleeding, which usually is controlled with local hemostatic measures. Recombinant activated factor VII (rFVIIa) occasionally is used to stop bleeding in a variety of off-label indications, with the main argument curtailing its use being thrombotic events. The authors describe the use of rFVIIa for bleeding after full-mouth extraction in a patient with undiagnosed B-cell lymphocytic leukemia/small lymphocytic lymphoma., Case Description: A 72-year-old man underwent full-mouth extraction (18 teeth). The next day, the patient experienced massive oral bleeding. The authors administered tranexamic acid, aminocaproic acid, and a total of 12 units of packed red blood cells in addition to local hemostatic measures without control of bleeding. On postoperative day 10, the authors administered 5,000 micrograms of rFVIIa, and within 2 hours oral the bleeding ceased. The authors performed flow cytometry and diagnosed B-cell lymphocytic leukemia/small lymphocytic lymphoma., Conclusions and Practical Implications: Unexplained massive oral bleeding despite adequate local hemostatic measures should prompt further investigations for underlying bleeding or coagulation disorders. The authors describe the successful use of rFVIIa in massive oral bleeding. Further studies are mandatory to study the effectiveness of this drug for this off-label indication., (Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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40. Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions.
- Author
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van Galen KP, Engelen ET, Mauser-Bunschoten EP, van Es RJ, and Schutgens RE
- Subjects
- Aminocaproic Acid therapeutic use, Blood Loss, Surgical prevention & control, Factor IX administration & dosage, Factor VIII administration & dosage, Hemophilia A complications, Hemophilia B complications, Humans, Minor Surgical Procedures adverse effects, Oral Hemorrhage etiology, Postoperative Hemorrhage etiology, Randomized Controlled Trials as Topic, Surgery, Oral, Tranexamic Acid therapeutic use, von Willebrand Diseases complications, Antifibrinolytic Agents therapeutic use, Hemophilia A drug therapy, Hemophilia B drug therapy, Oral Hemorrhage prevention & control, Postoperative Hemorrhage prevention & control, Tooth Extraction adverse effects, von Willebrand Diseases drug therapy
- Abstract
Background: Minor oral surgery or dental extractions (oral or dental procedures) are widely performed and can be complicated by hazardous oral bleeding, especially in people with an inherited bleeding disorder such as haemophilia or Von Willebrand disease. The amount and severity of singular bleedings depend on disease-related factors, such as the severity of the haemophilia, both local and systemic patient factors (such as periodontal inflammation, vasculopathy or platelet dysfunction) and intervention-related factors (such as the type and number of teeth extracted or the dimension of the wound surface). Similar to local haemostatic measures and suturing, antifibrinolytic therapy is a cheap, safe and potentially effective treatment to prevent bleeding complications in individuals with bleeding disorders undergoing oral or dental procedures. However, a systematic review of trials reporting outcomes after oral surgery or a dental procedure in people with an inherited bleeding disorder, with or without, the use of antifibrinolytic agents has not been performed to date., Objectives: The primary objective was to assess the efficacy of local or systemic use of antifibrinolytic agents to prevent bleeding complications in people with haemophilia or Von Willebrand disease undergoing oral or dental procedures. Secondary objectives were to assess if antifibrinolytic agents can replace or reduce the need for clotting factor concentrate therapy in people with haemophilia or Von Willebrand disease and to further establish the effects of these agents on bleeding in oral or dental procedures for each of these populations., Search Methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, compiled from electronic database searches of the Cochrane Central Register of Controlled Trials (CENTRAL), of MEDLINE and from handsearching of journals and conference abstract books. We additionally searched the reference lists of relevant articles and reviews. We searched PubMed, Embase and The Cochrane Library. Additional searches were performed in ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP).Date of last search of the Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register: 14 December 2015., Selection Criteria: Randomised and quasi-randomised controlled trials in people with haemophilia or Von Willebrand disease undergoing oral or dental procedures using antifibrinolytic agents (tranexamic acid or epsilon aminocaproic acid) to prevent perioperative bleeding compared to no intervention or usual care with or without placebo., Data Collection and Analysis: Two authors independently screened the titles and abstracts of all identified articles. Full texts were obtained for potentially relevant abstracts and two authors independently assessed these for inclusion based on the selection criteria. A third author verified trial eligibility. Two authors independently performed data extraction and risk of bias assessments using standardized forms., Main Results: While there were no eligible trials in people with Von Willebrand disease identified, two randomised, double-blind, placebo-controlled trials (total of 59 participants) in people with haemophilia undergoing dental extraction were included. One trial of tranexamic acid published in 1972 included 28 participants with mild, moderate or severe haemophilia A and B and one of epsilon aminocaproic acid published in 1971 included 31 people with haemophilia with factor VIII or factor IX levels less than 15%. Overall, the two included trials showed a beneficial effect of tranexamic acid and EACA, administered systemically, in reducing the number of bleedings, the amount of blood loss and the need for therapeutic clotting factor concentrates. Regarding postoperative bleeding, the tranexamic acid trial showed a risk difference of -0.64 (95% confidence interval -0.93 to - 0.36) and the EACA trial a risk difference of -0.50 (95% confidence interval 0.77 to -0.22). The combined risk difference of both trials was -0.57 (95% confidence interval -0.76 to -0.37), with the quality of the evidence (GRADE) for this outcome is rated as moderate. Side effects occurred once and required stopping epsilon aminocaproic acid (combined risk difference of -0.03 (95% CI -0.08 to 0.13). There was heterogeneity between the two trials regarding the proportion of people with severe haemophilia included, the concomitant standard therapy and fibrinolytic agent treatment regimens used. We cannot exclude that a selection bias has occurred in the epsilon aminocaproic acid trial, but overall the risk of bias appeared to be low for both trials., Authors' Conclusions: Despite the discovery of a beneficial effect of systemically administered tranexamic acid and epsilon aminocaproic acid in preventing postoperative bleeding in people with haemophilia undergoing dental extraction, the limited number of randomised controlled trials identified, in combination with the small sample sizes and heterogeneity regarding standard therapy and treatment regimens between the two trials, do not allow us to conclude definite efficacy of antifibrinolytic therapy in oral or dental procedures in people with haemophilia. No trials were identified in people with Von Willebrand disease.
- Published
- 2015
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41. Acute "Tumour-like" Tongue Haematoma: The Challenge to Diagnose Haemophilia A.
- Author
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Rath A, Nakamura L, van der Werf-Grohmann N, and Zieger B
- Subjects
- Child, Preschool, Diagnosis, Differential, Drug Therapy, Combination, Hemophilia A drug therapy, Humans, Male, Oral Hemorrhage diagnosis, Oral Hemorrhage drug therapy, Tongue Diseases drug therapy, Tranexamic Acid therapeutic use, Hemophilia A complications, Hemophilia A diagnosis, Oral Hemorrhage etiology, Tongue Diseases diagnosis, Tongue Neoplasms diagnosis
- Published
- 2015
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42. Haemorrhagic lesions in oral mucosa as the presentation of idiopathic thrombocytopenic purpura.
- Author
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Sanchis-Picó C, Morales-Angulo C, and García-Zornoza R
- Subjects
- Aged, Ecchymosis etiology, Hemorrhagic Disorders chemically induced, Humans, Male, Mouth Mucosa blood supply, Platelet Aggregation Inhibitors adverse effects, Purpura, Thrombocytopenic, Idiopathic complications, Telangiectasis etiology, Oral Hemorrhage etiology, Purpura, Thrombocytopenic, Idiopathic diagnosis
- Published
- 2015
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43. An adult blind man presenting severe impairment of the right finger, ecchymosis in the thorax region, and haemorrhagic blisters on the oral mucosa.
- Author
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Chaves FN, Fonteles CS, Carvalho FS, Ribeiro TR, Pereira KM, and Costa FW
- Subjects
- Blindness complications, Fingers, Humans, Male, Middle Aged, Mouth Mucosa, Thorax, Blister etiology, Ecchymosis etiology, Hand Dermatoses etiology, Oral Hemorrhage etiology, Purpura, Thrombocytopenic, Idiopathic complications, Purpura, Thrombocytopenic, Idiopathic diagnosis
- Published
- 2015
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44. Evaluation of palatal donor site haemostasis and wound healing after free gingival graft surgery.
- Author
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Keceli HG, Aylikci BU, Koseoglu S, and Dolgun A
- Subjects
- Adult, Blood Loss, Surgical, Color, Female, Follow-Up Studies, Gingivoplasty methods, Humans, Male, Operative Time, Oral Hemorrhage etiology, Pain Measurement methods, Pain, Postoperative etiology, Prospective Studies, Re-Epithelialization physiology, Sensation physiology, Wound Healing physiology, Young Adult, Free Tissue Flaps transplantation, Gingiva transplantation, Hemostatics therapeutic use, Palate surgery, Phytotherapy methods, Plant Extracts therapeutic use, Plants, Medicinal, Transplant Donor Site surgery
- Abstract
Aim: Evaluating effectiveness of a medicinal plant extract (MPE) in achieving haemostasis and early wound healing at free gingival graft (FGG) donor site in a randomized controlled fashion., Methods: Forty patients requiring FGG at lower anterior area were randomly assigned into two groups. FGG was performed to all patients and following graft procurement; wet gauze (WG) was applied alone (control: WG group) or with MPE (test: MPE + WG group) for haemostasis. Donor site working time, bleeding (BLE), colour match (CM), pain, epithelization (EP) and sensation loss (SL) were evaluated., Results: Thirty-three participants completed a 6-month period study. In the test group, primary BLE was shorter (p < 0.001) and fewer individuals showed secondary BLE during 3 days (p < 0.001). During the 6 days, pain scores were higher in WG patients (p < 0.05). Later on, no inter-group difference was observed. EP was relatively faster (p < 0.001) and CM was slightly better (p < 0.05) in MPE + WG group., Conclusion: MPE provided faster and continuous haemostasis that made a positive contribution to the early soft tissue healing to some extent but due to limitations; further trials are needed to demonstrate the efficiency of this material., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2015
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45. Efficacy of antibiotic prophylaxis on postoperative inflammatory complications in Chinese patients having impacted mandibular third molars removed: a split-mouth, double-blind, self-controlled, clinical trial.
- Author
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Xue P, Wang J, Wu B, Ma Y, Wu F, and Hou R
- Subjects
- Adolescent, Adult, Amoxicillin therapeutic use, Anti-Bacterial Agents therapeutic use, Clindamycin therapeutic use, Cross-Over Studies, Double-Blind Method, Female, Fever etiology, Humans, Male, Mandible surgery, Middle Aged, Operative Time, Oral Hemorrhage etiology, Oral Ulcer etiology, Osteotomy methods, Pain, Postoperative etiology, Placebos, Postoperative Hemorrhage etiology, Treatment Outcome, Young Adult, Antibiotic Prophylaxis, Dry Socket prevention & control, Molar, Third surgery, Surgical Wound Infection prevention & control, Tooth, Impacted surgery
- Abstract
We investigated the effect of antibiotic prophylaxis on postoperative inflammatory complications after operations for impacted mandibular third molars in Chinese patients. A total of 207 patients had their bilateral third molars removed in a split-mouth, double-blind, self-controlled, clinical trial in two visits. For one side amoxicillin (or clindamycin) was given (antibiotic group) from one hour before operation until 3 days postoperatively. For the other side a placebo was given (placebo group) at the same time. The outcome, including alveolar osteitis, surgical wound infection, prebuccal infection, and infection of the anterior isthmus of fauces, was assessed 2 and 10 days postoperatively. A total of 192 patients completed the study, and there was no difference between the groups in the incidence of inflammatory complications. In the treatment group, there were 4 cases of alveolar osteitis (2%), 2 infections of the wound (1%), and 14 other reactions (gastrointestinal (n=4), bleeding (n=2), ulcer (n=2), and fever (n=6)). In the placebo group, there were 6 cases of alveolar osteitis (3%), 2 wound infections (1%), and 22 other reactions (bleeding (n=6), ulcer (n=2) and fever (n=14)). There was no significant difference in the extraction time and postoperative reactions, except the pain score on day 10 (p=0.005). Prophylactic amoxicillin (or clindamycin) is not effective for the prevention or reduction of postoperative inflammatory complications after the removal of impacted mandibular third molars in Chinese patients., (Copyright © 2015. Published by Elsevier Ltd.)
- Published
- 2015
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46. Should aspirin be stopped before tooth extraction? A meta-analysis.
- Author
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Zhao B, Wang P, Dong Y, Zhu Y, and Zhao H
- Subjects
- Humans, Aspirin administration & dosage, Oral Hemorrhage etiology, Oral Hemorrhage prevention & control, Tooth Extraction
- Abstract
Objective: To carry out a standard meta-analysis to determine if aspirin should be stopped before tooth extraction., Study Design: The PubMed, ScienceDirect, EBSCOhost, and Science Citation Index databases were searched for studies published up to September 30, 2014. Eligible studies were restricted to randomized controlled trials (RCTs) and controlled, nonrandomized trials., Results: Three RCTs and seven controlled trials met the inclusion criteria (covering 1752 patients: 529 on aspirin therapy and 1223 not on aspirin therapy). The results showed that the risk of postoperative hemorrhage was significantly higher in patients on aspirin therapy (relative risk [RR] = 2.46; 95% confidence interval [CI]: 1.45-4.81) but that bleeding time (BT) was not significantly different between the two groups (standardized mean difference [SMD] = 0.63; 95% CI: -0.04 to 1.31). Sensitivity analyses showed that the results were unstable., Conclusions: We could reach a conclusion that BT is prolonged or hemorrhage is exacerbated by long-term use of aspirin. We recommend not stopping long-term aspirin use before tooth extraction but enhancing hemostasis methods, if necessary., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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47. Risk factors for postoperative hemorrhage after minor oral surgery in patients treated with antithrombotic agents.
- Author
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Ohba S, Yoshimura H, Matsuda S, Kobayashi J, Kimura T, Aiki M, Nagase J, Ishimaru K, and Sano K
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, International Normalized Ratio, Male, Middle Aged, Partial Thromboplastin Time, Risk Factors, Fibrinolytic Agents administration & dosage, Oral Hemorrhage etiology, Oral Surgical Procedures, Platelet Aggregation Inhibitors administration & dosage, Postoperative Hemorrhage etiology, Warfarin administration & dosage
- Abstract
It has been proposed that minor oral surgery can be performed safely in patients taking antithrombotic therapy without interrupting treatment; however, there is little evidence-based guidance about how to manage postoperative hemorrhage in patients taking antithrombotics, and few randomized trials that help to inform the risk-benefit ratio of continuing or suspending antithrombotic therapy. The aim of this study was to identify risk factors for postoperative hemorrhage to create a protocol for patients undergoing minor oral surgery with antithrombotic therapy. One hundred and two patients were enrolled, who subsequently underwent 142 minor oral surgical procedures while taking antithrombotic therapy. Demographic details including age and sex, laboratory coagulation investigations, and episodes of postoperative hemorrhage were recorded. The prothrombin time-international normalized ratio (PT-INR) of participants taking warfarin was <3.0 in all cases (mean 1.89 ± standard deviation 0.52; range 1.11-2.82). The activated partial thromboplastin time (APTT) was significantly associated with postoperative hemorrhage, which was significantly increased in patients taking warfarin alone or in combination with an antiplatelet agent compared with an antiplatelet agent alone. In 7 cases, postoperative hemorrhage continued for 4 days and more, requiring additional local hemostatic management. Our findings suggest that minor oral surgery can be performed under antithrombotic therapy without the need of discontinuing the antithrombotic agents. Local hemostatic materials did not suppress postoperative hemorrhage. APTT is a possible prediction factor for postoperative hemorrhage in such patients and, therefore, should be determined prior to minor oral surgery in addition to PT-INR value.
- Published
- 2015
- Full Text
- View/download PDF
48. Re: Bajkin BV, Urosevic IM, Stankov KM, Petrovic BB, Bajkin IA. Dental extractions and risk of bleeding in patients taking single and dual antiplatelet treatment.
- Author
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Curto A
- Subjects
- Female, Humans, Male, Oral Hemorrhage etiology, Platelet Aggregation Inhibitors therapeutic use, Postoperative Hemorrhage etiology, Tooth Extraction
- Published
- 2015
- Full Text
- View/download PDF
49. Dental surgery in anticoagulated patients--stop the interruption.
- Author
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Wahl MJ, Pinto A, Kilham J, and Lalla RV
- Subjects
- Contraindications, Dental Care for Chronically Ill, Hemostasis, Surgical, Humans, Oral Hemorrhage etiology, Risk Factors, Thromboembolism etiology, Anticoagulants administration & dosage, Blood Loss, Surgical prevention & control, Oral Hemorrhage prevention & control, Oral Surgical Procedures, Thromboembolism prevention & control
- Abstract
In a literature review, the incidence and morbidity of bleeding complications after dental surgery in anticoagulated patients was compared with embolic complications when anticoagulation was interrupted. Over 99% of anticoagulated patients had no postoperative bleeding that required more than local hemostatic measures. Of more than 5431 patients undergoing more than 11,381 surgical procedures, with many patients at higher than present therapeutic intenational normalized ratio (INR) levels, only 31 (∼0.6% of patients) required more than local hemostasis to control the hemorrhage; none died due to hemorrhage. Among at least 2673 patients whose warfarin dose was reduced or withdrawn for at least 2775 visits for dental procedures, there were 22 embolic complications (0.8% of cessations), including 6 fatal events (0.2% of cessations). The embolic morbidity risk in patients whose anticoagulation is interrupted for dental surgery exceeds that of significant bleeding complications in patients whose anticoagulation is continued, even when surgery is extensive. Warfarin anticoagulation, therefore, should not be interrupted for most dental surgery., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
50. Dental extractions and risk of bleeding in patients taking single and dual antiplatelet treatment.
- Author
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Bajkin BV, Urosevic IM, Stankov KM, Petrovic BB, and Bajkin IA
- Subjects
- Absorbable Implants, Aged, Aspirin administration & dosage, Aspirin therapeutic use, Clopidogrel, Collagen, Ecchymosis etiology, Female, Hematoma etiology, Hemostasis, Surgical instrumentation, Hemostatic Techniques, Humans, Male, Middle Aged, Prasugrel Hydrochloride administration & dosage, Prasugrel Hydrochloride therapeutic use, Prospective Studies, Risk Factors, Surgical Sponges, Suture Techniques, Ticlopidine administration & dosage, Ticlopidine analogs & derivatives, Ticlopidine therapeutic use, Time Factors, Oral Hemorrhage etiology, Platelet Aggregation Inhibitors therapeutic use, Postoperative Hemorrhage etiology, Tooth Extraction
- Abstract
Our aim was to evaluate the effects of single and dual antiplatelet treatment on postoperative bleeding in patients having dental extractions. The prospective clinical study included 160 patients who were taking antiplatelet drugs. The first group (n=43) were taking 2 drugs, mostly aspirin and clopidogrel, and the second group (n=117) were taking a single antiplatelet drug in the form of aspirin (n=84), clopidogrel (n=20), and ticlopidine (n=13). All patients had simple dental extractions, and local haemostasis was with resorbable collagen sponges, without suturing of the wound. The control group comprised 105 healthy subjects with a similar number of dental extractions. Bleeding was an "event" if it continued for more than 12h, made the patient call or return to the dental practice or emergency department, induced a large haematoma or ecchymosis within the oral soft tissues, or required blood transfusion. A total of 110 teeth were extracted on 59 occasions in the dual drug group, and 232 teeth on 128 occasions in the single drug group. Bleeding was recorded after extraction in only one patient on dual aspirin-clopidogrel treatment, which was mild and easily controlled by local haemostasis. The incidence of postoperative bleeding did not differ significantly among the three groups (χ(2)=4.3, p=0.11). However, the wound was sutured to achieve effective initial local haemostasis in 4/59 (6.8%) and 2/128 (1.6%) occasions of tooth extractions in the dual and single drug groups, respectively, and none in the control group (χ(2)=10.02, p=0.007). Patients taking single or dual antiplatelet drugs may have teeth extracted safely without interruption of treatment using only local haemostatic measures., (Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
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