Pier Carmine Passarelli1, Paolo De Angelis2, Guido Pasquantonio3, Paolo Francesco Manicone4, Fernando Verdugo5, Antonio D'Addona6. 1. Master Coordinator, Oral Surgery and Implantology Unit, Fondazione Policlinico A. Gemelli, Catholic University of Sacred Heart, Rome, Italy. Electronic address: piercarminepassarelli@hotmail.it. 2. Resident, Oral Surgery and Implantology Unit, Fondazione Policlinico A. Gemelli, Catholic University of Sacred Heart, Rome, Italy. 3. Associate Professor, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy. 4. Aggregate Professor, Oral Surgery and Implantology Unit, Fondazione Policlinico A. Gemelli, Catholic University of Sacred Heart, Rome, Italy. 5. Private Practitioner, Department of Periodontics, Veterans Affairs Hospital, Greater Los Angeles Healthcare System, and Private Practice, Altadena, CA. 6. Professor, Oral Surgery and Implantology Unit, Fondazione Policlinico A. Gemelli, Catholic University of Sacred Heart, Rome, Italy.
Abstract
PURPOSE: The aim of the present study was to analyze the management of single dental extractions and postoperative bleeding in patients with a diagnosis of factor V deficiency. A careful evaluation of each case will allow the team to categorize the risk and operate safely, minimizing the incidence of intraoperative and postoperative complications. If necessary, the oral-maxillofacial surgeon can choose to do so in collaboration with the hematologist on a case-by-case basis. PATIENTS AND METHODS: The present retrospective study included 5 patients with mild congenital factor V deficiency who had undergone at least 1 dental extraction. Mouth rinse with tranexamic acid, nonresorbable sutures, and gelatin sponge packed in the alveolar socket were used to obtain hemostasis. No systemic therapies, such as fresh frozen plasma, platelet concentrate, or recombinant activated factor VII, were administered. RESULTS: Twenty-five teeth were extracted. The factor V plasma levels ranged from 14.1 to 22.4%. Local antihemorrhagic treatments resulted in good hemostasis. No hemorrhagic complications or intraoperative or postoperative major bleeding was observed. CONCLUSIONS: Dental extractions appear to be safe procedures for patients with mild factor V deficiency when a bleeding risk assessment has been performed in conjunction with a hematologist and an appropriate treatment protocol is followed. Our treatment protocol was found to be effective and well tolerated by all the patients.
PURPOSE: The aim of the present study was to analyze the management of single dental extractions and postoperative bleeding in patients with a diagnosis of factor V deficiency. A careful evaluation of each case will allow the team to categorize the risk and operate safely, minimizing the incidence of intraoperative and postoperative complications. If necessary, the oral-maxillofacial surgeon can choose to do so in collaboration with the hematologist on a case-by-case basis. PATIENTS AND METHODS: The present retrospective study included 5 patients with mild congenital factor V deficiency who had undergone at least 1 dental extraction. Mouth rinse with tranexamic acid, nonresorbable sutures, and gelatin sponge packed in the alveolar socket were used to obtain hemostasis. No systemic therapies, such as fresh frozen plasma, platelet concentrate, or recombinant activated factor VII, were administered. RESULTS: Twenty-five teeth were extracted. The factor V plasma levels ranged from 14.1 to 22.4%. Local antihemorrhagic treatments resulted in good hemostasis. No hemorrhagic complications or intraoperative or postoperative major bleeding was observed. CONCLUSIONS: Dental extractions appear to be safe procedures for patients with mild factor V deficiency when a bleeding risk assessment has been performed in conjunction with a hematologist and an appropriate treatment protocol is followed. Our treatment protocol was found to be effective and well tolerated by all the patients.
Authors: P C Passarelli; M A Lopez; V Desantis; G B Piccirillo; E Rella; V Giovannini; A Speranza; M De Leonardis; P F Manicone; M Casale; A D'Addona Journal: Antibiotics (Basel) Date: 2020-04-29
Authors: Pier Carmine Passarelli; Stefano Pagnoni; Giovan Battista Piccirillo; Viviana Desantis; Michele Benegiamo; Antonio Liguori; Raffaele Papa; Piero Papi; Giorgio Pompa; Antonio D'Addona Journal: Int J Environ Res Public Health Date: 2020-04-09 Impact factor: 3.390