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ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery

Year 2013, Volume: 47 Issue: 3, 33 - 40, 12.12.2013

Abstract

ÖZ

Amaç: Hemofili, faktör VIII yada faktör IX eksikliğine bağlı, koagülasyon bozukluğuna sebep olan herediter bir hastalıktır. Diş tedavileri sonrasında aşırı kanama en sık karşılaşılan komplikasyondur. Bu çalışmanın amacı hemofili hastalarına uygulanan güncel tedavi yaklaşımlarını, uygulanan faktör protokollerini belirtmek ve dental yaklaşımı retrospektif olarak incelemektir.

Gereç ve Yöntem: İstanbul Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş, Çene Cerrahisi A.D.'na başvuran 15'i Hemofili A, 1'i Hemofili B, 4'ü Von Willebrand olmak üzere toplam 20 koagülasyon bozukluğu hastası çalışmamıza dahil edilmiştir. Bu hastalara oral cerrahi girişimler ve periodontal tedaviler atravmatik çalışılarak uygulanmıştır.

Bulgular: Ağır hemofili hastalarının dördünde post-operatif olarak orta dereceli kanama gözlendi. Kanamalar 1(%5) hastada lokal olarak traneksamik asit uygulaması ve 3(%15) hastada Ankaferd Blood Stopper uygulanarak kontrol altına alındı. Bir hastada lokal anestezi yapılan bölgede hematom oluşmuştur.

Sonuç: Diş hekimleri kanama bozukluğu hastalarda çalışırken, kanama kontrolünün tüm parametrelerine dikkat etmeli, atravmatik cerrahi teknikleri tercih etmelidirler.

Anahtar kelimeler: Hemofili A, hemofili B, von Willebrand hastalığı, oral cerrahi

ABSTRACT

Purpose: Hemophilia is a hereditary disorder of coagulation results in deficiency of factor VIII (Hemophilia A) or factor IX (haemophilia B). Excessive bleeding after dental procedures are one of the most frequent complications occurring in these patientsThe aim of this study is to present current surgical approach procedures to hemophilia patients with case series and literature review as a retrospective study.

Material and Methods: We included twenty Heamophiliac patients (15 Hemophila A, 1 Hemophilia B, 4 Von Wileebrand) who consulted to İstanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery to our study. We performed oral surgical procedures and periodontal treatments to our patients atraumatically.

Results: Four of severe Hemophiliac patient revealed mild level bleeding. One of these patients (%5) recieved tranecsamic asid and three of them (%15) received Ankaferd Blood Stopper. Then we contorol-led the bleeding. In one patient, we observed hematoma on the side where we applied local anesthesia.

Conclusion: Oral care providers that treat patients with bleeding disorders should be aware of all the measures for controlling bleeding and the principles of atraumatic surgery.

Keywords: Hemophilia A, hemophilia B, von Willebrand disease, oral surgery

References

  • Ak G, Ünür M, Zülfikar B. Hemofili hastalarında ağız-diş sağlığı. Turkiye Klinikleri J Sci, 1998; 18(2): 141-44. Hoyer LW. Hemophilia A. N Engl J Med, 1994; 330(1): 38-47. Berk Ö. Kan hastalıkları. Ankara: Türkiye Klinikleri Yayınevi, 1989. Bloom AL. Inherited disorders of blood coagulations. In: Bloom AL, Thomas DP, editors. Haemostasis and thrombosis. 2nd ed., Edinburgh: Churchill Livingstone, 1987, p.393-436. Gedikoğlu G, Zülfikar B, Devecioğlu
  • Ö, Ovalı F, Ayan I. An approach to hemophilia A, presenting with intracranial hemorrhage. Med Bull İstanbul, 1991; 24: 169-76. Frachon X, Pommereuil M, Berthier
  • AM, Lejeune S, Hourdin-Eude S, Quéro J, Mézière X, De Mello G, Garnier J. Management options for dental extraction in hemophiliacs: a study of 55 extractions (20002002). Oral Surg Oral Med Oral Pathol Oral
  • Radiol Endod, 2005; 99(3): 270-75. Bajkin BV, Rajic NV, Vujkov SB. Dental extraction in a hemophilia patient without factor replacement therapy: a case report. J
  • Oral Maxillofac Surg, 2012; 70(10): 2276Kelley LA. Raising child with hemophilia: a practical guide for parents. Blue Bell
  • Pennsylvania: Armour Pharmaceutical Company, 1993. Witmer C, Young G. Factor VIII inhibitors in hemophilia A: rationale and latest evidence. Ther Adv Hematol, 2013; 4(1): 59– Biggs R, Spooner RJ. National survey of haemophilia and Christmas disease patients in the United Kingdom: report on behalf of the Haemophilia Reference Centre directors of the U.K. Lancet, 1978; 1(8074): 1143 Fraser BM, Poon MC, Hoar DI. Identification of factor IX mutations in haemophilia B: application of polymerase chain reaction and single strand conformation analysis. Hum Genet, 1992; 88(4): 426-30.
  • Çilingir O, Müslümanoğlu MH, Özdemir M, Kavaklı K, Solak M, Artan S. Türk hemofili B hastalarında faktör IX geni mutasyonları. Kocatepe Tıp Dergisi, 2005; 6(1): 1-6.
  • Katz JO, Terezhalmy GT. Dental management of the patients with hemophilia. Oral Surg Oral Med Oral Pathol, 1988; 66(1): 139–44.
  • Piot B, Fiks-Sigaud M, Ferri J, Gordeeff A, Mercier J. Les extractions dentaires chez les he´mophiles et lesporteurs de la maladie de Willebrand. Propositionsthe´rapeutiques a` propos de 26 observations. Rev Stomatol Chir Maxillofac, 1994; 95(4): 263–67.
  • Keila S, Kaufman A, Itckowitch D. Uncontrolled bleeding during endodontic treatment as the first symptoms for diagnosing von Willebrand’s disease. Oral Surg Oral Med Oral Pathol, 1990; 69(2): 243–46. Vinckier F, Vermylen J. Dental extractions in hemophilia: reflections on 10 years experience. Oral Surg Oral Med Oral Pathol, 1985; 59(1): 6–9.
  • Heiland M, Weber M, Schmelzle R. Life-threatening bleeding after dental extraction in a hemophilia A patient with inhibitors to factor VIII: a case report. J Oral Maxillofac Surg, 2003; 61(1): 1350–53.
  • Mannucci PM, Tuddenham EG. The hemophilias –from royal genes to gene therapy. N Engl J Med, 2001; 344(23): 1773–79. Franchini M, Rossetti G, Tagliaferri A, Pattacini C, Pozzoli D, Lorenz C, Del Dot L, Ugolotti G, Dell’aringa C, Gandini G. Dental procedures in adult patients with hereditary bleeding disorders: 10 years experience in three Italian Hemophilia Centers. Haemophilia, 2005; 11(5): 504–09.
  • Lynch MA, Brightman VJ, Greenberg MS. Burket’s oral medicine, diagnosis and treatment. Philadelpha: JB Lippincott Co, 1994, p.554.
  • Lusher JM. Considerations for current and future management of haemophilia and its complications. Haemophilia, 1995; 1(1): 2- Zülfikar B, Akkuş A. Çocuklarda hemofili hastalığı. İstanbul: Emin Matbaacılık, 19 Cawson RA. Essentials of dental surgery and pathology. Hong Kong: Churcill
  • Livingstone, 1991. Zülfikar B. Hemofili el kitabı. İstanbul: Türkiye Hemofili Derneği Yayınları, 1997. Zanon E, Martinelli F, Bacci C, Zerbinati P, Girolami A. Proposal of a standart approach to dental extraction in haemophilia patients. A case-control study with good results. Haemophilia, 2000; 6(5): 533-36. Kumar JN, Kumar RA, Varadarajan
  • R, Sharma N. Specialty dentistry for the hemophiliac: is there a protocol in place? Indian J Dent Res, 2007; 18(2): 48-54. Brewer A, Correa ME. Guidelines for dental treatment of patients with inherited bleeding disorders. Treatment of Hemophilia, 2006; 40: 1-13. Hobson P. Dental care of children with haemophilia and related conditions. Br Dent
  • J, 1981; 151(8): 249-53. Ermiş G, Kavaklı K, Polat A, Koca H, Ertuğrul F, Aydınok Y, Çetingül E, Nişli G, Kantar M, Çetingül N, Öztop S. Dental care and current therapy in Turkish hemophiliacs.
  • Haemophilia, 1998; 4(suppl): 305a. Baskirt EA, Albayrak H, Ak G, Erdem
  • AP, Sepet E, Zülfikar B. Dental and periodontal health in children with hemophilia. Journal of Coagulation Disorders, 2009; 1(1): 7-10. Yazışma Adresi: Gülsüm AK
  • İstanbul Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi A.D. Tel: 0212 414 20 20 e-posta: akgulsum@yahoo.com

ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR

Year 2013, Volume: 47 Issue: 3, 33 - 40, 12.12.2013

Abstract

Amaç: Hemofili, faktör VIII yada faktör IX eksikliğine bağlı, koagülasyon bozukluğuna sebep olan herediter bir hastalıktır. Diş tedavileri sonrasında aşırı kanama en sık karşılaşılan komplikasyondur. Bu çalışmanın amacı hemofili hastalarına uygulanan güncel tedavi yaklaşımlarını, uygulanan faktör protokollerini belirtmek ve dental yaklaşımı retrospektif olarak incelemektir.Gereç ve Yöntem: İstanbul Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş, Çene Cerrahisi A.D.’na başvuran 15’i Hemofili A, 1’i Hemofili B, 4’ü Von Willebrand olmak üzere toplam 20 koagülasyon bozukluğu hastası çalışmamıza dahil edilmiştir. Bu hastalara oral cerrahi girişimler ve periodontal tedaviler atravmatik çalışılarak uygulanmıştır.Bulgular: Ağır hemofili hastalarının dördünde post-operatif olarak orta dereceli kanama gözlendi. Kanamalar 1(%5) hastada lokal olarak traneksamik asit uygulaması ve 3(%15) hastada Ankaferd Blood Stopper uygulanarak kontrol altına alındı. Bir hastada lokal anestezi yapılan bölgede hematom oluşmuştur.Sonuç: Diş hekimleri kanama bozukluğu hastalarda çalışırken, kanama kontrolünün tüm parametrelerine dikkat etmeli, atravmatik cerrahi teknikleri tercih etmelidirler.

References

  • Ak G, Ünür M, Zülfikar B. Hemofili hastalarında ağız-diş sağlığı. Turkiye Klinikleri J Sci, 1998; 18(2): 141-44. Hoyer LW. Hemophilia A. N Engl J Med, 1994; 330(1): 38-47. Berk Ö. Kan hastalıkları. Ankara: Türkiye Klinikleri Yayınevi, 1989. Bloom AL. Inherited disorders of blood coagulations. In: Bloom AL, Thomas DP, editors. Haemostasis and thrombosis. 2nd ed., Edinburgh: Churchill Livingstone, 1987, p.393-436. Gedikoğlu G, Zülfikar B, Devecioğlu
  • Ö, Ovalı F, Ayan I. An approach to hemophilia A, presenting with intracranial hemorrhage. Med Bull İstanbul, 1991; 24: 169-76. Frachon X, Pommereuil M, Berthier
  • AM, Lejeune S, Hourdin-Eude S, Quéro J, Mézière X, De Mello G, Garnier J. Management options for dental extraction in hemophiliacs: a study of 55 extractions (20002002). Oral Surg Oral Med Oral Pathol Oral
  • Radiol Endod, 2005; 99(3): 270-75. Bajkin BV, Rajic NV, Vujkov SB. Dental extraction in a hemophilia patient without factor replacement therapy: a case report. J
  • Oral Maxillofac Surg, 2012; 70(10): 2276Kelley LA. Raising child with hemophilia: a practical guide for parents. Blue Bell
  • Pennsylvania: Armour Pharmaceutical Company, 1993. Witmer C, Young G. Factor VIII inhibitors in hemophilia A: rationale and latest evidence. Ther Adv Hematol, 2013; 4(1): 59– Biggs R, Spooner RJ. National survey of haemophilia and Christmas disease patients in the United Kingdom: report on behalf of the Haemophilia Reference Centre directors of the U.K. Lancet, 1978; 1(8074): 1143 Fraser BM, Poon MC, Hoar DI. Identification of factor IX mutations in haemophilia B: application of polymerase chain reaction and single strand conformation analysis. Hum Genet, 1992; 88(4): 426-30.
  • Çilingir O, Müslümanoğlu MH, Özdemir M, Kavaklı K, Solak M, Artan S. Türk hemofili B hastalarında faktör IX geni mutasyonları. Kocatepe Tıp Dergisi, 2005; 6(1): 1-6.
  • Katz JO, Terezhalmy GT. Dental management of the patients with hemophilia. Oral Surg Oral Med Oral Pathol, 1988; 66(1): 139–44.
  • Piot B, Fiks-Sigaud M, Ferri J, Gordeeff A, Mercier J. Les extractions dentaires chez les he´mophiles et lesporteurs de la maladie de Willebrand. Propositionsthe´rapeutiques a` propos de 26 observations. Rev Stomatol Chir Maxillofac, 1994; 95(4): 263–67.
  • Keila S, Kaufman A, Itckowitch D. Uncontrolled bleeding during endodontic treatment as the first symptoms for diagnosing von Willebrand’s disease. Oral Surg Oral Med Oral Pathol, 1990; 69(2): 243–46. Vinckier F, Vermylen J. Dental extractions in hemophilia: reflections on 10 years experience. Oral Surg Oral Med Oral Pathol, 1985; 59(1): 6–9.
  • Heiland M, Weber M, Schmelzle R. Life-threatening bleeding after dental extraction in a hemophilia A patient with inhibitors to factor VIII: a case report. J Oral Maxillofac Surg, 2003; 61(1): 1350–53.
  • Mannucci PM, Tuddenham EG. The hemophilias –from royal genes to gene therapy. N Engl J Med, 2001; 344(23): 1773–79. Franchini M, Rossetti G, Tagliaferri A, Pattacini C, Pozzoli D, Lorenz C, Del Dot L, Ugolotti G, Dell’aringa C, Gandini G. Dental procedures in adult patients with hereditary bleeding disorders: 10 years experience in three Italian Hemophilia Centers. Haemophilia, 2005; 11(5): 504–09.
  • Lynch MA, Brightman VJ, Greenberg MS. Burket’s oral medicine, diagnosis and treatment. Philadelpha: JB Lippincott Co, 1994, p.554.
  • Lusher JM. Considerations for current and future management of haemophilia and its complications. Haemophilia, 1995; 1(1): 2- Zülfikar B, Akkuş A. Çocuklarda hemofili hastalığı. İstanbul: Emin Matbaacılık, 19 Cawson RA. Essentials of dental surgery and pathology. Hong Kong: Churcill
  • Livingstone, 1991. Zülfikar B. Hemofili el kitabı. İstanbul: Türkiye Hemofili Derneği Yayınları, 1997. Zanon E, Martinelli F, Bacci C, Zerbinati P, Girolami A. Proposal of a standart approach to dental extraction in haemophilia patients. A case-control study with good results. Haemophilia, 2000; 6(5): 533-36. Kumar JN, Kumar RA, Varadarajan
  • R, Sharma N. Specialty dentistry for the hemophiliac: is there a protocol in place? Indian J Dent Res, 2007; 18(2): 48-54. Brewer A, Correa ME. Guidelines for dental treatment of patients with inherited bleeding disorders. Treatment of Hemophilia, 2006; 40: 1-13. Hobson P. Dental care of children with haemophilia and related conditions. Br Dent
  • J, 1981; 151(8): 249-53. Ermiş G, Kavaklı K, Polat A, Koca H, Ertuğrul F, Aydınok Y, Çetingül E, Nişli G, Kantar M, Çetingül N, Öztop S. Dental care and current therapy in Turkish hemophiliacs.
  • Haemophilia, 1998; 4(suppl): 305a. Baskirt EA, Albayrak H, Ak G, Erdem
  • AP, Sepet E, Zülfikar B. Dental and periodontal health in children with hemophilia. Journal of Coagulation Disorders, 2009; 1(1): 7-10. Yazışma Adresi: Gülsüm AK
  • İstanbul Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi A.D. Tel: 0212 414 20 20 e-posta: akgulsum@yahoo.com
There are 20 citations in total.

Details

Primary Language English
Journal Section Original Research Articles
Authors

Mustafa Açıkgöz This is me

Gamze Güven This is me

Bülent Zülfikar This is me

Gülsüm Ak This is me

Publication Date December 12, 2013
Published in Issue Year 2013 Volume: 47 Issue: 3

Cite

APA Açıkgöz, M., Güven, G., Zülfikar, B., Ak, G. (2013). ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery. Journal of Istanbul University Faculty of Dentistry, 47(3), 33-40.
AMA Açıkgöz M, Güven G, Zülfikar B, Ak G. ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery. J Istanbul Univ Fac Dent. December 2013;47(3):33-40.
Chicago Açıkgöz, Mustafa, Gamze Güven, Bülent Zülfikar, and Gülsüm Ak. “ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery”. Journal of Istanbul University Faculty of Dentistry 47, no. 3 (December 2013): 33-40.
EndNote Açıkgöz M, Güven G, Zülfikar B, Ak G (December 1, 2013) ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery. Journal of Istanbul University Faculty of Dentistry 47 3 33–40.
IEEE M. Açıkgöz, G. Güven, B. Zülfikar, and G. Ak, “ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery”, J Istanbul Univ Fac Dent, vol. 47, no. 3, pp. 33–40, 2013.
ISNAD Açıkgöz, Mustafa et al. “ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery”. Journal of Istanbul University Faculty of Dentistry 47/3 (December 2013), 33-40.
JAMA Açıkgöz M, Güven G, Zülfikar B, Ak G. ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery. J Istanbul Univ Fac Dent. 2013;47:33–40.
MLA Açıkgöz, Mustafa et al. “ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery”. Journal of Istanbul University Faculty of Dentistry, vol. 47, no. 3, 2013, pp. 33-40.
Vancouver Açıkgöz M, Güven G, Zülfikar B, Ak G. ORAL CERRAHİDE HEMOFİLİ HASTALARINA GÜNCEL YAKLAŞIMLAR-Current Surgical Procedures for Hemophilic Patients in Oral Surgery. J Istanbul Univ Fac Dent. 2013;47(3):33-40.