Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

Severe Recurrent Gingival Bleeding and Toothache Control in a Patient with Liver Cirrhosis and Oral Metastatic Hepatoma: Report of a Case

간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고

  • Lee, Chun-Ui (Department of Oral Maxillofacial Surgery, College of Dentistry, Wonju Christian Hospital, Yonsei University) ;
  • Mo, Dong-Yub (Department of Oral Maxillofacial Surgery, College of Dentistry, Wonju Christian Hospital, Yonsei University) ;
  • Yoo, Jae-Ha (Department of Oral Maxillofacial Surgery, College of Dentistry, Wonju Christian Hospital, Yonsei University) ;
  • Choi, Byung-Ho (Department of Oral Maxillofacial Surgery, College of Dentistry, Wonju Christian Hospital, Yonsei University) ;
  • Kim, Jong-Bae (Department of Dentistry, Oral and Maxillofacial Surgery, Dongsan Medical Center, College of Medicine, Keimyung University)
  • 이천의 (연세대학교 치과대학 원주기독병원 구강악안면외과학교실) ;
  • 모동엽 (연세대학교 치과대학 원주기독병원 구강악안면외과학교실) ;
  • 유재하 (연세대학교 치과대학 원주기독병원 구강악안면외과학교실) ;
  • 최병호 (연세대학교 치과대학 원주기독병원 구강악안면외과학교실) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과학교실 구강악안면외과)
  • Received : 2010.08.04
  • Accepted : 2010.09.07
  • Published : 2010.11.30
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Abstract

The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

Keywords

References

  1. Sabiston DC : Textbook of surgery, Vol I. 13th ed. Philadelphia, WB Saunders Co, 1986, p.23.
  2. Kim GB, Kim CG, Lee YG et al : Contemporary surgery. Seoul, Il Cho Gak Publishing Co, 1987, p.96.
  3. Falace DA : Emergency dental care. Baltimore, Williams & Wilkins Co, 1995, p.227.
  4. Little JW, Falace DA, Miller CS, Rhodus NL : Dental management of the medically compromised patient, 6th ed. Saint Louis, CV Mosby Co, 2002, p.332.
  5. Glickman I : Clinical periodontology. Philadelphia, WB Saunders Co, 1972, p.123.
  6. Conley JJ : Blood vessel complications. In : Conley JJ. Complications of head and neck surgery. Philadelphia, WB Saunders Co, 1979, p.66.
  7. Kim SN, Yum KW, Lee MS et al : Emergency care in dental office, 3rd ed. Seoul, Jee Sung Publishing Co, p.162.
  8. Schulger S. Yuodelis RA Page R : Periodontal disease. Philadelphia, WB Saunders Co, 1977, p.459.
  9. Min BI : Maxillofacial plastic surgery. Seoul, Koon Ja Publishing Co, 1990, p.45.
  10. Yoo JH, Kang SH and Kim JB : A clinical study on the emergency patients with active oral bleeding. J Korean Assoc Oral Maxillofac Surg 28 : 383, 2002.
  11. Grossman LI : Endodontic practice, 8th ed. Philadelphia, Lea & Febiger Co, 1974, p.151.
  12. Lim SS : Clinical endodontics, 1st ed. Seoul, Medical and Dental Publishing Co, 1994, p.1.
  13. Sonis ST, Fazio RC, Fang L : Principles and practice of oral medicine, 2nd ed. Philadelphia, WB Saunders Co, 1995, p.242.
  14. Shin DH, Choi HR, Kim SY et al : Family medicine, 2nd ed. Seoul, Ke Chook Publishing Co, 2003, p.993.
  15. Sun HS, Kang JM, Kim YS et al : Harrison's principles of internal medicine, 16th ed. a translated literature. Seoul, MIP Publishing Co, 2006, p.731, p.2026.