• Title/Summary/Keyword: Active oral bleeding

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Excessive Bleeding after Implant Placement in the Anterior Mandible: Case Report (하악 전치부 임플란트 식립 후에 발생한 과다출혈: 증례보고)

  • Jo, Ji-Ho;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Kim, Jeong-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.171-175
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    • 2011
  • Implant placement on the anterior mandible is considered a common and safe surgical procedure. However, severe hemorrhage can occur if branches of the sublingual artery, which run through the lingual cortical plate of the mandible, are damaged. Excessive hemorrhage caused by injury to the sublingual artery can result in life-threatening problems such as airway obstruction. A 54-year old male patient without any generalized systemic conditions was referred due to active bleeding after implant placement in the anterior mandible. Gauze compression with surgicel and bosimin were performed and hemostasis was achieved. The patient was discharged after 3 days without any supplementary bleeding.

Dental treatment of the patient with antiplatelet agent (항혈소판제를 투여받는 환자의 치과치료)

  • Park, Hongju
    • The Journal of the Korean dental association
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    • v.57 no.10
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    • pp.606-612
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    • 2019
  • Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.

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Acute Airway Obstruction Secondary to Lingual Hematoma after Lower Third Molar Extraction: A Case Report

  • Yi, Sangmin;Oh, Je-Seok;Youn, Gap-Hee;Chung, Kwang;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.43-47
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    • 2014
  • Few dental procedures are potentially life-threatening. Note, however, that a dental extraction can result in preventable death. Severe post-extraction bleeding can occur, which may give rise to an alarming situation if there is any delay in detecting and managing the problem. The most immediate danger for a healthy patient with severe post-extraction hemorrhage is airway compromise. Acute airway obstruction from post-extraction hematoma is relatively uncommon, but it may occur with fatal consequences if there is any reluctance to maintain the airway clearance. Therefore, dentists and oral and maxillofacial surgeons should have clear understanding of the problem and measures to control it. Active bleeding that is not controlled by local measures in a dental office should be referred to the nearest hospital emergency department as soon as possible for appropriate management.

Pharyngeal flap damage caused by nasotracheal intubation in a patient who underwent palatoplasty and pharyngoplasty

  • Oh, Jong-Shik;Choi, Hong-Seok;Kim, Eun-Jung;Kim, Cheul-Hong;Yoon, Ji-Uk;Yoon, Ji-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.309-312
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    • 2016
  • Patients with cleft lip and palate (CLP) must undergo corrective surgeries during infancy and early childhood. Many patients with CLP undergo orthognathic surgery during their childhood for correction of skeletal asymmetries or pharyngoplasty with a pharyngeal flap to improve the quality of speech and velopharyngeal function. During orthognathic surgeries, nasotracheal intubation is performed under general anesthesia. In our case report, the patient had undergone palatoplasty and pharygoplasty previously. During the orthognathic surgery, a flexible fiberoptic bronchoscope-guided nasotracheal tube was inserted through the pharyngeal flap ostium; however, active bleeding occurred in the nasopharynx. Bleeding occurred because the flap was torn. After achieving hemostasis, the surgery was completed successfully. Thus, if a patient may show the potential for velopharyngeal port obstruction, nasotracheal intubation should be performed with utmost care.

SQUAMOUS CELL CARCINOMA WITH APLASTIC ANEMIA PATIENT (재생불량성 빈혈 환자의 편평상피세포암)

  • Lee, Kye-Young;Lee, Ju-Hyun;Min, Kyong-In;Kim, Chul-Whan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.65-68
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    • 2001
  • The major manifestations of aplastic anemia are characterized by persistent bone marrow aplasia and peripheral pancytopenia due to defective stem cells in which differentiation is not curtailed or preferential elimination of stem cells with self-renewal capacity, which results in serious complications such as bleeding and infection. Recent advances in the therapeutic modalities, such as bone marrow transplantation and immunosuppressive therapy, and in supportive measures as component transfusion and infection control with better quality of antibiotics resulted in an improved survival and subsequently increased possibility of complications which need surgical intervention. Considering the fact that surgery may not only control complications, but offers the opportunity to give effective therapy for aplastic anemia and therefore improves chances for survival, it is strongly suggested that active surgical intervention should be performed. We report a case of patient with aplastic anemia who had been performed surgical intervention of partial maxillectomy for the squamous cell carcinoma on maxilla without serious complications during perioperative and postoperative period.

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Effect of the tooth pick of the disabled person oral treatment (Toothpick method(와타나베법)을 이용한 장애인 구강건강관리 효과)

  • Oh, Ha-Min;Song, Kyoung-Hee
    • Journal of Korean Dental Hygiene Science
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    • v.1 no.1
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    • pp.37-46
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    • 2018
  • This study conducted a 'specialist tooth brushing' method against the severely disabled once every other week. The purpose of this study is to analyze and validate the effectiveness of maintaining healthy periodontal management when consistent oral hygiene lasts with minimum stimuli for 24 - months. The conclusions were as follows. Table 2 compares the difference between group 1 and 2 from the 1st to 11th management and verifies the actual difference in measurement of each index. Group 1 used a professional tooth brush while Group 2 used a general brush. There were found many significant differences in dental index. As for PHP, Oral Malodor index and gingival bleeding, it was found that one or two times of dental care can make substantial differences in dental health condition. These results show that as the number of toothbrush method has been increased, gingival bleeding and periodontal index are significantly improved, not to mention the improvement of gingivitis and periodontal disease. This is because periodontal tissue is affected by brushing method, brushing time and consistency of dental care. During the 6-month period, 20 minutes of active periodontal care was intensively conducted, and for 18-months the effect of consistent care was verified by 10-minute periodontal care once every other week. As a result of the test, it was found that there was no complete regression in the basic periodontal treatment and the periodontal health condition had been maintained for 24 months. Also this test shows that, despite of inconsistent dental hygienic care, regular plague control can prevent dental diseases and maintain the dental health. This study proved that periodontal condition can be maintained by periodontal care once every other week as the tooth brushing properly stimulates the gums with positive effect. Therefore, professional dental healthcareworkers should be designated for each facility for the disabled, and dental health of the disabled should be professionally cared on a regular basis, and consistent and repetitive management by the dental care specialist are required.

THE MANAGEMENT OF PATIENTS WITH SEVERE APLASTIC ANEMIA IN ORAL & MAXILLOFACIAL SURGERY (중증 재생불량성 빈혈환자의 구강악안면외과적 관리)

  • Yoon, Hyun-Joong;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.464-467
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    • 2001
  • Aplastic anemia is a hematopoietic disorder characterized by marked reduction or absence of erythoid, granulocytic, and megakariocytic cells in the bone marrow with resultant pancytopenia. To control of infection & bleeding secondary to leukopenia and thrombocytopenia, the inflammatory lesions in oral & maxillofacial area should be removed. Material & Method: The extractions were performed on 21 patients with severe aplastic anemia. The initial, pre-operative and postoperative CBCs were checked up. Amount and kind of transfused platelet in each patient and increment of platelet level were recorded. The complications were documented. Result : A mean of 2.9 teeth were extracted from each patient(ranging between 1 and 13). Furthermore, surgical extractions including ostectomy and odontectomy of the third molar were performed on 11 patients. The preoperative WBC levels presented between $600/{\mu}L$ and $5000/{\mu}L$(mean $2376/{\mu}L$). The WBC values decreased by an average of $145/{\mu}L$ per patient after extractions had been performed. The teeth of 16 patients were extracted under 10.0g/dL, and the mean change in postoperative hemoglobin levels in comparison with preoperative hemoglobin levels was -0.06 per patient. The initial platelet levels were between 1000/(L and $81,000/{\mu}L$(mean $20,174/{\mu}L$). In five patients, extractions were performed with platelet levels less than $50,000/{\mu}L$. Conclusion : The results suggest that more active and preventive treatments in the oral and maxillofacial area are possible and are necessary to remove the infectious foci on the patients with severe aplastic anemia. We report the results of our experiences and literature reviews in treatment of the patients with severe aplastic anemia in our department.

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A STUDY OF THE EFFECTS OF AUCUBIN ON THE PULP TISSUE AFTER PULPOTOMY IN DOGS (치수절단 후 Aucubin이 잔존치수조직에 미치는 영향에 관한 연구)

  • Baek, Seung-Ho;Lee, Sung-Woo
    • Restorative Dentistry and Endodontics
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    • v.24 no.4
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    • pp.554-559
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    • 1999
  • Aucubin, an iridoid glucoside isolated from Aucuba japonica, has pharmacological effects such as antimicrobial effect, liver protective function and inhibition of liver RNA and protein biosynthesis, etc. This study was performed to observe the effect of aucubin on the pulp tissue after pulpotomy. Aucubin was converted to aucubinogenin as an active form by ${\beta}$-glucosidase. In 3 Mongrel dogs, the pulps were mechanically exposed with a sterile round bur and excised with sterile excavator. After bleeding control, aucubin was applied on remaining pulp tissues and then they were sealed with IRM in experimental group. In control group, $Ca(OH)_2$ powder was applied on remaining pulp tissues and then they were sealed with IRM. After interval of 1 and 12 weeks, the dogs were sacrificed. The teeth were prepared for histologic evaluation and examined by light microscope. Aucubin 1 week group showed that mild inflammation and vascular congestion in most of the specimen. More various degree of inflammation was found in experimental group than in control group. Premature calcified mass were found in the both 1 weeks groups. Continuous well-formed dentin bridge was found in both 12 weeks groups. Collectively, this study suggests that the possibility of aucubin as a medicament after pulpotomy.

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Association of chairside salivary aMMP-8 findings with periodontal risk assessment parameters in patients receiving supportive periodontal therapy

  • Schmalz, Gerhard;Kummer, Max Kristian;Kottmann, Tanja;Rinke, Sven;Haak, Rainer;Krause, Felix;Schmidt, Jana;Ziebolz, Dirk
    • Journal of Periodontal and Implant Science
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    • v.48 no.4
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    • pp.251-260
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    • 2018
  • Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.

THE EFFECTS OF PLAQUE CONTROL INSTRUCTION IN ORTHODONTIC PATIENTS (치과교정환자의 치면세균막 관리교육 효과)

  • Jae, Young-Ji;Kim, Jin-Beom;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.24 no.1 s.44
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    • pp.221-231
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    • 1994
  • The short-term effects of plaque control instruction were studied in 42 adolescent orthodontic patients under active fixed treatment. At first visit, all the patients were received plaque control instruction using materials such as oral hygiene education slides, dentiform, disclosing agents, tooth brush and interdental brush. After that, Pateints were asked to perform the tooth brushing according to instructions. Such a procedure was repeated every week lot 3 weeks. Plaque index and bleeding index were scored once a week for 4 weeks and were compared according to ages, sex and duration with fixed appliance. The results were as follows: 1. Plaque control instruction was effective in reducing plaque accumulation and gingival inflammation of the orthodontic patients. 2. The effect of plaque control instruction was continued during 3 weeks among all groups of subjects, and it was prominent at the first week. 3. There was no statistically significant difference in the effects of the plaque control of instruction according to sex, ages, or duration with fixed appliances.

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