Cases reported "Gingival Hemorrhage"

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1/11. Effective periodontal treatment in a patient with type IIA von Willebrand's disease: report of a case.

    von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor viii and von willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45-year-old woman with type IIA vWD was referred for periodontal therapy because of an episode of gingival hemorrhage and percussion pain of teeth #18 and #47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth #46. After consultation with a hematologist, apically positioned flap surgery and hemisection were performed on tooth #46 following completion of oral hygiene instruction, scaling and root planing, and endodontic therapy. The patient was given 500 units of factor viii including vWf multimer 30 minutes before surgery. After healing of the periodontal tissue, prosthodontic treatment was undertaken on the posterior mandibular sextants. At follow-up, the probing depths ranged from 2 to 3 mm, and gingival bleeding on probing was minimal. The patient's children all had vWD. They had mild to moderate periodontitis with probing depths ranging from 2 to 5 mm and gingival bleeding on probing. With the combined efforts of the periodontist and hematologist, effective periodontal treatment can be provided to patients with von Willebrand's disease.
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2/11. Signs of medullar aplasia in the oral cavity: report of case.

    Medullar aplasia is a hematological disease characterized by medullar dysfunction that results in a marked decrease of various hematological cellular elements. This produces anemia, infections of different etiologies and also, spontaneous or provoked hemorrhagic syndromes of varying importance. A case of medullar aplasia affecting a child, diagnosed after a tooth extraction is reported, and accompanied by its pathological characteristics. In addition, an easy reading E.L.I.S.A/ test for diagnosing herpes virus type 1 or 2 is presented.
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3/11. erythema nodosum of dental origin.

    The association of erythema nodosum and dental infectious foci has rarely been described in the literature. This report concerns four women who developed erythema nodosum either following dental treatment associated with gingival bleeding or due to infectious dental foci. In these cases, tooth extraction, removal of dental deposits, interrupted pulp treatment, apical periodontitis, or a relicted root were identified as causes of the development of erythema nodosum. Upon admission to the hospital, these patients also presented fever and and a maximally elevated erythrocyte sedimentation rate (ESR). In all instances, surgical treatment of the dental foci and/or administration of antibiotics rapidly led to the regression of the erythema nodosum, as well as to the normalization of body temperature and ESR. The cases described indicate that antecedent dental treatment and the possible presence of infectious dental foci should be considered in the differential diagnosis of erythema nodosum when taking the patient's medical history. This approach may avoid unnecessary, possibly invasive diagnostic procedures and can lead to rapid improvement in the patient's clinical status.
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4/11. Palatal neurofibroma associated with localized periodontitis.

    BACKGROUND: Neurofibromatosis type 1 (NF1) is the most common form of neurofibromatosis. While typically considered a dermatologic disorder, intraoral signs of neurofibromatosis occur quite commonly. This clinical entity can be confused with periodontitis because of the presence of periodontal pockets. In this report, we present the case of a palatal neurofibroma with radiographic involvement in a patient with NF1. methods: A 40-year-old female patient was referred from her general dentist to evaluate advanced periodontitis in the maxillary left quadrant. The patient's medical history was significant for a soft tissue lesion excised from her back 11 years previously and diagnosed as a neurofibroma. Subsequent medical examination at that time confirmed a systemic diagnosis of NF1. A comprehensive periodontal evaluation was performed, and panoramic and periapical radiographs were taken. Teeth were tested for vitality. An incisional biopsy was completed for histopathologic examination. RESULTS: The periodontal evaluation revealed the presence of 6 to 9 mm probing depths adjacent to teeth #14 and #15. Panoramic and periapical radiographs showed a circumscribed 0.8x0.9-cm unilocular radiolucency superimposed over the root of tooth #13 and extensive horizontal bone loss on the distal side of #15. Incisional biopsy confirmed the presence of a neurofibroma, and because of the extent of the lesion, the patient was referred to the Oral and Maxillofacial Surgery service for complete excision. CONCLUSIONS: Neurofibromas can cause extensive destruction of alveolar bone, mimicking periodontitis. Due to the potential systemic and genetic implications, the diagnosis of neurofibroma requires appropriate medical referral.
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5/11. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.

    BACKGROUND: The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. methods: A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. RESULTS: Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. CONCLUSIONS: This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.
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6/11. A case of congenital factor v deficiency combined with multiple congenital anomalies: successful management of palatoplasty.

    A patient with congenital factor v deficiency combined with mental retardation and several congenital anomalies including cleft palate, dwarfism, microcephaly and right hydrocele testis is described. The levels of factor V activity and factor V antigen of plasma were significantly decreased. The platelet lysate obtained from him also showed a significantly low level of factor V activity. Palatoplasty and tooth extraction were successfully performed under transfusion therapy with fresh-frozen plasma.
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7/11. Severe hellp syndrome presenting with acute gum bleeding following toothbrushing at 38 weeks' gestation.

    We describe a case of hemolysis, elevated liver enzymes and low platelet count (hellp syndrome) at 38 weeks' gestation. This condition was diagnosed when the patient presented with acute, persistent gum bleeding after toothbrushing. Her platelet count was 26,000/mm3. Bleeding gums have rarely led to the diagnosis of this syndrome; this case appears to be the most severe description of this clinical presentation following toothbrushing yet presented in the literature. Although the patient had been hospitalized 48 hours earlier with nonspecific viral-like symptoms, she was discharged after being treated with intravenous hydration. Reexamination of laboratory studies obtained at the time of her first presentation revealed thrombocytopenia. The diagnosis of this syndrome could possibly have been made at that time. This case emphasizes the importance of maintaining a low threshold of suspicion for this syndrome.
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8/11. Exaggerated abrasion/erosion of human dental enamel surfaces: a case report.

    An atypical, rapidly proceeding abrasion/erosion of the labial enamel surfaces of the maxillary and mandibular incisors and canines in a 27-yr-old man is reported. Ultrastructural examination of a replica of the teeth showed a practically structureless enamel surface both at the initial examination and after 12 months. However, at the end of the period, minor areas of dentin tubules became visible, indicating that a substantial loss of the tooth substance had taken place. The patient's occupation involved daily environmental contact with proteolytic enzymes. in vitro study of enamel exposed to one of the actual proteolytic enzymes showed dissolution of enamel substance, and it cannot be excluded that enzymatic decomposition of the organic enamel matrix is a contributing cause of the observed exaggerated loss of tooth substance.
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9/11. Severe bleeding from a pregnancy tumor. A case report.

    BACKGROUND: Hyperplastic gingivitis and gingival hyperplasia accompanying gestation have been termed "pregnancy gingivitis" and "pregnancy tumor." The condition is benign but, rarely, is complicated by severe bleeding that is difficult to manage. A single case of a pregnancy tumor is reported. CASE: A 28-year-old woman in the third trimester was evaluated for treatment of a pregnancy granuloma with recurrent episodes of severe bleeding for two weeks. Conservative management by firm pressure on gauze packs was applied to control the bleeding, but in vain. Induction of labor was conducted at 37 weeks partially because of term pregnancy and uncontrollable bleeding from the gingiva. An emergency cesarean section was done because of acute fetal distress during induction of labor. A healthy infant was delivered. The gingival bleeding stopped spontaneously five days afterwards. The patient was given thorough dental prophylaxis and oral hygiene instructions. The buccal granulomatous tumor was decreased in size four weeks postpartum. CONCLUSION: Careful oral dental hygiene, removal of dental plaque and debris, and use of soft toothbrushes are important during pregnancy to avoid occurrence of a pregnancy tumor. If uncontrolled bleeding occurs, management should be based on the individual condition and should range from supportive therapy--such as desiccation of bleeders; local, firm compression and oral hygiene to blood transfusion--as well as medication to accelerate fetal lung maturity or even termination of pregnancy to save the patient's life, as with treatment of uncontrollable eclampsia.
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10/11. Arteriovenous malformation of the mandible: report of a case with a note on the differential diagnosis.

    arteriovenous malformations are extremely rare conditions that can result from congenital or acquired abnormalities in the structure of blood vessels; they are potentially fatal. arteriovenous malformations may be asymptomatic or may show various signs and symptoms including soft tissue swelling, pain, changes in skin and mucosal color, erythematous and bleeding gingiva, bruit, and paresthesia. Radiographically, there are no pathognomonic features. The present case illustrates an arteriovenous malformation in a 16-year-old Hispanic female. The case report is unique because the malformation was previously interpreted as a pathosis of pulpal origin and was initially treated as such, although the tooth showed no gross or radiographic dental caries. A broad view of the diagnostic imaging, radiographic differential diagnosis, treatment, and histopathologic description is also presented.
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