Cases reported "Oral Hemorrhage"

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1/16. 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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2/16. Sublingual hematoma formation during immediate placement of mandibular endosseous implants.

    BACKGROUND: Sublingual hematoma during placement of mandibular endosseous dental implants is a rare, but potentially life-threatening, complication. The development of a sublingual hematoma during a dental procedure may result in the need for acute airway management, including intubation or even emergent tracheostomy. dental implants are becoming a well-accepted treatment, and thousands of implants are placed every year by general practitioners and specialists, with few adverse sequelae. Clinicians rarely discuss this complication with patients before surgery, and no reports of death secondary to sublingual hematoma formation have been published. The incidence of this event is difficult to ascertain, and only, a few cases have been reported. CASE DESCRIPTION: A 56-year-old man with severe caries underwent multiple mandibular tooth extractions and alveoloplasty and received endosseous implants. During the surgical procedure, the patient developed a large sublingual hematoma that required hospitalization. CLINICAL IMPLICATIONS: Practitioners who perform implant surgery in the anterior mandible should notify patients of the potential risk of sublingual hematoma formation, and be able to manage acute airway issues that may result from this complication.
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3/16. Occult hemophilia: prolonged bleeding follows extraction.

    A 51-year-old man had delayed and recurrent bleeding after tooth extractions. Occult hemophilia b was discovered. This case emphasizes the importance of evaluating patients for an underlying coagulopathy when bleeding greater than expected occurs. In this case, the patient had no personal or family history of bleeding.
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4/16. Haemostatic management of intraoral bleeding in patients with congenital deficiency of alpha2-plasmin inhibitor or plasminogen activator inhibitor-1.

    Haemostatic management of intraoral bleeding was investigated in patients with congenital alpha2-plasmin inhibitor (alpha2-PI) deficiency or congenital plasminogen activator inhibitor- 1 (PAI-1) deficiency. When extracting teeth from patients with congenital alpha2-PI deficiency, we advocate that 7.5-10 mg kg(-1) of tranexamic acid be administered orally every 6 h, starting 3 h before surgery and continuing for about 7 days. For the treatment of continuous bleeding, such as post-extraction bleeding, 20 mg kg(-1) of tranexamic acid should be administered intravenously, and after achieving local haemostasis 7.5 mg kg(-1) of tranexamic acid should be administered orally every 6 h for several days. In addition, when treating haematoma caused by labial or gingival laceration or buccal or mandibular contusion, haemostasis should be achieved by administering 7.5-10 mg kg(-1) of tranexamic acid every 6 h. tranexamic acid can also be used for haemostatic management of intraoral bleeding in patients with congenital PAI-1 deficiency, but is less effective when compared with use in patients with congenital alpha2-PI deficiency. Continuous infusion of 1.5 mg kg(-1) h(-1) of tranexamic acid is necessary for impacted tooth extraction requiring gingival incision or removal of local bone.
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5/16. Disseminated intravascular coagulopathy: manifestations after a routine dental extraction.

    Clinical signs and symptoms of acute disseminated intravascular coagulopathy (DIC) include bleeding from body orifices, such as the nose, mouth, or ear, bleeding from an intravenous (IV) site, areas of ecchymosis, or blood in the urine or stool. The underlying disease triggering DIC usually determines the clinical presentation. However, patients with chronic DIC (compensated DIC) may possess subclinical signs and symptoms, and the bleeding disorder may only be identified through laboratory findings. In this compensated form, the triggering factor is exposed slowly and in small amounts (seen in malignancies and vasculitis), allowing replenishing of the augmented factors by the liver, adequate reticuloendothelial clearance of fibrin degradation products, and increased production of platelets, which prevent secondary fibrinolysis and the signs of bleeding. 1,4 We report a case of an 82-year-old male who presented to the emergency room 24 hours after a routine dental extraction with bleeding from the tooth socket, severe hypotension, and presence of ecchymosis on his chest. Clinical and radiographic exam revealed multiple thoracic and abdominal aortic aneurysms, as well as infrarenal and iliac aneurysms, continuous oral hemorrhage, and a unique presentation rarely documented in the literature: a bleeding tooth socket as the initial clinical sign and presentation of DIC.
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6/16. An extraction complicated by lateral and medial pterygoid tethering of a fractured maxillary tuberosity.

    We report a case in which the extraction of an upper second molar was complicated by a maxillary tuberosity fracture. Delivery of the tooth and bone fragment under local anaesthesia was unable to be achieved because of pain, brisk bleeding and tethering by the lateral and medial pterygoid muscles. The eventual removal of the fragment under general anaesthetic required the control of haemorrhage deep within the infratemporal fossa. When this complication is recognised by the general dentist the maxillary tuberosity should not be removed and the patient referred to a specialist unit.
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7/16. Vital bleach of hemorrhagic discoloration.

    An unusual case is presented of a maxillary central incisor with hemorrhagic discoloration that was successfully treated with the thermocatalytic vital bleach technique. This case emphasizes the need for a thorough radiographic and clinical examination to include vitality tests when a patient presents with a discolored tooth.
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8/16. factor xi deficiency disclosed following haemorrhage related to a dental extraction. Brief review and case report.

    factor xi deficiency is a relatively common hereditary coagulation disorder manifested generally as diffuse oozing from a surgical site. dentists may be the first to discover this deficiency and other coagulopathies after simple tooth extraction. A case is reported which illustrates a typical presentation of this disorder. The need for haematological examination and special dental care is discussed.
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9/16. Clinical effectiveness of desmopressin in a case of acquired von Willebrand's syndrome associated with benign monoclonal gammopathy.

    A case of acquired von Willebrand's syndrome (avWs) secondary to benign monoclonal gammopathy, is described, in which desmopressin (DDAVP) has proven effective repeatedly in preventing bleeding after tooth extraction. The laboratory pattern was similar to that of congenital type IA von Willebrand's disease. After DDAVP, prolonged bleeding time and factor viii/von willebrand factor activities were normalized. The disappearance rate of the elicited activities was similar to that observed in patients with congenital disease. This report adds to the scarce data concerning the haemostatic effectiveness of DDAVP in avWs and suggests that this agent might also be used in controlling or preventing bleeding in patients with the acquired disease, selected on the basis of their biological responsiveness to a test-infusion.
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10/16. Prostatic carcinoma presenting as a haemorrhagic diathesis after dental extraction.

    A fatal case of disseminated intravascular coagulation, secondary to a previously undiagnosed prostatic carcinoma, occurred following tooth extraction. The nature of the condition and its variable presentation are discussed, as well as problems in diagnosis and management.
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