J Korean Assoc Oral Maxillofac Surg.  2010 Jun;36(3):221-227. 10.5125/jkaoms.2010.36.3.221.

Crown removal and endodontic drainage as a last method in active gingival bleeding with liver cirrhosis and periodontitis: a case report

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. youngdent@naver.com
  • 2Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonju Christian Hospital, Yonsei University, Wonju, Korea.

Abstract

The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care.

Keyword

Active gingival bleeding; Liver cirrhosis; Dental crown removal; Emergency primary endodontic drainage

MeSH Terms

Airway Obstruction
Blood Platelets
Crowns
Dental Care
Drainage
Electrocoagulation
Emergencies
Glycosaminoglycans
Hemorrhage
Hemorrhagic Disorders
Humans
Hypoprothrombinemias
Inflammation
Liver
Liver Cirrhosis
Shock
Sutures
Syncope
Vomiting
Glycosaminoglycans

Figure

  • Fig. 1. Abnormal gingival bleeding view in maxillary left first and second molars.(#26, 27)

  • Fig. 2. The crown removal and primary endodontic drainage view on #26, 27 teeth.

  • Fig. 3. Removed crown view of #26, 27 teeth.

  • Fig. 4. Wet gauze biting view in the gingival bleeding sites of #26, 27 teeth.

  • Fig. 5. The pulpal disease progression view toward the periodontal disease.

  • Fig. 6. The periodontal disease progression view toward the pulpal disease.


Reference

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