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de Castro Ribeiro TT, Castillo RAD, Ozawa TO, Ramalho-Ferreira G, Castillo AAD, Janson G. Late alveolar bone grafting in complete unilateral cleft lip and palate (UCLP): Biomechanical considerations for the success of orthodontic finishing. J Orthod 2022; 49:457-462. [PMID: 35323076 DOI: 10.1177/14653125221087289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Orthodontic treatment in patients with cleft lip and palate (CLP) is challenging. Alignment of the maxillary segments and orthodontic levelling of the teeth adjacent to the cleft area are important before alveolar bone grafting (ABG), in the permanent dentition. In this clinical report, orthodontic procedures, before and after late ABG, are described as an alternative that can optimise the orthodontic and periodontal results. The gingival margins of the teeth adjacent to the cleft area were levelled. Root divergence was corrected. Interdental papilla and improvement of the periodontal condition were obtained.
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Affiliation(s)
- Tiago Turri de Castro Ribeiro
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Rosalinda Aliaga-Del Castillo
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Terumi Okada Ozawa
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Gabriel Ramalho-Ferreira
- Department of Oral and Maxillofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | | | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
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Yogui FC, Momesso GAC, Faverani LP, Polo TOB, Ramalho-Ferreira G, Hassumi JS, Rossi AC, Freire AR, Prado FB, Okamoto R. A SERM increasing the expression of the osteoblastogenesis and mineralization-related proteins and improving quality of bone tissue in an experimental model of osteoporosis. J Appl Oral Sci 2018; 26:e20170329. [PMID: 29742257 PMCID: PMC5933824 DOI: 10.1590/1678-7757-2017-0329] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/26/2017] [Accepted: 10/09/2017] [Indexed: 01/17/2023] Open
Abstract
Raloxifene is an antiresorptive drug, selective estrogen receptor modulator (SERM) used in the treatment of osteoporosis. Objective To evaluate proteins related to bone repair at the peri-implant bone in a rat model of osteoporosis treated with raloxifene. Material and Methods 72 rats were divided into three groups: SHAM (healthy animals), OVX (ovariectomized animals), and RLX (ovariectomized animals treated with raloxifene). Raloxifene was administered by gavage (1 mg/kg/day). Tibial implantation was performed 30 days after ovariectomy, and animals were euthanized at 14, 42, and 60 days postoperatively. Samples were collected and analyzed by immunohistochemical reactions, molecular analysis, and microtomographic parameters. Results RLX showed intense staining of all investigated proteins at both time points except for RUNX2. These results were similar to SHAM and opposite to OVX, showing mild staining. The PCR gene expression of OC and ALP values for RLX (P<0.05) followed by SHAM and OVX groups. For BSP data, the highest expression was observed in the RLX groups and the lowest expression was observed in the OVX groups (P<0.05). For RUNX2 data, RLX and SHAM groups showed greater values compared to OVX (P<0.05). At 60 days postoperatively, microtomography parameters, related to closed porosity, showed higher values for (Po.N), (Po.V), and (Po) in RLX and SHAM groups, whereas OVX groups showed lower results (P<0.05); (BV) values (P=0.009); regarding total porosity (Po.tot), RLX group had statistically significant lower values than OVX and SHAM groups (P=0.009). Regarding the open porosity (Po.V and Po), the SHAM group presented the highest values, followed by OVX and RLX groups (P<0.05). The Structural Model Index (SMI), RLX group showed a value closer to zero than SHAM group (P<0.05). Conclusions Raloxifene had a positive effect on the expression of osteoblastogenesis/mineralization-related proteins and on micro-CT parameters related to peri-implant bone healing.
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Affiliation(s)
- Fernanda Costa Yogui
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, São Paulo, Brasil
| | - Gustavo Antonio Correa Momesso
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, São Paulo, Brasil
| | - Leonardo Perez Faverani
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, São Paulo, Brasil
| | - Tarik Ocon Braga Polo
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, São Paulo, Brasil
| | - Gabriel Ramalho-Ferreira
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, São Paulo, Brasil
| | - Jaqueline Suemi Hassumi
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, São Paulo, Brasil
| | - Ana Cláudia Rossi
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Anatomia, Piracicaba, SP, Brasil
| | - Alexandre Rodrigues Freire
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Anatomia, Piracicaba, SP, Brasil
| | - Felippe Bevilacqua Prado
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Anatomia, Piracicaba, SP, Brasil
| | - Roberta Okamoto
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, São Paulo, Brasil
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Ramalho-Ferreira G, Faverani LP, Prado FB, Garcia IR, Okamoto R. Raloxifene enhances peri-implant bone healing in osteoporotic rats. Int J Oral Maxillofac Surg 2015; 44:798-805. [PMID: 25813087 DOI: 10.1016/j.ijom.2015.02.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/07/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to evaluate bone healing at the bone-implant interface in rats with induced osteoporosis. The rats underwent a bilateral ovariectomy (OVX) and were fed a low calcium and phosphate diet. The OVX rats were divided into three groups: one was treated with raloxifene (OVX-RAL), one with alendronate (OVX-ALE), and one received no medication (OVX-NT). The control group rats (SHAM-DN) underwent sham surgery and were fed a normal diet. Each animal received one implant in each tibia: a machined surface implant in the right tibia and an implant with surface etching in the left tibia. All animals were euthanized after 42 days. Analysis of variance (ANOVA) and Tukey post hoc tests were applied to the biomechanics (reverse torque) and bone-implant contact (BIC) data (P<0.05). The RAL and ALE groups showed improved peri-implant bone healing. However, the ALE group showed no significant difference from the OVX-NT group. Surface treatment promoted higher corticalization at the bone-implant interface, but showed the same characteristics of mature bone and bone neoformation in concentric laminations as the machined implant. There were no statistically significant differences in reverse torque (P=0.861) or BIC (P=0.745) between the OVX-RAL and SHAM-DN groups. Therefore, the use of raloxifene resulted in good biomechanical, BIC, and histological findings in the treatment of induced osteoporosis in rats.
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Affiliation(s)
- G Ramalho-Ferreira
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista - UNESP, Araçatuba, São Paulo, Brazil
| | - L P Faverani
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista - UNESP, Araçatuba, São Paulo, Brazil.
| | - F B Prado
- Department of Morphology, Piracicaba Dental School, University of Campinas, UNICAMP, Piracicaba, São Paulo, Brazil
| | - I R Garcia
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista - UNESP, Araçatuba, São Paulo, Brazil
| | - R Okamoto
- Department of Basic Sciences, Araçatuba Dental School, Universidade Estadual Paulista - UNESP, Araçatuba, São Paulo, Brazil
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Ramalho-Ferreira G, Faverani LP, Grossi-Oliveira GA, Okamoto T, Okamoto R. Alveolar bone dynamics in osteoporotic rats treated with raloxifene or alendronate: confocal microscopy analysis. J Biomed Opt 2015; 20:038003. [PMID: 25813805 DOI: 10.1117/1.jbo.20.3.038003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/06/2015] [Indexed: 06/04/2023]
Abstract
In this study, the characteristics of the alveolar bone of rats with induced osteoporosis were examined. Thirty-two rats were divided into four groups according to the induction of osteoporosis and drugs administered: OG, osteoporotic rats without treatment (negative control); SG, rats which underwent sham surgery ovariectomy (SHAM); alendronate (AG), osteoporotic rats treated with alendronate; and RG, osteoporotic rats treated with raloxifene (RG). On the 8th day after ovariectomy and SHAM surgeries, drug therapy was started with AG or RG. On the 52nd day, 20 mg/kg calcein was administered to all of the rats, and on the 80th day, 20 mg/kg alizarin red was administered. Euthanasia was performed on the 98th day. The bone area marked by fluorochromes was calculated and data were subjected to two-way ANOVA test and Tukey's post-hoc test (p < 0.05). The comparison of the induced osteoporosis groups showed no statistically significant differences in bone turnover only between RG and SG (p = 0.074) and AG and OG (p = 0.138). All other comparisons showed significant differences (p < 0.001). The largest bone turnover was observed in RG and SG groups. RG was the medication that improved the dynamics of the alveolar bone of rats with induced osteoporosis, resembling that of healthy rats.
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Affiliation(s)
- Gabriel Ramalho-Ferreira
- Universidade Estadual Paulista (UNESP), Araçatuba Dental School, Department of Surgery and Integrated Clinic, José Bonifácio, 1193, Aracatuba, Sao Paulo 16015-050, Brazil
| | - Leonardo Perez Faverani
- Universidade Estadual Paulista (UNESP), Araçatuba Dental School, Department of Surgery and Integrated Clinic, José Bonifácio, 1193, Aracatuba, Sao Paulo 16015-050, Brazil
| | - Gustavo Augusto Grossi-Oliveira
- Universidade Estadual Paulista (UNESP), Araçatuba Dental School, Department of Surgery and Integrated Clinic, José Bonifácio, 1193, Aracatuba, Sao Paulo 16015-050, Brazil
| | - Tetuo Okamoto
- Universidade Estadual Paulista (UNESP), Araçatuba Dental School, Department of Surgery and Integrated Clinic, José Bonifácio, 1193, Aracatuba, Sao Paulo 16015-050, Brazil
| | - Roberta Okamoto
- Universidade Estadual Paulista (UNESP), Araçatuba Dental School, Department of Basic Sciences, José Bonifácio, 1193, Aracatuba, Sao Paulo 16015-050, Brazil
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Faverani LP, Ramalho-Ferreira G, Fabris ALS, Polo TOB, Poli GHS, Pastori CM, Marzola C, Assunção WG, Garcia-Júnior IR. Intraoperative blood loss and blood transfusion requirements in patients undergoing orthognathic surgery. Oral Maxillofac Surg 2014; 18:305-310. [PMID: 23620250 DOI: 10.1007/s10006-013-0415-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 04/15/2013] [Indexed: 06/02/2023]
Abstract
Procedures for the surgical correction of dentofacial deformities may produce important complications, whether due to the potential for vascular injury or to prolonged surgery, both of which may lead to severe blood loss. Fluid replacement with crystalloid, colloid, or even blood products may be required. The aim of this study was to assess blood loss and transfusion requirements in 45 patients (18 males and 27 females; mean age 29.29 years, range 16-52 years) undergoing orthognathic surgery, assigned to one of two groups according to procedure type-rapid maxillary expansion or double-jaw orthognathic surgery. Preoperative hemoglobin and hematocrit levels and intraoperative blood loss were measured. There was a substantial individual variation in pre- and postoperative hemoglobin values (10.3-17 and 8.8-15.4 g/dL, respectively; p < 0.05). Mean hematocrit values were 41.53 % preoperatively (range 31.3-50.0 %) and 36.56 % postoperatively (range 25-43.8 %) (p < 0.05). Mean blood loss was 274.60 mL (range 45-855 mL). Only two patients required blood transfusion. Although blood loss and transfusion requirements were minimal in the present study, surgical teams should monitor the duration of surgery and follow meticulous protocols to minimize the risks.
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Affiliation(s)
- Leonardo Perez Faverani
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista (UNESP), São Paulo, Brazil,
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Faverani LP, Ramalho-Ferreira G, dos Santos PH, Rocha EP, Garcia Júnior IR, Pastori CM, Assunção WG. Surgical techniques for maxillary bone grafting - literature review. Rev Col Bras Cir 2014; 41:61-7. [PMID: 24770776 DOI: 10.1590/s0100-69912014000100012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 09/30/2012] [Indexed: 11/22/2022] Open
Abstract
For oral rehabilitation with implant-supported prostheses, there are required procedures to create the bone volume needed for installation of the implants. Thus, bone grafts from intraoral or extraoral donor sites represent a very favorable opportunity. This study aimed to review the literature on the subject, seeking to discuss parameters for the indications, advantages and complications of techniques for autogenous bone grafts.
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Faverani LP, Barão VAR, Ramalho-Ferreira G, Delben JA, Ferreira MB, Garcia Júnior IR, Assunção WG. The influence of bone quality on the biomechanical behavior of full-arch implant-supported fixed prostheses. Materials Science and Engineering: C 2014; 37:164-70. [DOI: 10.1016/j.msec.2014.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/25/2013] [Accepted: 01/05/2014] [Indexed: 11/29/2022]
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Faverani L, Ramalho-Ferreira G, Jardim E, Goiato M, Pereira F, Pastori C, Junior IG. Controversies in the satisfaction of surgeons and orthodontists on facial aesthetics after orthognathic surgery. Craniomaxillofac Trauma Reconstr 2014; 6:43-8. [PMID: 24436735 DOI: 10.1055/s-0032-1332209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 03/15/2012] [Indexed: 10/27/2022] Open
Abstract
Aim Acceptable facial aesthetics is a common desire among patients presenting with dentofacial deformities planning to undergo orthognathic surgeries. Thus, professionals must be alert to their patients' complaints as well as their desires regarding facial morphology, because this is quite subjective and personal. This research aimed at evaluating the different views of orthodontists and oral maxillofacial surgeons regarding the facial analysis of patients who undergo orthognathic surgery. Methods Thirty individuals were selected with a minimum postoperative period of 6 months and photographed in the frontal and profile norm. Facial morphology characteristics were recorded to observe the agreement of the assessments of four professionals (two orthodontists and two surgeons). Results A significant agreement was seen between the orthodontists regarding the nasolabial angle (80%). In the frontal analysis, the agreement percentage (60%) between orthodontists and surgeons was considerable regarding facial asymmetry assessment. Conclusions Professionals must keep alert to facial analysis, especially in terms of tegumental harmony, for the orthognathic surgery to reestablish, satisfactorily, the facial aesthetics in all parameters set.
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Affiliation(s)
| | | | | | - Marcelo Goiato
- Dental Materials and Prosthodontics, Aracatuba Dental School, Aracatuba, São Paulo, Brazil
| | | | - Claudio Pastori
- Oral and Maxillofacial Surgery, Bauru Hospital Association, Bauru, São Paulo, Brazil
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Faverani LP, Barão VAR, Ramalho-Ferreira G, Ferreira MB, Garcia-Júnior IR, Assunção WG. Effect of bleaching agents and soft drink on titanium surface topography. J Biomed Mater Res B Appl Biomater 2013; 102:22-30. [DOI: 10.1002/jbm.b.32949] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/17/2013] [Accepted: 03/27/2013] [Indexed: 12/23/2022]
Affiliation(s)
- Leonardo P. Faverani
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Valentim A. R. Barão
- Department of Prosthodontics and Periodontics; Piracicaba Dental School, University of Campinas (UNICAMP); Piracicaba SP Brazil
| | - Gabriel Ramalho-Ferreira
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Mayara B. Ferreira
- Department of Dental Materials and Prosthodontics; Aracatuba Dental School, Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Idelmo R. Garcia-Júnior
- Department of Surgery and Integrated Clinic; Aracatuba Dental School; Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
| | - Wirley G. Assunção
- Department of Dental Materials and Prosthodontics; Aracatuba Dental School, Univ Estadual Paulista (UNESP); Aracatuba SP Brazil
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Gaetti-Jardim EC, Faverani LP, Ramalho-Ferreira G, Pereira CCS, Silva PIS, Garcia IR, Shinohara EH. Endaural access to remove the projectile from a firearm. Oral Maxillofac Surg 2012; 17:219-23. [PMID: 23064796 DOI: 10.1007/s10006-012-0364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 09/25/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Surgical approaches to temporomandibular region have been the subject of numerous controversies in the literature. Pre-auricular approaches have been used with the observance of high success rate, and during surgery history, various modifications of this approach were conducted in order to reduce irreversible sequelae. Thus, given the relevance of the study, this article proposes to alert the professionals that carry out these surgical approaches in relation to the anatomical structures involved and to describe and emphasise the benefits of endaural approach. CASE REPORT A Caucasian male patient, victim of a firearm injury, sustained a wound on the right pre-auricular region, and at the time of assessment, he complained of pain, mouth opening difficulty and dysphagia. On physical examination, there was oedema and ecchymosis in the right periorbital region. In the radiological examination, a foreign body compatible with a firearm projectile was observed in the right pre-auricular region, being in accordance with the information collected. The endaural incision and divulsion by plans was then made until the projectile. DISCUSSION For proper exposure of the region, several studies were designed to evaluate the patterns of branching and anastomosis of the facial nerve. As for the best cosmetic result with the different pre-auricular approaches, the endaural approach was described as an approach that offers great cosmetic results because the incision design guides the surgeon in the wound closure and causes a decrease in the tension of flap, unlike that observed by some authors.
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Affiliation(s)
- Ellen Cristina Gaetti-Jardim
- Department of Surgery and Integrated Clinics, School of Dentistry, State of Sao Paulo University, Aracatuba, São Paulo, Brazil.
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Faverani LP, Gaetti-Jardim EC, Ramalho-Ferreira G, Gulinelli JL, Queiroz TP, Garcia Júnior IR. Ligature of external carotid artery as an optional technique in a patient with von Willebrand disease. Braz Dent J 2012; 22:435-8. [PMID: 22011902 DOI: 10.1590/s0103-64402011000500015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The von Willebrand disease (vWD) is a hereditary coagulopathy. There is no gender predilection. Clinically characterized by mucocutaneous bleeding, especially nose bleeding, menorrhagia and bleeding after trauma. This article reports a case of a 52-year-old Caucasian male patient with vWD, who presented with extensive bleeding in the tongue after a lacerating injury caused by accidental biting, and describes some clinical, pathological and treatment aspects of vWD. After repeated attempts to suture the wound and replace clotting factors, a decision was made to perform the ligature of the external carotid artery ipsilateral to the injury. There was favorable resolution of the case, with a good aspect of the scar 2 months after ligation. This case reinforces that it is extremely important to make a thorough review of medical history of all patients, searching for possible bleeding disorders or previous family history.
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Faverani L, Barão V, Ramalho-Ferreira G, Delben J, Wimmer M, Mathew M, Yan J, Sukotjo C, Garcia-Júnior I, Assunção W. Corrosion on the titanium surface resulting in greater lipopolysaccharide affinity. Int J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.ijom.2011.07.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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