Extractions dentaires chez l’enfant présentant une maladie hémorragique constitutionnelle : protocole thérapeutique et résultats

INTRODUCTION

We report the results of our 10-year experience with a protocol of local hemostasis specifically elaborated for children with congenital bleeding disorders.

MATERIAL AND METHOD

Sixty-four dental extractions procedures were performed in 37 children. Local hemostasis was achieved with the CO2 laser at the site of extraction previously filled with regenerated oxidized cellulose. The site of extraction was then protected with thermomolded splint. The replacement therapy (hemostasis factor concentrates, platelet concentrates) was coordinated by the hematologist and restricted as much as possible.

RESULTS

160 decidual teeth and 23 permanent teeth were extracted. None of the children with minor bleeding deficiency received replacement therapy. Ten post-operative bleedings were recorded but none was considered severe.

DISCUSSION

This protocol characterized by the use of CO2 laser for the hemostasis gave satisfaction in children. The rare and minor post-operative bleedings could be explained by multiple extractions, local infection and/or children's anxiety. This strategy requires a close cooperation between the stomatologist and the hematologist in order to determine the optimal therapeutic management.

[Old plants and medicines used by Anabaptists-Mennonits in the days of old]

The evangelic Christian Mennonits, issued from Helvetia, spread first in Alsace, then in the neighbouring countries, bringing so traditions in agronomy and folk medicine. As generally in rural areas, in the days of old, natural therapies were characterised by rather strange practices, sometimes imbued with superstitions and mystic ideas. Some works, books, almanacs, dweller manuscripts, allow us to reach some uses forsaken and replaced by modern and scientific medicines.