Izumi Y, Taniguchi T, Maruyama Y, Sueda T
Department of Periodontology, Kagoshima University Dental School, Japan.
J Periodontol. 1999 May;70(5):548-53. doi: 10.1902/jop.1999.70.5.548.
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.
血管性血友病（vWD）是最常见的遗传性出血性疾病之一。因子VIII和血管性血友病因子（vWf）的轻度至中度缺乏常与牙龈出血有关。在本病例报告中，描述了一名血管性血友病患者的牙周治疗情况。一名患有IIA型血管性血友病的45岁女性因18号和47号牙出现牙龈出血和叩痛而被转诊接受牙周治疗。牙周检查结果包括探诊深度为2至6毫米、水平骨丧失以及46号牙的II度根分叉病变。在与血液科医生会诊后，在完成口腔卫生指导、龈上洁治和根面平整以及牙髓治疗后，对46号牙进行了根向复位瓣手术和半切术。在手术前30分钟给患者注射了500单位包括vWf多聚体的因子VIII。牙周组织愈合后，对下颌后牙区进行了修复治疗。在随访时，探诊深度为2至3毫米，探诊时牙龈出血极少。该患者的子女均患有血管性血友病。他们患有轻度至中度牙周炎，探诊深度为2至5毫米，探诊时牙龈出血。在牙周科医生和血液科医生的共同努力下，可以为血管性血友病患者提供有效的牙周治疗。
