Toygar Hilal Uslu, Guzeldemir Esra
Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
J Periodontol. 2007 Jun;78(6):1154-8. doi: 10.1902/jop.2007.060393.
Glanzmann thrombasthenia (GT) is an exceedingly rare but well-defined inherited disorder of platelet function caused by a defect in the glycoprotein IIb/IIIa complex. The association of GT with consanguinity has been noted, especially in geographic regions in which intermarriage is common. In most patients, GT is diagnosed during early infancy or before the age of 5 years. Common manifestations of this disorder are gingival hemorrhage, purpura, epistaxis, petechiae, and menorrhagia. Chronic, prolonged, untreated, or unsuccessfully treated bleeding may be life threatening.
We report two female patients with GT who were referred by our hematology clinic to our periodontology department for the treatment of excessive gingival bleeding. The first patient was treated with a platelet transfusion and underwent periodontal therapy (scaling and root planing and dental polishing). The second patient, whose GT was undiagnosed at the time of her referral to our department, applied to our emergency service because of uncontrolled gingival bleeding that developed after scaling and root planing was performed by her dentist. Both patients had been called for regular dental visits.
All treated sites healed without complications. The first patient was monitored for 2 years, during which she practiced proper oral hygiene and experienced no periodontal complications. The other patient did not participate in follow-up.
Gingival bleeding is usually the first sign of most hematologic disorders, and dentists must be alert for the signs of unusual gingival bleeding. In such cases, collaboration with a hematologist is essential. Under the proper circumstances, periodontal treatment can be performed with an acceptable outcome. With proper oral hygiene, we believe that there will be no complications and no gingival bleeding.
Glanzmann血小板无力症（GT）是一种极其罕见但定义明确的遗传性血小板功能障碍，由糖蛋白IIb/IIIa复合物缺陷引起。GT与近亲结婚的关联已被注意到，尤其是在近亲通婚常见的地理区域。在大多数患者中，GT在婴儿早期或5岁之前被诊断出来。这种疾病的常见表现包括牙龈出血、紫癜、鼻出血、瘀点和月经过多。慢性、长期、未治疗或治疗不成功的出血可能危及生命。
我们报告了两名患有GT的女性患者，她们被血液科转诊至我们的牙周病科治疗牙龈过度出血。第一名患者接受了血小板输注并接受了牙周治疗（龈上洁治、龈下刮治和牙齿抛光）。第二名患者在转诊至我们科室时GT未被诊断出来，由于她的牙医进行龈上洁治和龈下刮治后出现无法控制的牙龈出血而前来我们的急诊服务。两名患者都曾被要求定期进行牙科检查。
所有治疗部位均愈合且无并发症。第一名患者被监测了2年，在此期间她保持了良好的口腔卫生，未出现牙周并发症。另一名患者未参与随访。
牙龈出血通常是大多数血液系统疾病的首发症状，牙医必须警惕异常牙龈出血的迹象。在这种情况下，与血液科医生合作至关重要。在适当的情况下，可以进行牙周治疗并取得可接受的结果。我们相信，通过适当的口腔卫生，不会出现并发症和牙龈出血。
