Periodontal considerations for Glanzmann's thrombasthenic patient
Journal name: Journal of Indian Society of Periodontology
Original article title: Periodontal considerations for Glanzmann's thrombasthenic patient
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Umesh Yadalam, K Kranti, Hema Seshan
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Periodontal considerations for Glanzmann's thrombasthenic patient
Year: 2008 | Doi: 10.4103/0972-124X.44095
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Glanzmann's thrombasthenia (GT) is a rare inherited bleeding disorder characterized by diminished clot retraction and normal platelet counts, prothrombin, and partial thromboplastin times. This autosomal recessive disorder results from a deficiency in the platelet membrane glycoprotein IIb–IIIa complex, leading to defective platelet hemostatic plug formation. Common manifestations of GT include purpura, epistaxis, gingival bleeding, and menorrhagia, with patients typically diagnosed in early childhood. This condition is particularly prevalent in consanguineous populations, and while it affects both sexes, males more frequently present with gingival bleeding.
Periodontal Treatment Considerations for GT
A significant concern in managing patients with GT involves the risk of bleeding during dental procedures. In a reported case, a 9-year-old girl with a known history of GT presented with gingival bleeding and was referred for periodontal treatment. The patient's medical history revealed repeated episodes of bleeding from minor trauma and the need for multiple blood transfusions. Upon examination, the patient exhibited signs of mild gingivitis. Treatment included scaling and polishing under platelet transfusion, coupled with strict oral hygiene protocols, the use of 0.12% chlorhexidine, and tranexamic acid mouth rinses. This careful management approach successfully decreased gingival bleeding and maintained the patient's oral health.
Conclusion
Effective management of periodontal health in patients with Glanzmann's thrombasthenia requires a collaborative effort between dental and hematological professionals to anticipate and mitigate bleeding risks. Through careful planning, a thorough medical history, appropriate hematological pretreatment, and emphasis on oral hygiene, periodontal treatments can be successful for GT patients. Regular monitoring and preventive care play a crucial role in managing this complex condition, highlighting the importance of interdisciplinary approaches in the treatment of bleeding disorders.
FAQ section (important questions/answers):
What is Glanzmann's thrombasthenia and its primary symptoms?
Glanzmann's thrombasthenia (GT) is a bleeding disorder characterized by defective platelet function. Common symptoms include purpura, epistaxis, gingival bleeding, and menorrhagia. Patients typically have normal platelet counts and prolonged bleeding times.
How is Glanzmann's thrombasthenia diagnosed?
Diagnosis of GT involves normal prothrombin time and partial thromboplastin time, prolonged bleeding time, and absence of platelet aggregation in presence of certain agonists. A family history, particularly in consanguineous unions, may also be significant.
What treatment is recommended for periodontal issues in GT patients?
For GT patients, periodontal treatment should ideally be done with platelet transfusions. Good oral hygiene and use of antiseptic mouth rinses, such as chlorhexidine, is crucial to prevent bleeding and manage gingival health.
How can bleeding risk be managed during dental procedures?
Bleeding risk in GT patients should be managed by ensuring thorough medical history review, consultation with a hematologist, and performing dental procedures during or after platelet transfusion. Preventive care is highly recommended.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Periodontal considerations for Glanzmann's thrombasthenic patient”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Bleeding:
Bleeding in Glanzmann's thrombasthenia (GT) is a critical symptom caused by a deficiency in the platelet glycoprotein IIb–IIIa complex, leading to impaired platelet function. Patients experience recurrent bleeding episodes such as purpura, epistaxis, and gum bleeding. Proper management, including platelet transfusions, is essential to prevent life-threatening hemorrhages during medical procedures.
2) Hygiene (Hygienic):
Hygiene is vital for individuals with GT to prevent infections and further bleeding risk. Dental hygiene, emphasized through regular brushing and the use of antiseptic mouth rinses like chlorhexidine, helps maintain oral health. Educating patients on meticulous oral hygiene practices ensures optimal outcomes, reducing the chance of periodontal disease and the associated bleeding.
3) Disease:
Glanzmann's thrombasthenia is a rare, inherited blood disorder characterized by normal platelet counts yet significant bleeding due to defective platelet aggregation. Recognizing the extent and variability of the bleeding manifestations is essential for diagnosis and management. Understanding this disease's pathology guides treatment decisions to ensure patient safety, especially in dental care.
4) Visit:
Visit refers to the dental appointments required for monitoring and treating GT patients. Killeading dental procedures should occur during or after platelet transfusions to manage the risk of bleeding effectively. Scheduled follow-ups are crucial for monitoring oral health, reinforcing hygiene practices, and ensuring successful management of GT-related dental complications.
5) Blood:
Blood plays a fundamental role in Glanzmann's thrombasthenia, as patients experience severe bleeding due to dysfunction in their blood platelets. Maintaining optimal blood levels and understanding the role of blood transfusions in managing bleeding episodes is crucial. This underscores the need for careful blood management during dental interventions to mitigate hemorrhagic risks.