Patients with hereditary coagulopathies such as hemophilia A and Von Willebrand disease may suffer dental implant and marginal bone loss similar to healthy controls after 2 years, according to a new study published in Medicina Oral, Patología Oral y Cirugía Bucal.
The researchers reviewed 39 panoramic radiographies from 13 patients with hereditary coagulopathies and 13 healthy control participants. The study group included a total of 37 implants, including 17 implants in 6 patients with hemophilia A and 20 implants in 7 patients with Von Willebrand disease. There were 26 implants in the control group.
According to the results, there was no statistical difference in marginal bone loss among the 2 groups. Two implants with external connection were lost in the group of patients with hereditary coagulopathies; none were lost in the control group.
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Patients with hemophilia A and Von Willebrand disease had longer and narrower implants compared with healthy participants, and 43.2% of them had an external prosthetic connection. Moreover, the change of prosthetic platform was more common in the group of healthy controls.
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Two patients with hereditary coagulopathies suffered hemorrhagic accidents, although the difference compared with healthy controls was not statistically significant. Patients with hemophilia A or Von Willebrand disease were more often diagnosed with hepatitis and HIV, and less with previous periodontitis.
The survival rate in patients with hereditary coagulopathies was 94.6% compared with 100% in healthy controls. The overall survival rate was 96.8%.
“Dentists should be very meticulous when opting for rehabilitation with implants in patients with hereditary coagulopathies, and always carry out a prior consultation with the hematology services to establish the action protocols,” Pérez-Fierro and colleagues emphasized.
There is a great aversion to surgical treatments in patients with hereditary coagulopathies, and dentists tend to steer away from this type of treatment.
Reference
Pérez-Fierro M, Castellanos-Cosano L, Hueto-Madrid JA, López-Jiménez J, Núñez-Vázquez RJ, Machuca-Portillo G. 2-years retrospective observational case-control study on survival and marginal bone loss of implants in patients with hereditary coagulopathies. Med Oral Patol Oral Cir Bucal. Published online April 26, 2023. doi:10.4317/medoral.25997
