Manejo odontológico del paciente con terapia antitrombotica / Dental management of patient with antithrombotic therapy

El presente manuscrito tiene como objetivo proporcionar una revisión bibliográfica del manejo odontológico del paciente que recibe terapia antitrombótica, debido a que las personas con enfermedad cardiovascular frecuentemente reciben este tipo de terapia y constituyen una amplia población en Venezuela, y junto a la alta prevalencia de caries y enfermedad periodontal, es necesario que los odontólogos y especialistas estén actualizados sobre el manejo de estos pacientes ya que, el tratamiento quirúrgico y no quirúrgico de las afecciones bucales pueden desencadenar complicaciones hemorrágicas y la suspensión del medicamento puede producir la aparición de un fenómeno trombótico, por otro lado, la terapéutica farmacológica empleada comúnmente en odontología puede interactuar con el tratamiento médico y provocar complicaciones; para el manejo de estos pacientes, es importante utilizar los agentes hemostáticos locales para evitar y controlar el sangrado intraoperatorio y postoperatorio.

The objective of the present work is to give information related to the dental management of patient receiving antithrombotic therapy, since people with heart disease frequently receive this kind of therapy, and they range a wide population in Venezuela , in addition to the high prevalence of cavities and periodontal disease ; therefore, it is necessary the specialists and dentist to be updated on the management of those patients, because the surgical and non surgical dental treatment may lead to hemorrhagic complications and on one hand, the withdrawal of medication may cause the onset of a thrombotic phenomenon, on the other hand, the pharmacological therapy commonly used in dentistry may interact to the medical treatment and cause complications; for managing those patients, it is important to use the haemostatic agents in order to avoid and control the local bleeding.

Evaluating periodontal conditions in patients with von Willebrand's disease in Hospital Universitario de Maracaibo (University Hospital, Maracaibo)-Venezuela.

OBJECTIVE: To evaluate the periodontal conditions of patients with von Willebrand's Disease (vWD who went for dental examination in the "Area of attention to patients with systemic disease" of the University Hospital in Maracaibo, Venezuela. DESIGN OF THE STUDY: 40 patients (28 female and 12 male), with ages ranging from 10 to 72 years, who regularly attended dental control, were evaluated along with a control group of patients with no hemorrhagic alterations. Periodontal conditions were evaluated using the Löe and Silness Gingival Index (GI) and Greene and Vermillon's Simplified Oral Hygiene Index (SOHI). The results were analyzed using averages, Standard Deviation, Student's T-test and the Chi(2) test, with P<0.0005. RESULTS: 92.5% of the patients had Type 1 vWD and 7.5% had Type 2 or 3. Periodontal Indices: GI (0.70+/-0.40, slight) and SOHI (1,70+/-0,80, acceptable). Comparison with the control group showed that there were statistically significant differences in the SOHI (P = 0.02). CONCLUSIONS: Periodontal conditions in patients with vWD regularly attending for dental control were within acceptable parameters. Education of the patient with regard to prevention and opportune treatment is of utmost importance, thereby avoiding the oral hemorrhagic complications produced by the periodontal disease. Of equal importance is multidisciplinary teamwork.

Evaluating periodontal conditions in patients with von Willebrand’s disease in Hospital Universitario de Maracaibo (University Hospital, Maracaibo) -Venezuela

Objective: To evaluate the periodontal conditions of patients with von Willebrand’s Disease (vWD) who went fordental examination in the “Area of attention to patients with systemic disease” of the University Hospital in Maracaibo, Venezuela. Design of the Study: 40 patients (28 female and 12 male), with ages ranging from 10 to 72 years, who regularly attended dental control, were evaluated along with a control group of patients with no hemorrhagicalterations. Periodontal conditions were evaluated using the Löe and Silness Gingival Index (GI) and Greene andVermillon’s Simplified Oral Hygiene Index (SOHI). The results were analyzed using averages, Standard Deviation,Student’s T-test and the Chi² test, with P<0.0005. Results: 92.5% of the patients had Type 1 vWD and 7.5% had Type 2 or 3. Periodontal Indices: GI (0.70±0.40, slight) and SOHI (1,70±0,80, acceptable). Comparison with the control group showed that there were statistically significant differences in the SOHI (P = 0.02). Conclusions: Periodontal conditions in patients with vWD regularly attending for dental control were within acceptable parameters. Education of the patient with regard to prevention and opportune treatment is of utmost importance, thereby avoiding the oral hemorrhagic complications produced by the periodontal disease. Of equal importance is multidisciplinary teamwork (AU)

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Relación entre las manifestaciones bucales asociadas al VIH-SIDA pediátrico y las categorías clínicas / The relationship between the oral manifestations associated with pediatric AIDS-HIV and clinical inmunological categories

El objetivo es relacionar las manifestaciones bucales asociadas al VIH-SIDA y las categorías clínicas inmunológicas de los pacientes que acuden al Servicio de Odontopediatría del Hospital Universitario de Maracaibo-Estado Zulia. Se estudiaron 32 pacientes en edades comprendidas entre 6 meses y 18 años, positivos para la prueba ELISA y Wester Blot. Se identificaron las manifestaciones bucales a través del examen clínico y se clasificaron de acuerdo con el grupo colaborador de las manifestaciones bucales para la infección por VIH pediátrico y se establecieron las categorías clínicas inmunológicas según el CDC de Atlanta en 1994. El 68,75 por ciento presentó manifestaciones bucales asociadas al VIH-SIDA, la mayoría (71,42 por ciento) se encontraban en el grupo de las más comunes (candidiasis, herpes, parotiditis y ulceras aftosas), siendo la más frecuente la candidiasis (47,61 por ciento) asociada a la categoría clínico inmunológica C de síntomas graves o SIDA y del grupo de las menos frecuentes en niños, sólo se presentó un linfoma de Burkitt correspondiente a la misma categoría. Los niños presentaron alto porcentaje de manifestaciones bucales las cuales estuvieron relacionadas con la categoría clínica inmunológica y depresión del sistema inmunitario.