Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study

Background: Glanzmann thrombasthenia (GT) is a very rare autosomal inherited bleeding disease affecting megakaryocyte lineage with impacts on oral health such as gingival bleeding, which requires specific management protocols. Very few clinical cases have been published in the dental and hematologic...

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Main Authors: Maxime Delarue, François Severac, Martine Soell, Léa Pierre, Dominique Desprez, Bornert Fabien
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Research and Practice in Thrombosis and Haemostasis
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Online Access:http://www.sciencedirect.com/science/article/pii/S2475037924003145
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author Maxime Delarue
François Severac
Martine Soell
Léa Pierre
Dominique Desprez
Bornert Fabien
author_facet Maxime Delarue
François Severac
Martine Soell
Léa Pierre
Dominique Desprez
Bornert Fabien
author_sort Maxime Delarue
collection DOAJ
description Background: Glanzmann thrombasthenia (GT) is a very rare autosomal inherited bleeding disease affecting megakaryocyte lineage with impacts on oral health such as gingival bleeding, which requires specific management protocols. Very few clinical cases have been published in the dental and hematologic literature. Objectives: This study focuses on a series of 21 patients affected specifically by GT and their hemorrhagic prophylaxis management with the use of recombinant activated factor VII (rFVIIa) for dental extractions and full-mouth debridement. Methods: Data were collected from medical and dental records. rFVIIa was administered prophylactically for oral procedures, following a standardized protocol. Each sessions were performed by experienced oral surgeons, and outcomes were analyzed with a focus on bleeding complications and adverse events. Results: Forty-one full-mouth debridements and 176 dental extractions were performed during 102 sessions of dental care in an outpatient setting. A total of 226 injections of rFVIIa was delivered. The mean number of injections was 2.2 (range, 1-4) per dental procedure. The overall rate of bleeding complications was 5.9% (n = 6). All 6 hemorrhagic complications were classified as minor bleeding. No thromboembolic event or allergic reaction was observed. Conclusion: The data presented in this retrospective observational study support the efficacy and safety of rFVIIa for the prevention of bleeding during invasive dental procedures in patients affected by GT. The rFVIIa protocol presented here seems to be a safe and efficient protocol for the prevention of bleeding during invasive oral procedures.
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spelling doaj-art-9e49e8bec0e44dfeb64cc3aa04e7a0be2025-08-20T02:40:07ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792024-11-018810261910.1016/j.rpth.2024.102619Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational studyMaxime Delarue0François Severac1Martine Soell2Léa Pierre3Dominique Desprez4Bornert Fabien5University of Strasbourg, Faculty of Dental Surgery, Strasbourg, France; University Hospital Strasbourg, Department of Oral Surgery, Strasbourg, France; Correspondence Maxime Delarue, University Hospital Strasbourg, Oral Surgery, 1 Place de l'Hôpital, 67000 Strasbourg, France.University of Strasbourg, Faculty of Medicine, Strasbourg, France; University Hospital Strasbourg, Department of Public Health, GMRC, Strasbourg, FranceUniversity of Strasbourg, Faculty of Dental Surgery, Strasbourg, France; University Hospital Strasbourg, Dental Unit, Hôpital de Hautepierre, Strasbourg, FranceUniversity Hospital Strasbourg, Department of Haemostasis, Regional Inherited Bleeding Diseases Center, Hôpital de Hautepierre, Strasbourg, FranceUniversity Hospital Strasbourg, Department of Haemostasis, Regional Inherited Bleeding Diseases Center, Hôpital de Hautepierre, Strasbourg, FranceUniversity of Strasbourg, Faculty of Dental Surgery, Strasbourg, France; University Hospital Strasbourg, Department of Oral Surgery, Strasbourg, France; INSERM (French National Institute of Health and Medical Research) UMR 1260, Regenerative Nanomedicine, CRBS, Strasbourg, FranceBackground: Glanzmann thrombasthenia (GT) is a very rare autosomal inherited bleeding disease affecting megakaryocyte lineage with impacts on oral health such as gingival bleeding, which requires specific management protocols. Very few clinical cases have been published in the dental and hematologic literature. Objectives: This study focuses on a series of 21 patients affected specifically by GT and their hemorrhagic prophylaxis management with the use of recombinant activated factor VII (rFVIIa) for dental extractions and full-mouth debridement. Methods: Data were collected from medical and dental records. rFVIIa was administered prophylactically for oral procedures, following a standardized protocol. Each sessions were performed by experienced oral surgeons, and outcomes were analyzed with a focus on bleeding complications and adverse events. Results: Forty-one full-mouth debridements and 176 dental extractions were performed during 102 sessions of dental care in an outpatient setting. A total of 226 injections of rFVIIa was delivered. The mean number of injections was 2.2 (range, 1-4) per dental procedure. The overall rate of bleeding complications was 5.9% (n = 6). All 6 hemorrhagic complications were classified as minor bleeding. No thromboembolic event or allergic reaction was observed. Conclusion: The data presented in this retrospective observational study support the efficacy and safety of rFVIIa for the prevention of bleeding during invasive dental procedures in patients affected by GT. The rFVIIa protocol presented here seems to be a safe and efficient protocol for the prevention of bleeding during invasive oral procedures.http://www.sciencedirect.com/science/article/pii/S2475037924003145blood platelet disordersdental scalinghemorrhageoralrFVIIasurgery
spellingShingle Maxime Delarue
François Severac
Martine Soell
Léa Pierre
Dominique Desprez
Bornert Fabien
Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
Research and Practice in Thrombosis and Haemostasis
blood platelet disorders
dental scaling
hemorrhage
oral
rFVIIa
surgery
title Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
title_full Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
title_fullStr Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
title_full_unstemmed Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
title_short Oral invasive procedures in Glanzmann thrombasthenia: a retrospective observational study
title_sort oral invasive procedures in glanzmann thrombasthenia a retrospective observational study
topic blood platelet disorders
dental scaling
hemorrhage
oral
rFVIIa
surgery
url http://www.sciencedirect.com/science/article/pii/S2475037924003145
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AT leapierre oralinvasiveproceduresinglanzmannthrombastheniaaretrospectiveobservationalstudy
AT dominiquedesprez oralinvasiveproceduresinglanzmannthrombastheniaaretrospectiveobservationalstudy
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