Dec 15, 2015
-HA
-HB
-Factor XI deficiency
-Factor II deficiency
-Factor V deficiency
-Factor XIII deficiency
-Factor VII deficiency
Dental problems in Hemophilia
-Severe Deficiency (Less than 1%)
-Moderate Deficiency (less than 1%)
-Moderate Deficiency (1%-5%)
-Mild Deficiency (≥ 5%)
Precoagolant classification
-Frequent bleeding
-Two or four per month
-Common sites (Joint , muscle , skin)
-Hemarthrosis
-Chronic muscular problems
-Debilitating painful arthritis
-Knee , elbow , ankle , Hip , shoulder
-Pseudotumor in jaw
-Mouth laceration
Severe deficiency Hemophilia
Hemophilia
Infrequently bleeding
Only surgery or Trauma
Purified concentration factor
Factor through recombinant technology
Whole blood , plasma , cryoprecipitate
Half life factor VIII , IX
Medical Treatment of Hemophilia
(…Continue)Factor VIII concentrate
Routine bleeding (40%)
Mild VIII Deficiency DDAVP
DDAVP Rise of factor VIII Activity/VWF
Tachyphylaxis
Water Retention
Hyponautremia
Seizures
Factor IX deficiency
Purified coagulation factor IX
concentrate
Pure production class protrombine
complex
PCC = factor IX + …
Repeated PCC Infusion DIC
Level factor (40%)
Hemophilia B Treatment
Vonwillbrand disease
Subtyping VWF
DDAVP (VWF)
Other modalities
Inhibitors(28% HA , 3% - 5% )in Severe HB
Low Response Rate to factors
Continue Hemorrhage
Arthritis
Degenerative joint disease
Viral Infection blood borne Infection
AIDS , Hepatitis B,C
Complications factor Infusion
Risks to dental staff
Acquiring hepatitis B,C
Acquiring HIV
Development of a treatment plan in the
hemophilia
Use of anti fibrinolytics ,Dosage
Side effect
Pain control in Hemophilia (…Continue)
Analgesia
Local Anesthesia
PDL Injection
Infiltration
Block Anesthesia
Prevention of Dental Disease
Periodontal therapy
Restorative procedures
Pulp therapy
Oral surgery
Surgical complications
Antibiotic prophylaxis
Orthodontic treatment
Dental Healthcare protocol in hemophilia
The end
Dr . Jabbarifar
2007
Fungal Infection
Viral Infection
Bacterial Infection
Neoplasm's
Idiopathic lesions
HIV-gingivitis , HIV – Periodontitis .
Oral manifestations HIV Infection
The end
Dr . Jabbarifar
2007