Article: Volume 43 Number 8 Page 786 - October 2016

  Dent Update 2016; 43: 786-789  Read article

Oral surgery:  Hypercoagulopathy and Dento-alveolar Surgery- A Case of Exodontia in a Patient with Hughes’ Syndrome

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Abstract: Antiphospholipid syndrome is a thrombophilic disorder in which the presence of serum autoantibodies to phospholipid causes disruption of the protein C antithrombotic pathway. Deposition of these autoantibodies in small blood vessels can lead to intimal hyperplasia and acute thromboses. The associated hypercoagulopathy is problematic in dentistry since, if proper haemostasis is not achieved prior to discharge of exodontia patients, excessive haematoma formation may result. This case report and review of the literature discusses the condition in the context of hypercoagulation with reference to a patient undergoing a simple extraction, and suffering post-operative complications amounting to a large haematoma requiring evacuation.

Clinical relevance: Post-operative bleeding is one of the most common complications of exodontia. This case report and review of the literature provides the reader with a concise summary of the clotting cascade in parallel with an unusual case of post-operative bleeding.

Author notes: Vahe Petrosyan, BDS(Hons), MFDS RCSEd, Staff Grade in Oral and Maxillofacial Surgery, Northampton General Hospital, (, Richard WF Carr, BSc(Hons), BDS(Hons), MFDS RCSEd, MB ChB, Clinical Fellow in Oral and Maxillofacial Surgery, Tim Milton, BDS, FDS RCS(Eng), FDS RCSI, MSurgDentRCS(Eng), DipConSed(Newc), Associate Specialist in Oral Surgery and Peter J Revington, TD, BDS, MBBS, MScD, FDS RCS, FRCS(Eng), Consultant Oral and Maxillofacial Surgeon, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK.

Objective: To describe a case of exodontia in a patient with Hughes’ Syndrome.