Dental Surgery in an Asplenic Patient

Journal of the International Clinical Dental Research Organization

article

Om Nemichand Baghele¹  Smita Umakant Malbhage¹  Vishnudas Dwarkadas Bhandari¹  Sharvaree Ratnakar Deshpande²  Saleem Khan Gaffar Khan¹  Sunanda Gaddaley² 

[1] Department of Periodontology, Maharashtra Institute of Dental Sciences and Research;Department of Conservative Dentistry and Endodontics, Maharashtra Institute of Dental Sciences and Research

关键词: Asplenic patient;    dental management;    endodontic treatment;    idiopathic thrombocytic purpura;    periapical surgery;    periodontal surgery;    persistent periapical infection;    splenectomy;   

DOI  :  10.4103/jicdro.jicdro_25_20

来源: Panstwowy Zaklad Wydawnictw Lakarskich

【 摘 要 】

Nonsurgical endodontic treatment is a highly predictable treatment option in most cases, but surgery may be indicated for teeth with persistent periradicular pathosis unresponsive to it. The persistence of infection usually, but not always, indicates reduced immunological resistance. In such scenario, the clinician should be vigilant and find out the source of immunological incompetence before implementing treatment. Following splenectomy, individuals have an elevated risk of infection, in particular to encapsulated bacteria, Gram-negative pathogens such as Capnocytophagia carnimorsus and Bordetella holmesii, and intra-erythrocyte parasites such as malaria and babesia. After splenectomy, there are alterations in cell counts, cell quality, and immunological responses. Initially, after splenectomy, a reactive thrombocytosis and leukocytosis is observed. Splenectomized individuals are at risk to, overwhelming bacterial sepsis (overwhelming postsplenectomy infection). The complications are now infrequent because of pneumococcal vaccinations, prophylactic penicillin, and prompt medical attention at the first sign of fever. This case presents relevant management of a periradicular lesion in a 32-year-old male who has undergone splenectomy because of idiopathic thrombocytopenic purpura. The tooth was first endodontically treated that was followed by periodontal and periapical surgical treatment.

【 授权许可】

Unknown