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Managing Oral Surgery in von Willebrand Disease: Lessons from a Challenging Case
Giuliano Ascani1,2, Paola Ranalli2,3, Francesca Azzuni1,4
1Department of Maxillofacial Surgery, Spirito Santo Hospital, Pescara, Italy.
Journal of Clinical and Experimental Dentistry
|July 7, 2025
Summary
Diagnosing undiagnosed von Willebrand disease during dental extraction is challenging. A multidisciplinary approach with factor concentrates and tranexamic acid prevents severe bleeding in oral surgery.
Area of Science:
- Hematology
- Oral Surgery
Background:
- Von Willebrand disease is a rare inherited bleeding disorder affecting platelet function.
- Diagnosis can be delayed, posing risks during invasive dental procedures.
Observation:
- A patient experienced severe bleeding during impacted third molar extraction.
- Initial bleeding was unresponsive to standard hemostatic measures, prompting further investigation.
Findings:
- Hematological evaluation confirmed Type I von Willebrand disease.
- A multidisciplinary protocol involving factor concentrates and tranexamic acid successfully managed subsequent extractions, preventing complications.
Implications:
- Highlights the critical need for early diagnosis of bleeding disorders in dentistry.
- Emphasizes the importance of a collaborative, multidisciplinary approach for safe oral surgery in patients with von Willebrand disease.
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