Hemofilija i oralno zdravlje

master's thesis

• Title (english): Hemophylia and oral health
• Author: Anđela Krstanović
• Mentor: Petar Gaćina (mentor)
• Committee member: Petar Gaćina (predsjednik povjerenstva)
• Committee member: Gorana Mirošević (član povjerenstva)
• Committee member: Marko Nikolić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Internal Medicine); Zagreb
• Defense date and country: 2021-06-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Hemofilija A i B nasljedni su poremećaji krvarenja uzrokovani kongenitalnim nedostatkom ili defektom koagulacijskih čimbenika VIII ili IX. Hemofilija A i B se nasljeđuju X-vezano recesivno, a oboljeli su uglavnom osobe muškoga spola. U pacijenata s teškom hemofilijom javljaju se opsežna krvarenja zbog traume u prvim mjesecima života. Ipak, karakteristična spontana krvarenja poput hemartroza, većinom se javljaju s početkom hodanja. S druge strane, blagi oblici hemofilije mogu ostati neprepoznati do starije životne dobi, kad se jave krvarenja povezana s operacijama ili traumom. Krvarenja se u hemofiličara većinom zaustavljaju i preveniraju nadomjesnom terapijom faktora VIII i IX do razine potrebne za zadovoljavajuću hemostazu. Koriste se i dodatna sredstva za lokalnu i sistemsku primjenu. Oralne bolesti nisu direktno uzrokovane hemofilijom. Njihova visoka učestalost u
hemofiličara posljedica je straha pacijenata i stomatologa od stomatoloških zahvata i pravilnog održavanja oralne higijene kako bi izbjegli krvarenja. Održavanje oralnog zdravlja prioritet je u ovakvih pacijenata. Da bi im se pružila adekvatna stomatološka skrb, pacijenti moraju biti educirani o važnosti oralne higijene, fluoridacije, pravilne prehrane i učestalih stomatoloških pregleda.
Tijekom rutinskih dentalnih tretmana krvarenja se uglavnom ne javljaju, stoga ne postoje kontraindikacije za takve postupke kod hemofiličara. Za invazivnije tretmane, poput kirurških ili davanja provodne anestezije, potrebna je nadomjesna terapija faktorima. Takvi zahvati zahtijevaju konzultaciju s pacijentovim hematologom, a stomatolog mora biti upoznat s mjerama održavanja lokalne hemostaze. Za adekvatno stomatološko liječenje pacijenata s hemofilijom esencijalno je poboljšanje u komunikaciji između stomatologa i hematologa.

Abstract (english)

Hemophilia A and B are hereditary bleeding disorders caused by congenital deficiency or defect of coagulation factor VIII or IX. Hemophilia A and B are X-linked recessive disorders and the affected are mostly males. Patients with severe forms of hemophilia experience extensive bleedings as a result of trauma during the first few months of life. However, the most characteristic spontaneous bleedings, such as hemarthrosis, usually occur with the onset of walking. On the other side, mild hemophilia may not be recognized until later in life when bleeding related to surgery or trauma occurs. Bleedings in hemophiliacs are usually treated or prevented by replacement therapy of factor VIII or IX up to hemostatically adequate levels. In addition, ancillary local and systemic treatments are used. Although hemophilias do not directly cause oral diseases, high incidence of dental problems secondary to the bleeding disorder cause fear of dental treatments both in patients and dentists. Mantaining good oral health is a priority in hemophiliacs. To provide effective dental treatment, they should be educated about the importance of oral hygiene, fluoridation, proper nutrition and frequent dental examinations.
Bleeding does not usually occur in routine dental procedures so there are no contraindications to those treatments. Adequate increase of the factor level is required prior to more invasive treatments, such as surgery or block anesthesia. Such treatments must be discussed with the patient's hematologist, and the dentist should be familiar with the measures of local hemostasis. The improvement of communication between doctors of dental medicine and hematologists is essential for effective dental treatment of patients with hemophilia.

• Keywords: hemofilija; oralno zdravlje; zgrušavanje krvi
• Keywords (english): Hemophilia A; Oral Health; Blood Coagulation Factors
• Language: croatian
• URN:NBN: urn:nbn:hr:127:281096
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-09-01 07:48:27