Evidence map›Paper›PMID 40621141›Full record

ArticleJournal of clinical and experimental dentistry2025

Managing Oral Surgery in von Willebrand Disease: Lessons from a Challenging Case.

Giuliano Ascani, Paola Ranalli, Francesca Azzuni, Silvia Benfatto, Michele Romano, Erminia Di Nobile

Abstract readCase Reports
In one paragraph

Article in Journal of clinical and experimental dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Giuliano AscaniDepartment of Maxillofacial Surgery, Spirito Santo Hospital, Pescara, Italy.
Paola RanalliUniversity of Chieti - Pescara, Chieti, Italy.
Francesca AzzuniDepartment of Maxillofacial Surgery, Spirito Santo Hospital, Pescara, Italy.
Silvia BenfattoDepartment of Maxillofacial Surgery, Spirito Santo Hospital, Pescara, Italy.
Michele RomanoDepartment of Maxillofacial Surgery, Spirito Santo Hospital, Pescara, Italy.
Erminia Di NobilePrivate Dental Practice, Chieti and Pescara, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Von Willebrand disease is a rare inherited bleeding disorder characterized by deficient or defective von Willebrand factor, crucial for platelet adhesion and aggregation. This case report aims to highlight the challenges of diagnosing undiagnosed von Willebrand disease in dental practice and to describe a multidisciplinary management approach to prevent life-threatening complications during oral surgery. A 32-year-old male with no significant medical history underwent surgical extraction of an impacted third molar. The patient experienced severe intraoperative bleeding unresponsive to standard local hemostatic measures. Subsequent hematological evaluation confirmed Type I von Willebrand disease. For the extraction of the remaining impacted molars, a tailored protocol was implemented, including preoperative administration of von Willebrand factor-containing factor VIII concentrates, tranexamic acid therapy, local hemostatic agents, and close perioperative monitoring in collaboration with hematology specialists. The initial procedure resulted in excessive bleeding, leading to the diagnosis of von Willebrand disease. Following the implementation of the multidisciplinary protocol, the patient underwent multiple extractions without immediate or delayed bleeding complications. Hemoglobin levels remained stable postoperatively, and the patient reported satisfactory pain control. Early identification and tailored management of bleeding disorders are critical in oral surgery to prevent severe hemorrhagic complications. A multidisciplinary approach involving dentists, oral surgeons, and hematologists ensures safe and effective care for patients with von Willebrand disease, emphasizing the importance of comprehensive preoperative assessments and structured treatment protocols.

Identifiers

PMID40621141
PMCPMC12225761

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