{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T20:37:34Z","timestamp":1779395854414,"version":"3.53.1"},"reference-count":34,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,20]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Haemorrhagic disorders combined with soft tissue inflammation and infection may lead to severe bleeding complications before, during or after dental treatment. In selected cases, a combined therapeutic approach involving clinical therapies and systemic and local medication could improve the treatment outcomes and the patient\u2019s quality of life. This clinical case report, presents for the first time a successful combined approach, completed in a 38-year-old male patient with severe type-B haemophilia in which an infected tooth was extracted, an immediate implant was inserted, bone grafting was performed and early implant loading was successfully applied. In addition to the clinical therapy, medication was provided orally, systemically and locally, thus preventing the haemorrhagic complications and improving the patient\u2019s quality of life.<\/jats:p>","DOI":"10.1136\/bcr-2019-229204","type":"journal-article","created":{"date-parts":[[2019,3,23]],"date-time":"2019-03-23T04:07:50Z","timestamp":1553314070000},"page":"e229204","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Infected tooth extraction, bone grafting, immediate implant placement and immediate temporary crown insertion in a patient with severe type-B hemophilia"],"prefix":"10.1136","volume":"12","author":[{"given":"Jose Luis","family":"Calvo-Guirado","sequence":"first","affiliation":[{"name":"International Dental Research Cathedra Department of Oral Surgery, Universidad Catolica San Antonio de Murcia Facultad de Ciencias de la Salud, Murcia, Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios E","family":"Romanos","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Stony Brook University, \nStony Brook\n, New York, USA"},{"name":"Department of Oral Surgery and Implant Dentistry, Johann Wolfgang Goethe University, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Arcesio","family":"Delgado-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Digital Technology, Stony Brook University, Stony Brook, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,22]]},"reference":[{"key":"2025082709575347000_12.3.e229204.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200108023450522"},{"key":"2025082709575347000_12.3.e229204.2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/sj.bdj.2008.693","article-title":"Access to special care dentistry, part 5. Safety","volume":"205","author":"Dougall","year":"2008","journal-title":"Br Dent J"},{"key":"2025082709575347000_12.3.e229204.3","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/hae.13075","article-title":"Non-genetic risk factors in haemophilia A inhibitor management - the danger theory and the use of animal models","volume":"22","author":"L\u00f6vgren","year":"2016","journal-title":"Haemophilia"},{"key":"2025082709575347000_12.3.e229204.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02728.x"},{"key":"2025082709575347000_12.3.e229204.5","doi-asserted-by":"crossref","unstructured":"Torres-Ortu\u00f1o A , Cuesta-Barriuso R , Nieto-Munuera J , et al . The behaviour and perception of illness: modulating variables of adherence in patients with haemophilia. Vox Sang 2018:577\u201383.doi:10.1111\/vox.12669","DOI":"10.1111\/vox.12669"},{"key":"2025082709575347000_12.3.e229204.6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/hae.13130","article-title":"Determining the health-related quality of life in individuals with haemophilia in developing economies: results from the Brazilian population","volume":"23","author":"Salomon","year":"2017","journal-title":"Haemophilia"},{"key":"2025082709575347000_12.3.e229204.7","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.jse.2015.06.018","article-title":"Hemophilic arthropathy of the elbow: prophylaxis, imaging, and the role of invasive\u00a0management","volume":"24","author":"Dale","year":"2015","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082709575347000_12.3.e229204.8","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1038\/sj.bdj.2013.1097","article-title":"Guidance on the dental management of patients with haemophilia and congenital bleeding disorders","volume":"215","author":"Anderson","year":"2013","journal-title":"Br Dent J"},{"key":"2025082709575347000_12.3.e229204.9","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/ID.0000000000000145","article-title":"Protocol for oral implant rehabilitation in a hemophilic HIV-positive patient with type C hepatitis","volume":"23","author":"Castellanos-Cosano","year":"2014","journal-title":"Implant Dent"},{"key":"2025082709575347000_12.3.e229204.10","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.joms.2005.01.009","article-title":"Rehabilitation of a hemophiliac with implants: a medical perspective and case report","volume":"63","author":"Gornitsky","year":"2005","journal-title":"J Oral Maxillofac Surg"},{"key":"2025082709575347000_12.3.e229204.11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.22203\/eCM.v008a01","article-title":"A review of bioceramics and fibrin sealant","volume":"8","author":"Le Gu\u00e9hennec","year":"2004","journal-title":"Eur Cell Mater"},{"key":"2025082709575347000_12.3.e229204.12","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00402-004-0748-4","article-title":"In vivo biological performance of composites combining micro-macroporous biphasic calcium phosphate granules and fibrin sealant","volume":"125","author":"Jegoux","year":"2005","journal-title":"Arch Orthop Trauma Surg"},{"key":"2025082709575347000_12.3.e229204.13","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/clr.12592","article-title":"Role of mechanical compression on bone regeneration around a particulate bone graft material: an experimental study in rabbit calvaria","volume":"29","author":"Romanos","year":"2018","journal-title":"Clin Oral Implants Res"},{"key":"2025082709575347000_12.3.e229204.14","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/clr.12942","article-title":"Biological effects of compressive forces exerted on particulate bone grafts during socket preservation: animal study","volume":"29","author":"Delgado-Ruiz","year":"2018","journal-title":"Clin Oral Implants Res"},{"key":"2025082709575347000_12.3.e229204.15","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s10006-016-0560-7","article-title":"Prevention of post-operative bleeding in hemostatic compromised patients using native porcine collagen fleeces-retrospective study of a consecutive case series","volume":"20","author":"Zirk","year":"2016","journal-title":"Oral Maxillofac Surg"},{"key":"2025082709575347000_12.3.e229204.16","first-page":"CD009961","article-title":"Treatment for preventing bleeding in people with haemophilia or other congenital bleeding disorders undergoing surgery","volume":"9","author":"Coppola","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082709575347000_12.3.e229204.17","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1046\/j.1365-2516.2000.00423.x","article-title":"Proposal of a standard approach to dental extraction in haemophilia patients. A case-control study with good results","volume":"6","author":"Zanon","year":"2000","journal-title":"Haemophilia"},{"key":"2025082709575347000_12.3.e229204.18","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/j.1834-7819.2010.01242.x","article-title":"Management of third molar removal with a single dose of recombinant Factor IX (BeneFIX) and local measures in severe haemophilia B","volume":"55","author":"Hewson","year":"2010","journal-title":"Aust Dent J"},{"key":"2025082709575347000_12.3.e229204.19","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/MBC.0b013e32834ee182","article-title":"Treatment of odontogenic large cysts in haemophiliac patients","volume":"23","author":"Cakr","year":"2012","journal-title":"Blood Coagul Fibrinolysis"},{"key":"2025082709575347000_12.3.e229204.20","first-page":"239","article-title":"Management of third molar removal with doses of native plasma-derived factor IX (Octanine) and local measures in a female patient with severe hemophilia B: a case report","volume":"45","author":"Peisker","year":"2014","journal-title":"Quintessence Int"},{"key":"2025082709575347000_12.3.e229204.21","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12573"},{"key":"2025082709575347000_12.3.e229204.22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/hae.12805","article-title":"Choosing and using non-steroidal anti-inflammatory drugs in haemophilia","volume":"22","author":"Arachchillage","year":"2016","journal-title":"Haemophilia"},{"key":"2025082709575347000_12.3.e229204.23","first-page":"149","article-title":"Acute periodontal lesions","volume":"2014","author":"Herrera","year":"2000","journal-title":"Periodontol"},{"key":"2025082709575347000_12.3.e229204.24","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1080\/17474086.2018.1489719","article-title":"The benefits of prophylaxis in patients with hemophilia B","volume":"11","author":"Castaman","year":"2018","journal-title":"Expert Rev Hematol"},{"key":"2025082709575347000_12.3.e229204.25","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12672"},{"key":"2025082709575347000_12.3.e229204.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2007.01625.x"},{"key":"2025082709575347000_12.3.e229204.27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01843.x"},{"key":"2025082709575347000_12.3.e229204.28","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2001.00534.x"},{"key":"2025082709575347000_12.3.e229204.29","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/sj.ebd.6401226","article-title":"Preventing perioperative bleeding in patients with inherited bleeding disorders","volume":"18","author":"Watterson","year":"2017","journal-title":"Evid Based Dent"},{"key":"2025082709575347000_12.3.e229204.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0765.1988.tb01030.x"},{"key":"2025082709575347000_12.3.e229204.31","first-page":"1","article-title":"Topical application of tranexamic acid for the reduction of bleeding","volume":"7","author":"Ker","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082709575347000_12.3.e229204.32","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1002\/j.1552-4604.1987.tb05605.x","article-title":"Distribution of tranexamic acid to plasma and saliva after oral administration and mouth rinsing: a pharmacokinetic study","volume":"27","author":"Sindet-Pedersen","year":"1987","journal-title":"J Clin Pharmacol"},{"key":"2025082709575347000_12.3.e229204.33","doi-asserted-by":"crossref","unstructured":"Ockerman A , Miclotte I , Vanhaverbeke M , et al . Local haemostatic measures after tooth removal in patients on antithrombotic therapy: a systematic review. Clin Oral Investig 2018.doi:10.1007\/s00784-018-2576-x","DOI":"10.1007\/s00784-018-2576-x"},{"key":"2025082709575347000_12.3.e229204.34","first-page":"197","article-title":"Le fratture negli emofilici","volume":"2","author":"Boni","year":"1976","journal-title":"Giornale Italiano Di Ortopedia E Traumatoloi\u0131\u2019a"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:58:06Z","timestamp":1756313886000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,22]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2019-229204"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229204","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}