{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:03:42Z","timestamp":1789049022945,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Aplastic anemia is an intractable disease characterized by pancytopenia, susceptibility to infection, and difficulty in achieving hemostasis. In patients with severe periodontal disease and aplastic anemia, spontaneous bleeding from the gingival tissue due to thrombocytopenia and during brushing is common, which may further exacerbate dental issues. Comprehensive periodontal treatment for patients with aplastic anemia is highly challenging and requires collaboration with a hematologist. Here, we discuss the case of a patient with aplastic anemia and severe periodontitis who was successfully treated in collaboration with our hematology department.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 36-year-old Japanese woman with chief complaints of spontaneous gingival bleeding, pain, and increasing tooth mobility consulted our department. She had developed pancytopenia at age 11\u00a0years and was later diagnosed with aplastic anemia, making her susceptible to infection due to leukopenia. The results of the initial periodontal examination led to a diagnosis of severe generalized periodontitis (generalized stage IV grade C periodontitis) caused by leukopenia and poor oral hygiene. We adopted a comprehensive treatment plan, including invasive dental procedures. The patient exhibited no postoperative bleeding due to aplastic anemia-induced thrombocytopenia and experienced a good outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Both physicians and dentists should be aware that immunocompromised patients with aplastic anemia are at risk of developing severe periodontitis with severe alveolar bone resorption if the condition is combined with poor oral hygiene. Even in the presence of aplastic anemia, patients with severe periodontitis can undergo comprehensive dental treatment, including dental extraction and periodontal surgery, if bleeding and susceptibility to infection are controlled. This requires the cooperation of the patient and hematologists and can ultimately contribute to improving the patient\u2019s quality of life.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-03170-0","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T16:02:33Z","timestamp":1639152153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Proposed protocol for treatment of severe periodontitis without platelet transfusion in patients with aplastic anemia: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-2888","authenticated-orcid":false,"given":"Satoru","family":"Morikawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Usuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Miyashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taneaki","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"3170_CR1","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1056\/NEJMra1413485","volume":"379","author":"NS Young","year":"2018","unstructured":"Young NS. 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Dental extraction in the thrombocytopenic patient is safe and complications are easily managed. J Oral Maxillofac Surg. 2013;71:1647\u201352.","journal-title":"J Oral Maxillofac Surg"},{"key":"3170_CR5","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1200\/JCO.1989.7.6.798","volume":"7","author":"SK Williford","year":"1989","unstructured":"Williford SK, Salisbury PL 3rd, Peacock JE Jr, Cruz JM, Powell BL, Lyerly ES, et\u00a0al. The safety of dental extractions in patients with hematologic malignancies. J Clin Oncol. 1989;7:798\u2013802.","journal-title":"J Clin Oncol"},{"key":"3170_CR6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/j.1754-4505.2004.tb01707.x","volume":"24","author":"Y Morimoto","year":"2004","unstructured":"Morimoto Y, Niwa H, Imai Y, Kirita T. Dental management prior to hematopoietic stem cell transplantation. 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A copy of the written consent is available for review by the Editor-in-Chief of the journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"581"}}