Management of a dentigerous cyst in a medically compromised geriatric patient: a case report.

Abstract

BACKGROUND:

Because of the increasing number of older persons seeking dental care, the growing trend towards a longer dental appointment and increased administration of drugs in dentistry, the possibility of occurrence of medical emergencies in dental offices has shown an upward trend.

OBJECTIVE:

This case report discusses enucleation of a central dentigerous cyst in a 72-year old male on long-term low dose aspirin therapy.

MATERIAL AND METHODS:

Surgical removal of impacted tooth with total enucleation of cystic lesion was performed in the dental chair under 2% lidocaine with 1:200,000 adrenaline, 3 days after aspirin cessation. After complete debridement of the surgical site, the wound was sutured and a gauge saturated with 10% tranexamic acid was placed on surgical site for 30 minutes.

RESULT:

No post-operative complications or bleeding was seen on subsequent appointment and healing was normal.

CONCLUSION:

A geriatric and medically compromised patient demands special care and attention; and the decision to cease aspirin before surgery or not is of critical importance.

• Authors: Anju Loomba, Kapil Loomba, Rhythm Bains, Vivek K Bains
• Journal: Gerodontology (Gerodontology) Vol. 29 Issue 2 Pg. e1190-4 (Jun 2012) ISSN: 1741-2358 [Electronic] England
• PMID: 22612836 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Chemical References

• Anesthetics, Local
• Antifibrinolytic Agents
• Hemostatics
• Platelet Aggregation Inhibitors
• Vasoconstrictor Agents
• Tranexamic Acid
• Lidocaine
• Aspirin
• Epinephrine

Topics

• Aged
• Anesthetics, Local (administration & dosage)
• Antifibrinolytic Agents (therapeutic use)
• Aspirin (administration & dosage, therapeutic use)
• Bicuspid (surgery)
• Dental Care for Chronically Ill
• Dentigerous Cyst (surgery)
• Epinephrine (administration & dosage)
• Follow-Up Studies
• Hemostatics (therapeutic use)
• Humans
• Lidocaine (administration & dosage)
• Male
• Mandibular Diseases (surgery)
• Nerve Block (methods)
• Patient Care Planning
• Platelet Aggregation Inhibitors (administration & dosage, therapeutic use)
• Postoperative Hemorrhage (prevention & control)
• Thromboembolism (prevention & control)
• Tooth, Impacted (surgery)
• Tranexamic Acid (therapeutic use)
• Vasoconstrictor Agents (administration & dosage)