Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Epistaxis in dental and maxillofacial practice: a comprehensive review

  • Psillas, George (1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital) ;
  • Dimas, Grigorios Georgios (1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital) ;
  • Papaioannou, Despoina (School of Dentistry, Aristotle University of Thessaloniki, AHEPA Hospital) ;
  • Savopoulos, Christos (1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital) ;
  • Constantinidis, Jiannis (1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital)
  • Received : 2021.01.24
  • Accepted : 2021.04.20
  • Published : 2022.02.28
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Abstract

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

Keywords

References

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