RETROSPECTIVE STUDY OF A SURGICAL PROTOCOL, COMPLICATIONS AND SURVIVAL OF IMPLANTS PLACED IN PATIENTS WITH VON WILLEBRAND DISEASE.

Abstract

Von Willebrand's disease (VWD), described by Erik von Willebrand, is the most frequent hemorrhagic disorder. Its main symptom is mucosal bleeding. VWD occurs due to a qualitative or quantitative defect of the von Willebrand factor (VWF) molecule and follows an autosomal inheritance pattern. For dental implant placement, the treatment of hemorrhage caused by this disease requires close collaboration between hematologists and oral surgeons. The aim of this study was to evaluate the clinical success rate of dental implants and the incidence of bleeding in patients with VWD when a local surgical protocol was applied, supported by systemic and local hemostatic measures. A retrospective study was performed between January 2018 and December 2023 on patients over 18 years old diagnosed with VWD. All patients had an interview with their hematologist to determine whether they needed a single preoperative dose of DDAVP. A surgical implant protocol was implemented, supported by systemic and local hemostatic measures. Data on age, sex, type of VWD, DDAVP administration, and whether implants were immediate or deferred, flapless or minimally invasive were collected from the medical records. The success rate was evaluated considering absence of pain, mobility and suppuration. Implant stability was measured using a resonance frequency analyzer (Osstell). Data were described by frequencies and percentages with 95% confidence intervals or summary measures, as appropriate. Twenty-eight surgeries were performed, placing 41 implants in 26 patients (23 females and 3 males), with a mean (range) age of 50.5 (23 to 72) years. Among the patients evaluated, 21 had type 1 VWD and one had type 2. No bleeding was recorded. Mean implant stability measured with the Osstell frequency analyzer was 71. Implant stability and success rate in patients with VWD was similar to that reported in other studies on patients without systemic disorders. Systemic and local protocols are essential to avoid complications and ensure successful treatment.