Effective periodontal treatment in a patient with type IIA von Willebrand's disease: Report of a case

von Willebrand's disease (vWD) is one of the most common hereditary hemorrh agic: disorders. A mild to moderate deficiency of factor VIII and von Wille brand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45 -year-old woman with type IIA vWD was referred for periodontal therapy beca use of an episode of gingival hemorrhage and percussion pain of teeth #18 a nd #47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth #46 After consultation with a hematologist, apically positioned flap surgery a nd hemisection were performed on tooth #46 following completion of oral hyg iene instruction, scaling and root planing, and endodontic therapy. The pat ient was given 500 units of factor VIII including vWf multimeter 30 minutes before surgery. After healing of the peridontal tissue, prosthodontic trea tment was undertaken on the posterior mandibular sextants. At follow-up, th e probing depths ranged from 2 to 3 mm, and gingival bleeding on probing wa s minimal. The patient's children all had vWD. They had mild to moderate pe riodontitis with probing depths ranging from 2 to 5 mm and gingival bleedin g on probing. With the combined efforts of the periodontist and hematologis t, effective periodontal treatment can be provided to patients with von Wil lebrand's disease.