Abstract
Introduction:Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation, that may lead to thrombosis, ischemia and finally, end-organ failure. The clinical presentation of DIC depends on the site of intravascular coagulation and the severity of the disease process. Avascular osteonecrosis is a pathological state, that can occur secondary to DIC and where a reduced vascular supply leads to ischemia and bone necrosis.Observation:A 83 years old patient was sent to the oral surgery department for tooth mobility in the premaxilla, following the diagnosis of sepsis and DIC induced acute myeloid leukemia, one month ago. The examination showed an exposed avascular bone behind the 12-11-21. A diagnosis of DIC induced osteonecrosis of the premaxilla was made. A resection surgery was then programmed.Discussion:DIC may generates thrombi that might occlude intraosseous vessels in the premaxilla, and lead to bone necrosis. The maxilla is supplied by multiple branches of external carotide artery, therefore, usually, there is a lower risk of osteonecrosis in the maxilla. Nevertheless, since 1993, 4 cases of avascular necrosis of the maxilla secondary to DIC are repported in literature.Conclusion:This kind of complication, although being rare, can be dramatic for the patient as bone and aesthetic defects. Early support and management of these complications is necessary.
Highlights
Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation cascade, that may lead to thrombosis, ischemia and end-organ failure
The clinical presentation of DIC depends on the site of intravascular coagulation, the severity of the disease process and wether haemodynamic instability occurs predominantly from vascular obstruction or haemorrhage
DIC is a systemic complex disorder characterized by a widespread activation of the haemostasis system, that may generates to thrombosis and ischemia of organs and soft tissues
Summary
Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation cascade, that may lead to thrombosis, ischemia and end-organ failure. This may occur from the extrinsic or the intrinsic pathway. Avascular osteonecrosis is a pathological state where a reduced vascular supply leads to ischemia and bone necrosis. This have been reported in orthopedic literature [2,3] but only few cases described maxillary bone necrosis, in particular secondary to DIC. As DIC is mostly a vital emergency and because of its major symptoms in early stage (multiple organ dysfunction, massive haemorrhage), the oral consequences are often diagnosed later and may lead to major bone defect
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
