Abstract
BackgroundVon Willebrand disease (VWD) is the most common inherent bleeding disorder. Gingival bleeding is a frequently reported symptom of VWD. However, gingival bleeding is also a leading symptom of plaque-induced gingivitis and untreated periodontal disease. In type 1 VWD gingival bleeding was not increased compared to controls. Thus, this study evaluated whether type 2 and 3 VWD determines an increased susceptibility to gingival bleeding in response to the oral biofilm.MethodsTwenty-four cases and 24 controls matched for age, sex, periodontal diagnosis, number of teeth and smoking were examined hematologically (VWF antigen, VWF activity, factor VIII activity) and periodontally (Gingival Bleeding Index [GBI]), bleeding on probing [BOP], Plaque Control Record [PCR], periodontal inflamed surface area [PISA], vertical probing attachment level).ResultsBOP (VWD: 14.5±10.1%; controls: 12.3±5.3%; p = 0.542) and GBI (VWD: 10.5±9.9%; controls: 8.8±4.8%; p = 0.852) were similar for VWD and controls. Multiple regressions identified female sex, HbA1c, PCR and PISA to be associated with BOP. HbA1c and PCR were associated with GBI. Number of remaining teeth was negatively correlated with BOP and GBI.ConclusionType 2 and 3 VWD are not associated with a more pronounced inflammatory response to the oral biofilm in terms of BOP and GBI.
Highlights
Von Willebrand disease (VWD) is the most common inherent bleeding disorder [1]
Multiple regressions identified female sex, HbA1c, Plaque Control Record (PCR) and Periodontal inflamed surface area (PISA) to be associated with Bleeding on probing (BOP)
Number of remaining teeth was negatively correlated with BOP and Gingival Bleeding Index (GBI)
Summary
The disease is caused by deficiency or dysfunction of von Willebrand factor (VWF), a plasma protein that mediates platelet hemostatic function and stabilizes blood coagulation factor VIII. The most prevalent and mildest form is VWD type 1 (about 75%) representing a partial quantitative deficiency of VWF [1]. Subtype 2B shows increased, type 2M decreased affinity of VWF for platelet GPIb receptor. VWD type 3 (0.6 to 6% of cases) represents complete quantitative deficiency of VWF [1, 3, 4]. These three major types of VWD may affect both males and females. This study evaluated whether type 2 and 3 VWD determines an increased susceptibility to gingival bleeding in response to the oral biofilm
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