Zeynep Afra Akbıyık Az
Zeynep Afra Akbıyık Az was born in Istanbul in 1991. She obtained her secondary education from Istanbul (Male) High School in 2009 and subsequently pursued a master's degree in dentistry at Istanbul University, which she completed in 2014. Following a two-year stint as an independent dentist, she commenced her doctoral studies in Oral Medicine at the Department of Oral and Maxillofacial Surgery in the Faculty of Dentistry at Istanbul University in 2016. She successfully completed her doctoral degree in 2022. Currently, Zeynep Afra Akbıyık Az is employed as a Research Assistant Doctor in the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry at Istanbul University, where she is actively engaged in both academic and clinical studies. In addition to her academic pursuits, she is an esteemed member of the Osseointegration Academy Association (Osseder) and the European Association for Osseointegration (EAO). Her areas of expertise encompass advanced implant surgery, bone augmentation techniques, and oral medicine.
Are Dental Implant Applications Contraindicated in Patients with Congenital Bleeding Disorders?
Congenital bleeding disorders (CCD) usually develop due to decreased production or defective production of one of the coagulation proteins. Deficiencies or dysfunctions of the factors involved in the coagulation system cause bleeding tendency. Hemophilia is a recessive CCD that is carried by women and affects men. It is caused by mutations on the X chromosome and is characterized by decreased or absent functional activity of factor VIII in Hemophilia A or factor IX in Hemophilia B. von Willebrand disease (vWD) is an autosomal-recessive bleeding diathesis characterized by a prolonged bleeding time caused by a deficiency or functional impairment of von Willebrand factor (vWF). vWD, with an estimated prevalence of 1-2%, is the most common congenital bleeding disorder. Hemophilia A affects one in 5,000 male births, while hemophilia B affects one in 30,000.
CCD may increase the risk of bleeding during implant surgery. Although bleeding is a common contraindication in dental implant surgery, there is no evidence in the literature that CCD are a contraindication to dental implant treatment. Due to the lack of information regarding hemostasis, traditional literature advises against treating hemophiliacs with dental implants. However, there are case reports in the literature reporting that hemophilic were successfully treated with dental implants. There is currently no approved reliable protocol for the application of dental implants in CCD patients, but there are several guidelines regarding the planning of surgery. Communication with the patient's hematologist is essential for successful treatment. The patient's hematologist should be consulted beforehand to reduce the possibility of bleeding complications. The size of the surgical procedure to be performed should be specified, as well as the replacement of dose factors and drug regulation. Following a successful multidisciplinary approach and under the appropriate conditions, patients with CCD can receive dental implants under the same conditions as healthy individuals.