Javiera Cancino G.; Sebastian Martinez V. & Diego Fonseca
Summary
Hereditary angioedema (HAE) is an autosomal dominant disease with incomplete penetrance. It is caused by deficiency or dysfunction of the C1 esterase inhibitor (C1-INH), resulting in recurrent edema in the skin, internal organs, and respiratory tract. Certain dental procedures can cause emotional stress and varying degrees of mechanical trauma, which can trigger an attack. If clinicians do not have sufficient knowledge about the disease and its proper management, they can provoke complications, including potentially fatal asphyxia due to laryngeal edema. The aim of this study was to describe, through a scoping review, the preventive measures available in the literature for performing surgical interventions in the oral cavity in patients diagnosed with hereditary angioedema type I or II. An exploratory systematic review (scoping review) was conducted using the databases PubMed, Scopus, LILACS, and Web of Science, published between April 2000 and April 2023. Short- and long-term preventive measures, intraoperative measures, and post-dental intervention angioedema attacks were evaluated. The 15 articles included in the review comprised 8 case reports, 5 retrospective observational studies, and 2 case series. The described prophylactic measures included the use of plasma-derived C1-INH, attenuated androgens such as danazol, and bradykinin antagonists (B2). A total of 137 angioedema attacks were reported, with 16 of them receiving prophylaxis with plasma-derived C1-INH 500U-100U. The remaining cases did not use prophylactic measures. Shortterm prophylactic measures, intraoperative measures such as sedation and intraoperative analgesia, are effective in preventing angioedema episodes in patients undergoing dental procedures.
KEY WORDS: hereditary angioedema, oral surgery, management practice, dental surgical procedures.
How to cite this article
CANCINO, G. J.; MARTINEZ V, S. & FONSECA, D. Preventive measures in patients with hereditary angioedema type I and II undergoing dental procedures: A scoping review. Int. J. Odontostomat., 18(4):433-440, 2024.