Exodontia.Info
Platelet Disorders & Deficiencies
& Oral Surgery
Patients with Platelet Disorders & Deficiencies

Platelets are cell fragments that function in the clotting /
coagulation system.

Platelets circulate for 7 - 10 days.  About one third are
always transiently sequestered in the
spleen.

The
platelet count is normally 140,000 - 440,000/μL.  
However, the count can vary slightly according to menstrual
cycle phase, decrease during near-term pregnancy
(
gestational thrombocytopænia) & increase in response to
inflammatory
cytokines (secondary or reactive
thrombocytosis
).

Platelets are eventually destroyed, primarily by the spleen.

Platelet disorders include:

  • Abnormal increase in platelets (thrombocythæmia)
  • Decrease in platelets (thrombocytopænia)
  • Platelet dysfunction

Any of these conditions, even those in which
platelets are
increased, may cause defective formation of
hæmostatic
plugs
& bleeding.

The risk of bleeding is inversely proportional to the
platelet
count
.

When the
platelet count is < 50,000/μL, minor bleeding
occurs easily & the risk of major bleeding increases.

Counts between 20,000 - 50,000/μL predispose to bleeding
with trauma, even minor trauma.

With counts < 20,000/μL, spontaneous bleeding may occur.

With counts < 5000/μL, severe spontaneous bleeding is
more likely.

However, patients with counts < 10,000/μL may be
asymptomatic for years.
Useful Articles:

Canadian Hæmophilia Society 2001.  Glanzmann Thrombasthenia.  An inherited
bleeding disorder

J Oral Maxillofac Surg 2001.  Management of the Oral and Maxillofacial Surgery
Patient With Thrombocytopenia

Canadian Children's Platelet Study Group 2002.  Disorders of Platelet Function

Treatment of Hæmophilia 2008.  Platelet Function Disorders
Last Updated 1st August 2012