Das zentrale Hämangiom - lebensbedrohliche Gefahr in der Zahnarztpraxis

In the literature there are few individual reports about fatal conditions after tooth extraction in regions with central hemangiomas. The X-ray examinations are often not pathognomonic and may lead the dentist to misdiagnosis. We report on two children with intraosseous hemangioma of the mandible, which suffered from excessive periodontal bleeding on the occasion of conservative dental treatment. Up to 49 interventions under general anesthesia in one child had been performed to treat the haemangioma with arterial embolisation, surgical procedures and coiling. None of these methods could permanently prevent further bleeding. Using a new method of direct radiographically controlled intraosseous embolisation with histoacrylic agents, both central haemangiomas could be permanently eliminated and secondary bone resection could be performed without additional blood supply. To our knowledge this is the first report on successful permanently direct transosseous embolisation of central haemangiomas in human. By means of this case reports we point out the life threatening danger of undetected central haemangiomas in the dental office and we demonstrate an appropriate treatment using radiograhically controlled intraosseous embolisation and subsequent secondary stage resection of the mandible and its reconstruction. Keywords: Hämangiom, AVM