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Figure 2.; Representative images of hemostasis and intraoral preop and postop views in study participants. (A) Adequate hemostasis of tooth #I; (B) inadequate hemostasis of tooth #I; (C) intraoral preop occlusal view; and (D) intraoral postop occlusal view with zirconia crowns on #B and #I.
Afsoon Fazeli,
 Travis M. Nelson,
 Mir Sohail Fazeli,
 Yvonne S. Lin, and
 JoAnna Scott
Figure 2.
Figure 2.

Representative images of hemostasis and intraoral preop and postop views in study participants. (A) Adequate hemostasis of tooth #I; (B) inadequate hemostasis of tooth #I; (C) intraoral preop occlusal view; and (D) intraoral postop occlusal view with zirconia crowns on #B and #I.

Cardiovascular Safety and Hemostatic Efficacy of Topical Epinephrine in Children Receiving Zirconia Crowns
Afsoon Fazeli DDS, MSD,
 Travis M. Nelson DDS, MSD, MPH,
 Mir Sohail Fazeli MD, PhD,
 Yvonne S. Lin PhD, and
 JoAnna Scott PhD
Article Category: Research Article
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
DOI: 10.2344/anpr-68-02-05
Page Range: 133 – 140

receiving prefabricated zirconia crowns require circumferential subgingival preparation, leading to tissue irritation and bleeding. If hemostasis is inadequate during cementation, blood contamination will affect the integrity of the tooth-cement-crown interface. Blood incorporated into the cement may also cause visible discoloration because of the translucent nature of zirconia, resulting in poor esthetics. Preoperative or intraoperative administration of nonsteroidal anti-inflammatory drugs (eg, ketorolac) for analgesia can compound this problem because of impaired

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Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 2
Benjamin J. Statman DDS
Article Category: Research Article
Volume/Issue: Volume 70: Issue 1
Online Publication Date: Mar 28, 2023
DOI: 10.2344/anpr-70-01-06
Page Range: 37 – 48

Table 1. Periprocedural Thrombotic Risk Stratification 1 Thromboembolic Risk The American College of Chest Physicians (ACCP) and the International Society on Thrombosis and Haemostasis (ISTH) have both established a 3-tiered system stratifying patients into high, moderate, or low risk for perioperative thromboembolism ( Table 2 ). 4 – 6 For patients on anticoagulation for atrial fibrillation, risk is based on their CHA 2 DS 2 VASc score

Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 1
Benjamin J. Statman DDS
Article Category: Other
Volume/Issue: Volume 69: Issue 3
Online Publication Date: Oct 06, 2022
DOI: 10.2344/anpr-69-03-05
Page Range: 40 – 47

HEMOSTASIS AND COAGULATION Hemostasis is the body's normal response to stop bleeding and involves the processes of forming and ultimately degrading a fibrin clot at the site of a vessel injury. It involves the complex coordination of 4 components: (1) vascular endothelium, (2) platelet aggregation, (3) coagulation factor activation, and (4) fibrinolysis. 1 Upon damage or disruption to the vascular endothelium, primary hemostasis occurs within seconds, consisting of vasoconstriction of the damaged vessels and initiation of platelet

Figure 1.; Participant flow in single-blinded, split-mouth randomized controlled pilot study.
Afsoon Fazeli,
 Travis M. Nelson,
 Mir Sohail Fazeli,
 Yvonne S. Lin, and
 JoAnna Scott
Figure 1.
Figure 1.

Participant flow in single-blinded, split-mouth randomized controlled pilot study.

Figure 1.; Classic coagulation cascade model featuring the extrinsic, intrinsic, and common coagulation pathways.
Benjamin J. Statman
Figure 1.
Figure 1.

Classic coagulation cascade model featuring the extrinsic, intrinsic, and common coagulation pathways.

Figure 2.; Contemporary coagulation model demonstrating the 3 phases: activation (A-C), amplification (D-F), and clot propagation (G).3
Benjamin J. Statman
Figure 2.
Figure 2.

Contemporary coagulation model demonstrating the 3 phases: activation (A-C), amplification (D-F), and clot propagation (G). 3

Use of a Modified Endotracheal Tube for Postoperative Intranasal Hemorrhage
Yasuhiko Sakata DDS,
 Saori Takagi DDS, PhD,
 Shinnosuke Ando DDS,
 Ryoko Kono DDS,
 Yuki Kiyohara DDS,
 Yuka Oono DDS, PhD, and
 Hikaru Kohase DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 71: Issue 1
Online Publication Date: May 03, 2024
DOI: 10.2344/anpr-70-03-09
Page Range: 34 – 38

Orthognathic surgery or surgical/anesthetic procedures than induce substantial epistaxis postoperatively require swift, appropriate management to avoid potentially catastrophic complications. We report a patient in whom the use of a modified endotracheal tube (ETT) with a cuff as a transnasal airway and a choanal hemostasis balloon was effectively applied for emergent epistaxis control following orthognathic surgery. The patient provided written consent to publish the details of this case. CASE PRESENTATION The patient was a 27-year-old woman (height 165

Deliberate Hypotensive Anesthesia With the Rapidly Acting, Vascular-Selective, L-Type Calcium Channel Antagonist—Clevidipine: A Case Report
Kevin Croft DDS and
 Stephen Probst MD
Article Category: Other
Volume/Issue: Volume 61: Issue 1
Online Publication Date: Jan 01, 2014
DOI: 10.2344/0003-3006-61.1.18
Page Range: 18 – 20

Severe Bleeding During Orthognathic Surgery for a Noonan Syndrome Patient
Haruka Sasaki DDS and
 Kentaro Mizuta DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 69: Issue 4
Online Publication Date: Dec 19, 2022
DOI: 10.2344/anpr-69-02-02
Page Range: 22 – 25

of 1% lidocaine with 1:200,000 epinephrine (lidocaine 110 mg, epinephrine 55 μg) for local anesthesia prior to the Le Fort I osteotomy, hemostasis was difficult to achieve from the start of the surgery even though her blood pressure was not elevated (109–93/53–44 mm Hg). Therefore, mild hypotensive anesthesia was started to reduce blood loss using a nitroglycerin infusion 0.5–0.8 μg/kg/min for a targeted mean arterial blood pressure of 65 mm Hg. At the end of the Le Fort I osteotomy, blood loss reached 825 mL and hematological examination revealed anemia