title: Is gingival bleeding a symptom of patients with type 1 von Willebrand disease? A case-control study.
abstract: BACKGROUND
  Von Willebrand disease (VWD) is the most common inherent bleeding disorder resulting in prolonged bleeding time. Gingival bleeding is a frequently reported symptom of VWD. However, gingival bleeding is also known as a leading symptom of plaque-induced gingivitis and untreated periodontal disease. Gingival bleeding in VWD patients (VWD) may be triggered by gingival inflammation and not a genuine symptom. Thus, this study evaluated whether type 1 VWD determines an increased susceptibility to gingival bleeding in response to the oral biofilm.
  
  
  METHODS
  Fifty cases and 40 controls were examined haematologically (VWF antigen, VWF Ristocetin cofactor, factor VIII activity) and periodontally [Gingival Bleeding Index (GBI), bleeding on probing (BOP), Plaque Control Record (PCR), periodontal inflamed surface area (PISA), vertical probing attachment level].
  
  
  RESULTS
  GBI was significantly higher in controls (12.2%) than in VWD (10%). The study failed to find a significant difference regarding BOP between VWD (17%) and controls (17.2%). Multiple regressions identified PCR and PISA to be associated with GBI and BOP. VWD was negatively associated with GBI. Smoking and number of remaining teeth was negatively associated with BOP.
  
  
  CONCLUSIONS
  VWD is not associated with a more pronounced inflammatory response to the oral biofilm in terms of GBI and BOP.
authors.affiliation: Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Weickert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Miesbach
authors.forename: Sonja Rosa
authors.initials: SR
authors.lastname: Alesci
authors.forename: Peter
authors.initials: P
authors.lastname: Eickholz
authors.forename: Katrin
authors.initials: K
authors.lastname: Nickles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D010520:Aggressive Periodontitis / Q000145:classification; D018441:Biofilms; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000145:classification; D003773:Dental Plaque / Q000145:classification; D004198:Disease Susceptibility; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005884:Gingival Hemorrhage / Q000209:etiology*; D005889:Gingival Recession / Q000145:classification; D005891:Gingivitis / Q000145:classification; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D011446:Prospective Studies; D012907:Smoking; D055815:Young Adult; D056725:von Willebrand Disease, Type 1 / Q000150:complications*; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII
keywords: Von Willebrand disease; bleeding on probing; gingival bleeding; periodontal diseases; plaque-induced gingivitis