Abstract
Congenital protein S deficiency is a disorder associated with increased risk of thrombosis resulting from defect of protein S, a vitamin K-dependent anticoagulant protein.
We experienced an extraction of impacted wisdom teeth in a patient with protein S deficiency and deep venous thrombosis (DVT). A 21-year-old male patient was referred to our hospital complaining of pain in the lower left wisdom tooth region due to incomplete impaction of the wisdom tooth. Diagnosis of congenital protein S deficiency and DVT of the lower extremity were established when he was 17-year-old. He received warfarin potassium anticoagulant therapy.
Prior to the extraction of the wisdom teeth, we consulted and discussed anticoagulant therapy and anesthesia with the staff of the Departments of Cardiovascular Surgery and Anesthesiology. As to the results of the clinical examination and ultrasonography, the existing thrombotic lesion was considered to be an old thrombotic lesion and, thus, the possibility of fragmentation or detachment of the thrombosis from the present location was regarded as minimal. We decided that the ultimate method for having the extraction of his three impacted wisdom teeth was under general anesthesia with continuation of his anticoagulant therapy with heparin calcium. There has been no evidence of postoperative complication such as excessive hemorrhage, thromboembolism or swelling of his lower extremity.
