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British Journal of Oral and Maxillofacial Surgery (2001) 39, 407
© 2001 The British Association of Oral and Maxillofacial Surgeons
Letters to the Editor
doi: 10.1054/bjom.2000.0554, available online at http://www.idealibrary.com on
Re: Prince SE, Simpson MT. Osteogenesis
imperfecta. Br J Oral Maxillofac Surg 2000;
38: 399–400
Sir,
We were interested to read the article by Miss Prince and Mr
Simpson,1 in particular that there was more bleeding encoun-
tered during orthognathic surgery than usual. Clinically signifi-
cant postoperative haemorrhage following orthognathic surgery
in a patient with osteogenesis imperfecta (OI) has been reported
before.2 Investigations for the possible abnormalities responsi-
ble for this bleeding tendency in patients with OI have shown
that increased capillary fragility, decreased platelet retention
and reduced factor VIII R: Ag have been found to be the most
common abnormalities, while reduced ristocetin cofactor, defi-
cient platelet aggregation induced by collagen and prolonged
bleeding time were less common findings.3 The tourniquet test
is the most valuable screening test for these haemostatic defects
observed.3 It may be advisable therefore when orthognathic
surgery is performed on patients with osteogenesis imperfecta
that a tourniquet test and appropriate haematological studies are
performed to identify patients at risk, blood is cross-matched
and packed cells and fresh frozen plasma are available.
N. F. F. Ribeiro
SHO
A. El Rasheed
SHO
G. C. S. Cousin
Senior Registrar
Maxillofacial Unit
North Manchester General Hospital
Delaunays Road
Crumpsall
Manchester M8 5RB, UK
REFERENCES
1. SE Prince, MT Simpson. Osteogenesis imperfecta. Br J Oral
Maxillofac Surg 2000; 38: 397–398.
2. ME Morton. Excessive bleeding after surgery in osteogenesis
imperfecta. Br J Oral Maxillofac Surg 1987; 25: 507–511.
3. SA Evensen, L Myhre, H Stormorken. Haemostatic studies in
osteogenesis imperfecta. Scand J Haematol 1984; 33: 177–179.
407
BRITISH
Journal of
Oral and
Maxillofacial
Surgery
doi: 10.1054/bjom.2000.0555, available online at http://www.idealibrary.com on
Re: Mollaoglu N. Oral lichen planus: a review.
Br J Oral Maxillofac Surg 2000; 38: 370–377
Sir,
It was with great disappointment that I scanned through the
above article. There is a considerable body of evidence showing
that traditional style reviews on topics are as biased as many
trials are. This article illustrates many of the pitfalls that are
encountered when attempting to do a review on a very large
topic without using a systematic approach. Reviews should
contain a methodology on how articles were selected and what
inclusion and exclusion criteria were used. The reviewer then
performs a critical appraisal of the papers to give the reader an
indication of the validity of the results. The author obviously did
not search the Cochrane Library for material as this database
contains a systematic review on interventions used for the treat-
ment of symptomatic lichen planus. This has recently been
reviewed by Gallagher in Evidence-Based Dentistry.1 The
Cochrane Library now contains the largest database of clinical
trials world-wide and no review is complete without searching
that database. The quality and orientation of the clinical pic-
tures leaves much to be desired.
Dr Joanna M. Zakrzewska
Senior Lecturer/Honorary Consultant in Oral Medicine
Queen Mary College
University of London
Department of Clinical and Diagnostic Oral Sciences
Turner Street
London E1 2AD, UK
REFERENCE
1. Gallagher GT. Review of Chan ES-Y, Thornhill M, Zakrzewska J.
Interventions for treating oral lichen planus. The Cochrane Library
1999; 2: 1. Evidence-Based Dentistry 2000; 2: 14.