Liang-Ho Lin

Chang Gung University, Hsin-chu-hsien, Taiwan, Taiwan

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Publications (4)3.13 Total impact

  • Shin-Yu Lu · Chi-Yu Tsai · Sheng-Nan Lu · Liang-Ho Lin
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    ABSTRACT: Background/purpose: Most Western studies do not recommend interrupting warfarin therapy or replacing it with heparin prior to tooth extraction if the international normalized ratio (INR) levels are maintained. However, this issue remains controversial in Taiwan. The aim of this study was to investigate whether Taiwanese patients who had an INR within the therapeutic range required cessation of warfarin prior to dental extractions. Materials and methods: A total of 60 patients on warfarin with INR <4.0 who underwent 207 dental extractions in 70 occasions were divided into two groups. Thirty-two patients were allocated to the control group (warfarin stopped and switched to heparin under hospitalization) with average preoperative INR (range) from 2.30 (1.32-3.12) brought down to 1.14 (1.04-1.32), and 28 patients were allocated to the study group (warfarin continued) with an average preoperative INR of 1.95 (1.06-3.08). Results: The incidence of postoperative bleeding in the study group was higher (3/33, 9.1%) than in the control group (3/37, 8.1%), but this difference was not significant. Local hemostasis with Gelfoam sponge was sufficient in most patients. Postoperative hemorrhage can be successfully managed by repacking with Gelfoam impregnated with tranexamic acid powder in five patients and resuturing in one patient. Conclusion: The study proved that dental extractions can be performed without interruption or alteration of warfarin regime in Taiwanese patients, provided the INR is below 4.0. A sufficient hemostasis can be obtained using local measures. This approach can save these individuals from becoming exposed to the risk of thromboembolism and the inconvenience of bridging anticoagulation with heparin.
    No preview · Article · Jul 2015 · Journal of dental sciences
  • Shin-Yu Lu · Chi-Cheng Liang · Liang-Ho Lin
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    ABSTRACT: Background/purpose Bisphosphonate-related osteonecrosis of the jaw (BRONJ) appears to be refractory to conventional treatment approaches. We offer our experiences and treatment strategies regarding the successful resolution of BRONJ. Materials and methods Thirty sites of BRONJ in 27 patients were clinicopathologically proven. The mandible was more commonly affected than the maxilla (67% versus 33%). The appearance of 23 (77%) BRONJ sites was preceded by a tooth extraction, dental infection, or oral trauma, and the remaining sites occurred spontaneously. There was a female predilection with a ratio of 3.5:1, and 22 (81%) patients were oral bisphosphonate (BPh) users. The treatment strategies included: (1) nonsurgical treatment using antimicrobial rinses; (2) removal of necrotic bone followed by insertion of Gelfoam impregnated with tetracycline; or (3) filling with alloplastic bone substitute plus tetracycline as the procedure of guided bone regeneration (GBR); and (4) radical resection of all necrotic bone and immediate reconstruction. Results In 25 (93%) patients with 27 (90%) sites, BRONJ was successfully treated. The three treatment failures were all in two intravenous BPh users. There was no significant dependence of the treatment results on the severity of BRONJ. However, there was a significant dependence of the treatment result on the route of BPh administration. Conclusion Our study demonstrates a high success rate of conservative and surgical treatment of BRONJ. This is the first reported use of GBR to successfully treat oral BPh-related osteonecrosis of the jaw. Irrigation with antimicrobial rinses may result in pain reduction, and regression or even resolution of BRONJ.
    No preview · Article · Jun 2014 · Journal of dental sciences
  • Liang-Ho Lin · Shin-Yu Lu · Sheng-Nan Lu
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    ABSTRACT: A possible association between oral lichen planus (OLP) and hepatitis C virus (HCV) infection has been documented in certain populations such as Japan and Southern Europe; however, the issue remains controversial. The aim of this study was to investigate the prevalence of HCV antibodies among patients with OLP in Southern Taiwan, and to assess the possible association between OLP and HCV infection. All patients enrolled in the study sought care at a hospital dental clinic. Serum samples of 104 patients with OLP and 100 controls with healthy oral mucosa, whose age and gender were matched, were respectively screened for anti-HCV antibodies by the microparticle enzyme immunoassay (AxSYM HCV version 3.0). The prevalence of HCV infection was 22.1% in the study group (23 of 104 OLP patients) and 2% in the control group (2 of 100 control subjects) respectively (P < .001). Eleven of 23 HCV-infected OLP patients (47.8%) were unaware of their HCV infection status in the study. A positive association between OLP and HCV in Southern Taiwan exists, suggesting that routine HCV infection testing of patients with OLP in Southern Taiwan should be considered.
    No preview · Article · Mar 2010 · Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
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    ABSTRACT: Background/purpose: Oral lichen planus (OLP) is the most frequent oral lesion found in patients with hepatitis C virus (HCV) infection. The aims of this study were to investigate the prevalence of OLP among chronic hepatitis C patients, to clarify the role of HCV in the pathogenesis of OLP, and to assess its relationship to transaminase levels. Materials and methods: Two groups of subjects were studied; 277 hepatitis C patients were examined for OLP (Group 1) and 5273 outpatients seeking dental care within 1 year were used as a control (Group 2) to determine the prevalence of OLP in the general population. The dental and hepatic records were collected and analyzed. Results: The prevalences of OLP were 4.7% (n=13) in Group 1 and 2.0% (n=104) in Group 2 and significantly differed (P=0.002). All 13 OLP cases occurred in hepatitis C patients who had experienced elevated alanine transaminase levels of >80IU/L within the 2 previous years, regardless of whether they were treated with interferon-ribavirin combination therapy or not. There was a strong association between elevated transaminase levels and the development of HCV-related OLP lesions (P=0.014). Of the 13 OLP patients, two were in the group with a sustained virologic response (SVR) to HCV therapy, two were in the group without an SVR, and nine were in the non-therapy group. The incidence of OLP in hepatitis C patients did not significantly differ between those who showed an SVR to HCV therapy and those who did not respond or did not receive therapy (P=0.560). Conclusion: We concluded that: (1) elevation of transaminase levels is associated with the detection of HCV-related OLP, and (2) HCV-related OLP can remain unchanged for years after an SVR to HCV therapy. The findings revealed that the role of HCV in OLP pathogenesis is due to host factors induced by HCV rather than a direct cytopathic effect of HCV. © 2009 Association for Dental Sciences of the Republic of China.
    No preview · Article · Dec 2009 · Journal of dental sciences