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case_images: PMC9931487_02
case_images: PMC9931487_03
case_images: Patient case 3. (a) Bleeding and blood clot 36 hours after placement of SSC on his permanent lower left first molar. (b) Six months postoperatively, no radiographic pathology associated with the SSC on a permanent lower molar.
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case_images: fig1
case_images: ER at a tertiary Medical Center with excessive gingival bleeding 2 days after treatment with SSC in his permanent lower first molar. Excessive gingival bleeding was evident around the crown, blood clots covered his SSC, filled his mouth, and were absorbed in his clothes (Figure 1(a)). Follow-up after 6 months, no recurrent bleeding was reported, and the panoramic X-ray revealed healthy alveolar bone surrounding the treated tooth (Figure 1(b)).
case_images: Patient case 4. (a) Excessive bleeding and a blood clot in the mouth of a 4.5-year-old girl 3 days after placing SSCs. (b) The bleeding continued for 18 hours after rinsing the mouth for 30 minutes.
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case_images: fig2
case_images: On her arrival at our clinic, clinical examination revealed her primary right lower second molar was completely covered with a clot and with active bleeding (Figure 2).
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case_images: Patient case 5. (a) Excessive bleeding and a blood clot in the mouth of a girl, 16 hours after placing SSCs on her primary lower left first and second molars. (b) A periapical radiograph taken 1-day postoperatively reveals no pathology that may contribute to the excessive bleeding.
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case_images: fig3
case_images: Case 5: A healthy 5-year-old girl presented to the ER at our tertiary Medical Center with a blood clot filling her mouth (Figure 3(a)) following re-occurring bleeding at different intensities accompanied by vomiting. The periapical radiographs of the treated teeth were without pathologic findings (Figure 3(b)), therefore, the gingiva around the SSCs were sutured, under nitrous oxide analgesia, which eventually stopped the bleeding.
case_images: PMC9931487_05
case_images: Patient case 6. (a) Excessive bleeding and a blood clot, 4 days after placing 2 SSCs and following receiving IV antifibrinolytic tranexamic acid and biting on an oral pack soaked with solution of antifibrinolytic tranexamic acid. (b) Three and four days after placing 2 SSCs that were pre-soaked in water for 5 weeks before use. Small blood clots were visible, only in the morning, at the corner of the child's lips.
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case_images: fig4
case_images: Clinical examination revealed that the child still had blood clots over his crowns, but without active bleeding (Figure 4(a)). Three and 4 days postoperatively, a small drop of clotted blood was visible in the morning at the corner of his lips (Figure 4(b)).