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中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 287 -294. doi: 10.3877/cma.j.issn.1674-1366.2024.05.001

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医源性牙外伤的发生原因和防治策略
张茜柳1, 余东升1,()   
  1. 1. 中山大学附属口腔医院,光华口腔医学院,广东省口腔医学重点实验室,广东省口腔疾病临床医学研究中心,广州 510055
  • 收稿日期:2024-03-25 出版日期:2024-10-01
  • 通信作者: 余东升

Causes and prevention strategies of iatrogenic dental trauma

Xiliu Zhang1, Dongsheng Yu1,()   

  1. 1. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangzhou 510055, China
  • Received:2024-03-25 Published:2024-10-01
  • Corresponding author: Dongsheng Yu
  • Supported by:
    National Natural Science Foundation of China(82303713, 82373255); Natural Science Foundation of Guangdong Province(2024A1515013113); China Postdoctoral Science Foundation(2023M744009); Research Foundation of Medical Science and Technology of Guangdong Province(A2023501)
引用本文:

张茜柳, 余东升. 医源性牙外伤的发生原因和防治策略[J]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 287-294.

Xiliu Zhang, Dongsheng Yu. Causes and prevention strategies of iatrogenic dental trauma[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(05): 287-294.

医源性牙外伤是指在口腔及全身疾病治疗过程中由医源性因素如拔牙、麻醉等有创诊疗意外造成的牙外伤。医源性牙外伤表现为累及牙体硬组织、牙髓和牙周组织的单一或合并损伤。针对医源性牙外伤的预防和处理策略是临床诊疗的重点和难点。显微镜、数字化导航技术等精准和微创的辅助设备在口腔及全身治疗中的逐渐普及和应用,为降低医源性牙外伤提供更多可能性。本文通过系统性总结医源性牙外伤的发生原因,以期为临床中如何避免发生医源性牙外伤的治疗方案选择提供参考。

Iatrogenic dental trauma refers to tooth injuries caused by iatrogenic factors such as extractions, anesthesia, and other invasive treatment accidents during the management of oral and systemic diseases. These injuries can manifest as isolated or combined damages to the hard tissues of the tooth, the pulp, and the periodontal tissues. Preventive and management strategies for iatrogenic dental trauma are critical and challenging aspects of clinical practice. The increasing use and integration of precision and minimally invasive auxiliary equipment, such as microscopes and digital navigation technology, in both oral and systemic treatments offer more possibilities for reducing iatrogenic dental trauma. This article systematically reviewed the causes of iatrogenic dental trauma, aiming to provide references for selecting treatment plans in clinical practice to avoid such injuries.

[1]
Sondeijker CFWLamberts AABeckmann SH,et al. Development of a clinical practice guideline for orthodontically induced external apical root resorption[J]. Eur J Orthod202042(2):115-124. DOI:10.1093/ejo/cjz034.
[2]
Fouad AFAbbott PVTsilingaridis G,et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries:2. Avulsion of permanent teeth[J]. Dent Traumatol202036(4):331-342. DOI:10.1111/edt.12573.
[3]
郝燕清,唐蓉,王金孟,等. 2014 ~ 2019年根管治疗后移位型根折发生占比的CBCT回顾性研究[J].口腔医学研究202238(2):181-185. DOI:10.13701/j.cnki.kqyxyj.2022.02.017.
[4]
叶周熹,杨驰,樊林峰.下颌阻生第三磨牙拔除术邻牙损伤风险及预防[J].中国口腔颌面外科杂志201513(5):429-434. DOI:CNKI:SUN:ZGKQ.0.2015-05-018.
[5]
叶周熹.精准微创拔除困难下颌阻生第三磨牙——邻牙损伤及下牙槽神经损伤风险分级(类)与手术设计[D].上海:上海交通大学,2016.
[6]
王旭燕,田素景,卢志宾,等.上颌多生牙误诊为鼻腔异物1例[J].临床耳鼻咽喉头颈外科杂志201630(22):1811-1812. DOI:10.13201/j.issn.1001-1781.2016.22.019.
[7]
赵宏宠,刘文曙.微创拔除儿童埋伏多生牙临床效果研究[J].中国临床医生杂志201543(7):76-77. DOI:10.3969/j.issn.2095-8552.2015.07.029.
[8]
Shih WYHsieh CYTsai TP. Clinical evaluation of the timing of mesiodens removal[J]. J Chin Med Assoc201679(6):345-350. DOI:10.1016/j.jcma.2015.10.013.
[9]
Zidane B. Recent advances in the diagnosis of enamel cracks:A narrative review[J]. Diagnostics(Basel)202212(8):2027. DOI:10.3390/diagnostics12082027.
[10]
Hämmerle CHFTarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants:A narrative review[J]. J Periodontol201889(Suppl 1):S291-S303. DOI:10.1002/JPER.16-0810.
[11]
谌东明.临床口腔种植的风险因素分析及防范策略[J].中国医药指南201418(12):53-54. DOI:10.15912/j.cnki.gocm.2014.18.294.
[12]
Yi YJPark IWKu JK,et al. Long term clinical result of implant induced injury on the adjacent tooth[J]. Sci Rep202111(1):7913. DOI:10.1038/s41598-021-87062-9.
[13]
Du Toit JGluckman HGamil R,et al. Implant injury case series and review of the literature Part 1:Inferior alveolar nerve injury[J]. J Oral Implantol201541(4):e144-e151. DOI:10.1563/aaid-joi-D-14-00022.
[14]
Gintautaitė GKenstavičius GGaidytė A. Dental roots′ and surrounding structures′ response after contact with orthodontic mini implants:A systematic literature review[J]. Stomatologija201820(3):73-81.
[15]
张冬梅,潘佳雨,徐秋芳,等.龈下刮治术后常见并发症及其处理[J].中国实用口腔科杂志201710(8):463-466. DOI:10.19538/j.kq.2017.08.004.
[16]
刘调玲.正畸治疗时固定矫治器对患者口腔黏膜、牙体、牙周的损伤情况分析[J].临床研究201826(2):66-68. DOI:10.3969/j.issn.1004-8650.2018.02.034.
[17]
Beck BWHarris EF. Apical root resorption in orthodontically treated subjects:Analysis of edgewise and light wire mechanics [J]. Am J Orthod Dentofacial Orthop1994105(4):350-361. DOI:10.1016/s0889-5406(94)70129-6.
[18]
Sameshima GTSinclair PM. Predicting and preventing root resorption:PartⅡ. Treatment factors[J]. Am J Orthod Dentofac Orthop2001119(5):511-515. DOI:10.1067/mod.2001.113410.
[19]
Wang CWYu SHMandelaris GA,et al. Is periodontal phenotype modification therapy beneficial for patients receiving orthodontic treatment?An American Academy of Periodontology best evidence review[J]. J Periodontol202091(3):299-310. DOI:10.1002/JPER.19-0037.
[20]
李煌,武秀萍,黄兰,等.正畸根尖区牙根外吸收的风险因素及其临床处理建议的专家共识[J].华西口腔医学杂志202240(6):629-637. DOI:10.7518/hxkq.2022.06.002.
[21]
Razaeian SLiebich HK. Anti-toothbreaker:A novel low-budget device enabling contactless dental protection and a forbidden technique during direct laryngoscopy for endotracheal intubation [J]. Diagnostics(Basel)202313(4):594. DOI:10.3390/diagnostics13040594.
[22]
Doğan ÖAltıntepe Doğan SSAltintepe N,et al. An analysis of anesthetists′ awareness,knowledge,and attitudes toward peri-anesthetic dental trauma[J]. Dent Traumatol202137(6):786-794. DOI:10.1111/edt.12702.
[23]
Sowmya BRaghavendra P. Management of dental trauma to a developing permanent tooth during endotracheal intubation[J]. J Anaesthesiol Clin Pharmacol201127(2):266-268. DOI:10.4103/0970-9185.81843.
[24]
Andrade TIPontes KTAraújo FR,et al. Dentoalveolar trauma induced by intubation in urgent maxillofacial surgery:Case report[J]. Rev Gaúch Odontol202270:e20220028. DOI:10.1590/1981-863720200003520200063.
[25]
Doğan SSADoğan ÖDoğan Ö,et al. Protective potential of different mouthguard thicknesses against perianaesthetic dental trauma:A patient specific-finite element study[J]. Comput Methods Biomech Biomed Engin2023:1-11. DOI:10.1080/10255842.2023.2247515.
[26]
Hanna SNPerez Alfayate RPrichard J. Vital pulp therapy an insight over the available literature and future expectations[J]. Eur Endod J20205(1):46-53. DOI:10.14744/eej.2019.44154.
[27]
Bhamri SDey SGupta M,et al. Intraoperative dental injury in a neurosurgical patient:Concerns for the anesthesiologist[J]. Cureus202214(11):e31268. DOI:10.7759/cureus.31268.
[28]
中华口腔医学会口腔急诊专业委员会.恒牙外伤牙固定术技术专家共识[J].中华口腔医学杂志202257(4):326-333. DOI:10.3760/cma.j.cn112144-20220119-00023.
[29]
东红岗,顾泽旭,文星,等.片段弓技术对外伤脱位牙固定疗效与邻牙关系探讨[J].中国美容医学200918(3):371-373. DOI:10.3969/j.issn.1008-6455.2009.03.032.
[30]
Bayir FBolat Gumus E. External apical root resorption after orthodontic treatment:Incidence,severity and risk factors[J]. J Dent Res Dent Clin Dent Prospects202115(2):100-105. DOI:10.34172/joddd.2021.017.
[31]
郑雪妮,薛洋,马洋,等.神经及精神疾病人群拔牙的风险及防治[J].中国实用口腔科杂志201811(9):513-517. DOI:10.19538/j.kq.2018.09.001.
[32]
张紫阳,宣鹏,胡潇文,等.深圳市12 ~ 15岁儿童牙科畏惧症流行现状及影响因素分析[J].中国学校卫生202142(3):404-407. DOI:10.16835/j.cnki.1000-9817.2021.03.021.
[33]
张舜皓,王宇轩,李名立.牙科焦虑症心理治疗方法的研究进展[J].口腔疾病防治202230(9):680-684. DOI:10.12016/j.issn.2096-1456.2022.09.011.
[34]
白玉兴.正畸治疗中的风险认识与风险管理[J].中华口腔医学杂志201954(12):793-797. DOI:10.3760/cma.j.issn.1002-0098.2019.12.001.
[35]
Lau XELiu XChua H,et al. Heat generated during dental treatments affecting intrapulpal temperature:A review[J]. Clin Oral Investig202327(5):2277-2297. DOI:10.1007/s00784-023-04951-1.
[36]
Farah RI. Effect of cooling water temperature on the temperature changes in pulp chamber and at handpiece head during high-speed tooth preparation[J]. Restor Dent Endod201944(1):e3. DOI:10.5395/rde.2019.44.e3.
[37]
张述寅,莫静珍,胡开进.两种手术拔除下颌水平阻生第三磨牙的效果比较[J].实用口腔医学杂志202339(1):64-68. DOI:10.3969/j.issn.1001-3733.2023.01.011.
[38]
王峰,单兆臣,贾海鸥.口腔外科门诊临床教学中常见差错事故的预防[J].北京口腔医学201624(3):168-169. DOI:CNKI:SUN:BJKX.0.2016-03-013.
[39]
Yassir YANabbat SAMcIntyre GT,et al. Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment:An overview of systematic reviews[J]. Clin Oral Investig202226(3):2353-2370. DOI:10.1007/s00784-021-04361-1.
[40]
刘伟,周宏志,胡开进,等.邻牙、对颌牙及颞下颌关节损伤原因及防治[J].中国实用口腔科杂志20147(11):648-651. DOI:10.7504/kq.2014.11.003.
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