失活剂烧伤致乳磨牙早失及恒牙胚丧失2例

Devitalization has been widely used in the root canal therapy of primary and permanent teeth in China more than ten years ago. With the development of local anesthetic drugs and injection technologies, this treatment method with high potential risks has been gradually abandoned. However, a questionnaire survey targeted all the participants at the 2018 China Pediatric Dentistry Conference showed that the devitalizer utilization proportion was still as high as 38.1% (383/1 005), even though the ratio was much lower than 75.5% (105/139) in 2003. These doctors had pay more attention to tissue burn caused by devitalizer marginal leakage or direct leakage, and know how to identify and handle with devitalizer burn. Devitalizers were usually made of arsenic trioxide, metal arsenic or paraformaldehyde, which have cytotoxicity, allergenicity, mutagenicity, carcinogenicity, and teratogenic effects on animals. Marginal leakage of devitalizers have high risks of causing soft and hard tissue necrosis. Most of the dentists have an understanding of the potential damages of arsenic-containing devitalizers, so they will choose parafor-maldehyde with relatively less toxicity. Paraformaldehyde has a certain self-limitation, and there are few cases reported, so some dentists lack of vigilance. Paraformaldehyde can also causes tissue necrosis if leakage happens, and the treatment methods are similar to that of arsenic-containing devitalizers. When handling with devitalizers burn, the necrosed soft and hard tissue, for example gingiva, alveolar bone or teeth that cannot keep, must be completely removed until fresh blood appears, then rinse with large amount of saline and seal with iodoform gauze. This paper described two cases of devitalizer burn during the root canal treatment of primary molars, both of the doctors failed to identify the devitalizer burn symptoms in the early stage, thus didn’t do proper treatments immediately after burning. Resulting in the necrosis of large area of gingiva and alveolar bone, loss of primary molars and permanent tooth germs 1-2 months after devitalizer burn. This paper reported these two cases in detail in order to warn dentists the high risks of using any kind of devitalizers, help them learn how to identify and treat devitalizer burn, and remind them to stop using devitalizers as soon as possible.     

52例乳磨牙伴髓底穿的保存治疗

乳磨牙不仅要承担咀嚼功能，还要维持牙列的完整，引导继承恒牙的萌出。乳磨牙多由龋齿所致引起乳磨牙髓底的穿通，传统的观点认为髓底穿通的患牙应拔除，作者经过3个月～2年观察，对52例乳磨牙底穿部位进行修补，进行临床观察，疗效满意，报道如卜。1材料和方法材料：氢氧化钙1份，氧化锌1份，碘仿少许，临用时上述药混合与丁香油调成糊剂。空管糊剂配方：强力霉素0．1g，碘腹增效剂0．1g，灭滴灵0．2g，地塞米松0．75mm，木榴油适量调成糊剂装瓶备用。磷酸锌粘固粉，银汞合金粉。病例选择：本组52例，男性28例，女性24例，其中6岁16例，7…     

羟基磷灰石与氢氧化钙治疗乳磨牙穿底的临床比较

目的　对比羟基磷石与氢氧化钙在治疗乳磨牙穿底的效果。方法　选择乳磨牙穿底病例 132例 ,随机分成A、B 2组 ,A组 6 6例 ,羟基磷灰石调成糊剂 ,对穿底处置该糊剂后用磷酸锌粘固粉暂封 1个月 ,无症状后做永久性封闭。B组 6 6例 ,用氢氧化钙 1份 ,氧化锌 1份 ,碘仿少许与丁香油调成糊剂 ,将该材料置于穿底处后 ,根管口置干髓剂 ,再用氧化锌暂封 ,观察 1周后 ,无症状去除部分氧化锌 ,做永久性封闭。结果　A组在第 4、8及 12个月后 ,成功率分别为 89 83% ,86 2 %及 95 % ;B组在第 4、8及 12个月后成功率分别为 76 2 7%、74 5 1%及 6 7 5 9%。结论　治疗乳磨牙穿底采用羟基磷灰石较为优越。     

多颗恒牙缺失致乳尖牙及尖牙同时存留1例

恒牙列先天性缺牙是牙齿数目异常的一种,牙缺失达5颗以上本就少见,而本患者多颗恒牙缺失后致双侧上颌乳尖牙及尖牙同时存留则更为罕见。通过对本例患者的报道及文献回顾,讨论总结对多颗恒牙缺失导致的替牙异常及错[牙合]畸形的临床表现、病因、治疗及早期阻断方法。     

失活剂外泄致邻牙急性牙髓炎1例

失活剂外泄致邻牙急性牙髓炎１例刘英路,黎民宇患者女,２８ａ,于１９９４年１１月７日因远中邻滩龋在某院门诊治疗,开髓后封快速失活剂亚砷酸,次日未及时复诊,１１月１５日来我院时诉右上后牙自发性疼痛,及冷热刺激疼。检查：原封完好,有叩痛,冷热试验阴性,远中...     

先天性多个乳牙伴全口恒牙胚缺如1例

患者男,6岁,因多数牙未萌出而在我科就诊。体格检查:营养发育一般,智力正常。皮肤干燥无光泽,头发稀疏、卷曲,眉毛浅淡、细而少,颜面无畸形,未发现其他全身性器质性疾病。既往体健,其父母否认家族病史及近亲婚配。口腔专科检查:颌面部两侧对称,颌骨发育正常,面下1/3稍显短,似无牙颌面容;唇腭正常,口腔粘膜无异常;上下牙弓窄小,牙槽嵴高度尚可,龈垫较厚;舌体比较肥大,但活动自如。萌出的乳牙51、61、64、65、74、55、85形态异常,乳中切牙小而呈圆锥状,牙间隙较大,乳磨牙合面无正常形态,呈不规则状,口内存留牙均无松动。X线曲面断层片显示:上…     

穿琥宁注射液致过敏性休克1例

患者,女,28岁。因腹痛、腹泻伴发热1天,诊断为急性肠炎。给予穿琥宁注射液400mg(宜宾制药厂生产、批号980703),加入5%GNS2500ml中静滴(40滴/分)。15分钟后,患者感胸闷、心慌、出冷汗。血压8/6kPa,心率106次/分、脉搏细弱。治疗:立即停用穿琥注射液,给予吸氧、肌注非那根25mg,5%葡萄糖100ml加入地塞米松10mg静滴,10分钟后血压13/10kPa,脉搏86次/分,病情稳定穿琥宁注射液致过敏性休克1例@王玎$成都市第一人民医院!610016@刘惠茹$成都市第一人民医院!610016@黄俊$成都市第一人民医院!610016…     

穿琥宁注射液致过敏性休克1例

1临床资料 患者，女，36岁，因颈部出现簇集成群的粟粒至绿豆大小红色丘疹于2006年1月21日入我院治疗。入科查体：体温38．5℃、脉搏78次／min、血压120／80mmHg，临床诊断为带状疱疹。入院后外用炉甘石洗剂局部治疗，并用穿琥宁注射液400mg加入0．09％氯化钠注射液250ml中，静脉滴注。约5min后，患者出现胸闷、心慌、呼吸困难、口唇紫绀，继而出现心悸、出汗、全身瘫软无力、意识丧失、血压下降（70．0／10mmHg）。立即停止输液，给予吸氧，肌肉注射异丙嗪25mg，地塞米松10mg，肾上腺素1ml静脉注射；用药10min后胸闷心慌消失，血压110／75mmHg，脉搏90次／min，     

穿琥宁致过敏反应1例报告

患儿,男,4岁半。因咳嗽4天伴发热3天,于2003年 4月13日入院,入院体检:T38．6℃,咽充血,双侧扁桃体Ⅱ°肿大,双肺呼吸音粗,可闻痰鸣音,余未见异常,辅助检查:人院时血常规WBC12．6×109/L,N 0．175,L 0．285, HCBl10g/L,胸透示肺部感染。诊断为急性支气管肺炎。入院后静脉给予苯唑青霉紊1．0g,0．2％氧氟沙星135ml及穿琥宁160mg等抗感染支持对症处理,患儿在输完穿琥宁,刚输 0．2％氧氟沙星时,发现患儿颜面潮红,左眼睑下缘突起红     

穿琥宁针致过敏性休克1例

1　患者 ,男 ,2 9岁。因发热、咽痛 2天。拟病毒性上感入院。入院查 :Ｔ39℃ ,Ｐ90次 /分 ,Ｒ2 2次 /分 ,ＢＰ16 /10ｋＰａ。咽充血明显 ,双肺ＢＳ粗 ,余 (- )。血常规 :ＷＢＣ6 .0 ｇ/Ｌ ,ＬＹＭ2 .4ｇ/Ｌ ,ＧＲＡＮ4.7ｇ/Ｌ。否认有药物过敏史 ,当日予 5 %葡萄糖液5 0 0ｍｌ 穿琥宁针剂 0 .32静滴 ,4小时后 ,症状减轻 ,Ｔ38℃。次日医嘱同前 ,在常规操作下作静脉穿刺 ,一次穿刺成功后固定好输液针头 ,调滴速至 40滴 /分。约 5分钟后 ,患者诉舌、面部麻木 ,恶心欲吐 ,立即停止输液 ,约半分钟后患者诉头晕、胸闷、呼吸不畅 ,面色苍白 ,Ｔ38…     

穿琥宁注射液致过敏性休克1例

患,女,54岁,因咳嗽、吐痰、周身乏力;而给予静滴穿琥宁注射液400mg,加生理盐水250ml,5分钟后突然出现胸闷,瞥气、头晕、恶心、呼吸困难、出冷汗、尿失禁。既往无过敏史。     

静脉滴注穿琥宁致过敏反应1例

<正>1病例介绍患者,男,2岁,于2009年5月1日来笔者所在医院就诊。查体:体温37.2℃,呼吸26次/min,心率108次/min。咽部充血,双侧扁桃体不肿大,双肺呼吸音粗糙,未闻及干湿性啰音。诊断:上呼吸道感染。予以5%葡萄糖盐水100 ml加穿琥宁80 ml(黑龙江哈尔滨医科大学药业有限公司生产,批号:20090102)静脉滴注,5 min后患儿出现面色苍白,口唇发绀,意识不清,四肢发凉。查体:体温37.8℃,脉搏112次/min,呼吸32次/min。诊为:穿琥宁过敏。立即停用该药,换上5%葡萄糖100 ml,给予氧气吸入,并皮下注射肾上腺素