牙齿重度磨耗露髓45例误诊分析

目的:减少牙齿重度磨耗露髓在口腔科的误诊误治。方法:收集最终确诊为重度磨耗露髓的患者资料45例,年龄61-78岁,调查其初诊诊断情况。确诊方法:患者重度磨耗之牙本质中央,可见针尖大穿髓孔,探针探诊无探痛,用8号扩大针可自穿髓处刺入,诱发剧烈疼痛。结果:初诊诊断:12例无阳性症状无法诊断,建议继续观察;18例诊断为牙本质过敏,给以脱敏治疗;3例怀疑根裂,建议拔除牙齿;6例怀疑三叉神经痛,建议到神经内科诊治;6例诊断为邻牙病变。结论:重度磨耗露髓的患牙,可能不伴有自发痛,容易被误诊误治。在露髓孔极小的情况下,可使用8号扩大针代替临床常用的一次性探针,能减少因一次性探针相对过粗无法探入露髓孔导致的漏诊误诊。

Misdiagnosis of pulp exposure by severe tooth abrasion

Objective:To reduce the misdiagnosis and mistreatment of pulp exposure due to severe tooth abrasion.Method:We collected 45 cases,which were finally diagnosed as pulp exposure due to severe tooth abrasion,33 males and 12 females,aged from 61 to 78,to investigate the situation of the initial diagnosis.Methods of the definite diagnosis:No pain is incurred by probing small holes in the center of severe abrased dentin with a probe,however,severe pain is incurred by piercing the same holes with 8 # reamer.Results...