- 期刊
牙髓病治療發生感覺異常的原因與處理
The Etiologies and Management of Endodonticrelated Paresthesia
摘要
在牙科診療過程中，神經組織受到損傷而導致嚴重併發症如感覺異常的現象並不常見。但是在實際臨床治療步驟中，諸如局部麻醉注射（local anesthesia injection），根管修型及沖洗溶液的使用，根管封填，牙根尖周圍手術（periradicular surgery）的進行等，都極有可能因緊靠三叉神經（trigeminal nerve）各分枝位置而有損傷神經的機會。此外，許多與齒源性（odontogenic）相關的原因如大範圍的根尖病變感染（large apical lesion），牙齒外傷（trauma），囊腫（cyst）與腫瘤（tumor）等病理結構，發炎組織都有可能壓迫促使神經受損而引發感覺異常的結果。要正確鑑別診斷神經組織損傷而導致感覺異常的現象，必須有詳盡的病史，合適的臨床檢查與輔助的放射線診斷資料。本綜合文獻著重於診斷與處理有關於牙髓病根管治療過程中所促成相關的神經損傷，期待有助於臨床醫師在根管治療過程中，避免與處理可能導致的三叉神經受傷的情形。
並列摘要
Altered sensation due to a nerve injury is an infrequent and severe complication of dental treatment. Practically all dental treatment procedures including root canal therapy such as local anesthesia injection, root canal preparation and irrigation, root canal filling, and periradicular surgery, those are performed in the vicinity of trigeminal nerve branches may trigger nerve injury. Many odontogenic-related entities such as large infectious apical lesion, trauma, cystic lesion and tumors or idiopathic disease have also been suggested as possible origins of altered sensation of trigeminal nerve. The diagnosis of a nerve injury requires a combination of a thorough anamnesis, a proper clinical evaluation such as neurosensory test, and an adjunct radiographic evaluation when indicated. The review article will focus on the diagnosis and management of endodontic related nerve injuries, and aims to provide the practitioner with the knowledge and useful means to manage nerve injury when performing endodontic treatment.