Roeykens Herman, Van Maele Georges, Martens Luc, De Moor Roeland
Department of Operative Dentistry & Endodontology, University of Ghent, Belgium.
Dent Traumatol. 2002 Apr;18(2):86-91. doi: 10.1034/j.1600-9657.2002.180208.x.
The reliability of laser Doppler flowmetry in a two-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-year-old Caucasian female, tooth pulp vitality was studied in six maxillary front teeth over 30 weeks using two-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be as reliable indicators of revascularisation, as significant results are obtained later (7 weeks) than using laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a strong indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive, as denervation was postponed and pulp vascularisation evident.
激光多普勒血流仪用于牙髓血流双探头评估的可靠性是众所周知的。本病例报告的目的是确定其在长期随访中作为牙齿活力诊断的唯一可靠工具的用途。一名24岁白种女性因外伤,使用双探头激光多普勒血流仪和电流敏感性测试,对6颗上颌前牙的牙髓活力进行了30周的研究。228周后重复了类似评估。面对牙槽骨骨折且骨折线中有一颗牙齿、一颗嵌入牙和几颗松动牙的情况,发现电流敏感性测试并非血管再通的可靠指标,因为与激光多普勒血流仪测试(1周)相比,电流敏感性测试获得显著结果的时间较晚(7周)。通过激光多普勒血流仪测试发现了牙髓缺血(3周)、充血(7周)和恢复血液供应的过程,并避免了牙髓治疗。牙齿血管化正常发展(228周)。尽管所有敏感性测试都强烈表明需要进行牙髓治疗,但激光多普勒血流仪测试的结果明确,比敏感性测试更可靠且具有唯一性,因为神经支配延迟且牙髓血管化明显。