Loushine Robert J, Weller R Norman, Kimbrough W Frank, Liewehr Frederick R
Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta 30912-1244, USA.
J Endod. 2003 Apr;29(4):272-4. doi: 10.1097/00004770-200304000-00011.
A thorough diagnostic examination is essential before providing endodontic treatment. The sequence of diagnostic procedures must begin with a well-organized review of the medical history. In the early screening process, a health history that reveals a systemic disorder must be investigated further because it may have a significant impact on the dental diagnosis and ultimate endodontic treatment. There are a number of systemic diseases that can cause bone lesions throughout the body. Chronic renal failure is one disorder that may stimulate a secondary hyperparathyroidism that can cause a variety of bone lesions. In some instances these lesions appear in the periapical region of teeth and can lead to a misdiagnosis of a lesion of endodontic origin. The following case report of a patient referred for endodontic treatment demonstrates the importance of understanding the effects of end-stage renal disease on the dental structures.
在进行牙髓治疗之前，全面的诊断检查至关重要。诊断程序的顺序必须从条理清晰地回顾病史开始。在早期筛查过程中，若健康史显示存在全身性疾病，则必须进一步调查，因为这可能对牙齿诊断及最终的牙髓治疗产生重大影响。有多种全身性疾病可导致全身骨骼病变。慢性肾衰竭就是一种可能引发继发性甲状旁腺功能亢进的疾病，进而导致各种骨骼病变。在某些情况下，这些病变出现在牙齿根尖周区域，可能会导致对牙髓源性病变的误诊。以下这例因牙髓治疗前来就诊的患者病例报告，说明了了解终末期肾病对牙齿结构影响的重要性。
