Seow W K
School of Dentistry, The University of Queensland, Brisbane.
Aust Dent J. 2003 Sep;48(3):156-68. doi: 10.1111/j.1834-7819.2003.tb00026.x.
Although the majority of dental abscesses in children originate from dental caries or trauma, a few are associated with unusual conditions which challenge diagnosis and management. Recent research findings have shed light on these unusual entities and greatly improved understanding of their clinical implications. These conditions include developmental abnormalities such as dens invaginatus in which there is an invagination of dental tissues into the pulp chamber and dens evaginatus in which a tubercle containing pulp is found on the external surface of a tooth crown. In addition, inherited conditions which show abnormal dentine such as dentine dysplasia, dentinogenesis imperfecta, and osteogenesis imperfecta predispose the dentition to abscess formation. Furthermore, 'spontaneous' dental abscesses are frequently encountered in familial hypophosphataemia, also known as vitamin D-resistant rickets, in which there is hypomineralization of dentine and enlargement of the pulp. In addition to developmental conditions, there are also acquired conditions which may cause unusual dental abscesses. These include pre-eruptive intracoronal resorption which was previously known as 'pre-eruptive caries' or the 'fluoride bomb'. In addition, some undiagnosed infections associated with developing teeth are now thought to be the mandibular infected buccal cysts which originate from infection of the developing dental follicles. In the present paper, these relatively unknown entities which cause unusual abscesses in children are reviewed with the aim of updating the general practitioner in their diagnosis and management.
尽管儿童的大多数牙脓肿源于龋齿或外伤，但少数与一些不寻常的情况有关，这些情况对诊断和治疗构成挑战。最近的研究结果揭示了这些不寻常的实体，并极大地增进了对其临床意义的理解。这些情况包括发育异常，如牙内陷（牙组织向内陷入牙髓腔）和牙外突（在牙冠外表面发现含有牙髓的结节）。此外，表现出异常牙本质的遗传性疾病，如牙本质发育异常、牙本质生成不全和成骨不全，使牙列易形成脓肿。此外，在家族性低磷血症（也称为维生素D抵抗性佝偻病）中经常遇到“自发性”牙脓肿，该病中牙本质矿化不足且牙髓增大。除了发育方面的情况，还有一些后天性情况可能导致不寻常的牙脓肿。这些包括萌出前牙冠内吸收，以前称为“萌出前龋齿”或“氟中毒”。此外，一些与正在发育的牙齿相关的未确诊感染现在被认为是下颌感染性颊囊肿，其起源于发育中的牙滤泡感染。在本文中，对这些在儿童中导致不寻常脓肿的相对不为人知的实体进行了综述，目的是使全科医生了解其诊断和治疗方法。
