Vogel Jobst, Stübinger Stefan, Kaufmann Markus, Krastl Gabriel, Filippi Andreas
Center of Dental Traumatology and Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basle, Basle, Switzerland.
Dent Traumatol. 2009 Feb;25(1):73-7. doi: 10.1111/j.1600-9657.2008.00670.x.
Even though it is known that dental injuries may occur in connection with tracheal intubation, the topic has hardly been evaluated in literature so far. Thus, this retrospective study was conducted including the data of 115-151 patients. All patients involved had been exposed to general anesthesia between 1995 and 2005. The resulting tooth injuries were assessed according to the following parameters: age, kind of hospital conducting treatment, intubation difficulties, pre-existing tooth damage, type and localization of tooth, type of tooth damage, and the number of teeth injured. At least 170 teeth were injured in 130 patients, while patients 50 years of age and older were especially affected. In contrast to older patients where in the majority of cases the periodontium (lateral dislocation) was injured, in younger patients dental hard tissue (crown fracture) was more likely to be affected. It was calculated that patients from the cardiothoracic surgery clinic were showing the highest risk of tooth damage. In more than three-fourth of all cases the anterior teeth of the maxilla, especially the maxillary central incisors, were affected. Pre-existing dental pathology like caries, marginal periodontitis and tooth restorations were often distinguishable prior to operation. Mouthguards in connection with tracheal intubation are not generally recommended as preventive device, due to the already limited amount of space available. Instead, pre-existing risk factors should be thoroughly explored before the induction of intubation narcosis.
尽管已知气管插管可能会导致牙齿损伤，但迄今为止该主题在文献中几乎未得到评估。因此，本研究进行了一项回顾性研究，纳入了115至151例患者的数据。所有纳入患者在1995年至2005年期间接受了全身麻醉。根据以下参数对由此产生的牙齿损伤进行评估：年龄、进行治疗的医院类型、插管困难程度、术前存在的牙齿损伤情况、牙齿类型和位置、牙齿损伤类型以及受伤牙齿的数量。130例患者中至少有170颗牙齿受伤，其中50岁及以上的患者受影响尤为明显。与老年患者不同，老年患者在大多数情况下牙周组织（侧向脱位）受损，而年轻患者的牙齿硬组织（冠折）更易受到影响。据计算，心胸外科诊所的患者牙齿损伤风险最高。在所有病例中，超过四分之三的上颌前牙，尤其是上颌中切牙受到影响。术前通常可以辨别出龋齿、边缘性牙周炎和牙齿修复等术前存在的牙齿病变。由于可用空间已经有限，一般不建议将气管插管时使用的口腔护具作为预防装置。相反，在诱导插管麻醉前应彻底探究术前存在的危险因素。
