可能由于 16 号牙不当的牙髓治疗导致软组织填充物出现颊侧生物膜并发症。

Probable biofilm formation in the cheek as a complication of soft tissue filler resulting from improper endodontic treatment of tooth 16.

机构信息

Academy of Face Sculpturing, Medical University of Warsaw, Warsaw, Poland.

出版信息

Int J Nanomedicine. 2012;7:1441-7. doi: 10.2147/IJN.S27994. Epub 2012 Mar 14.

Abstract

Injectable filling agents offer the promise of a better appearance without surgery and, among them, hyaluronic acid is the most commonly used. Although complications are rare, it is necessary to know the possible side effects and complications in order to be prepared for their management. That is why many researchers have been focusing on the interactions between hyaluronic acid and pathogens, inflammatory mediators, the immune system, and markers of oxidative stress to achieve efficient drug delivery, given that hyaluronic acid has widening applications in the field of nanomedicine. Here we report the case of a 37-year-old female patient who returned to our clinic with an abscess in her left cheek 3 months after a deep injection of 1 mL of stabilized hyaluronic acid in both cheeks. Steroid and antibiotic therapy was initiated without success, and abscess drainage was performed. Extraction of tooth 16 was performed 11 days after insertion of drains into the abscess. Laboratory blood tests showed acute inflammation of presumed bacterial etiology. Microbiological examination of pus was negative. Bacterial cultures were found in the extracted tooth. After antibiotic therapy, a complete reversal of the pathological process was observed. The present report highlights the need to assess periodontal problems prior to any aesthetic facial treatment. Analyses of further case reports and clinical studies are necessary to understand the potential role of hyaluronic acid in the formation of biofilm, and how to avoid this complication, thereby increasing the safety of hyaluronic acid-based procedures.

摘要

注射填充剂无需手术即可带来更好的外观,其中透明质酸是最常用的。尽管并发症罕见,但为了能够妥善处理,了解可能的副作用和并发症是必要的。这就是为什么许多研究人员一直在关注透明质酸与病原体、炎症介质、免疫系统和氧化应激标志物之间的相互作用,以实现高效的药物输送,因为透明质酸在纳米医学领域的应用越来越广泛。在此,我们报告了一名 37 岁女性患者的病例,她在双侧脸颊深部注射 1 毫升稳定透明质酸 3 个月后,左侧脸颊出现脓肿。尽管开始了类固醇和抗生素治疗,但脓肿仍未消退,进行了脓肿引流。在脓肿中插入引流管 11 天后,拔出了 16 号牙。实验室血液检查显示为疑似细菌性病因的急性炎症。脓液的微生物检查为阴性。在拔出的牙齿中发现了细菌培养物。经过抗生素治疗,观察到病理过程完全逆转。本报告强调了在进行任何美容面部治疗之前评估牙周问题的必要性。有必要对进一步的病例报告和临床研究进行分析,以了解透明质酸在生物膜形成中的潜在作用,以及如何避免这种并发症,从而提高基于透明质酸的治疗的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7642/3356214/2f6fcdee9200/ijn-7-1441f1.jpg

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