El Hayderi L, Delvenne P, Rompen E, Senterre J M, Nikkels A F
Department of Dermatology, University Medical Center Liège, 4000, Liège, Belgium.
Clin Oral Investig. 2013 Nov;17(8):1961-4. doi: 10.1007/s00784-013-0986-3. Epub 2013 Apr 21.
Dental extraction is reported to trigger recurrent herpes labialis (RHL).
This aims to prospectively study the clinical occurrence of RHL and the oral herpes simplex virus type 1 (HSV-1) viral shedding before and 3 days after different dental procedures.
Oral HSV-1 DNA was measured by real-time PCR before and 3 days after dental procedures of the inferior dentition in 57 immunocompetent patients (mean age 32.4 years) who were selected and divided into four distinct subgroups (dental inspection without anesthesia, n = 19; dental filling under local anesthesia, n = 14; molar extraction under local anesthesia, n = 15; and molar extraction under general anesthesia, n = 9) and compared to 32 healthy controls (mean age 33 years).
None of the patients suffered from RHL at day 3. Oral HSV-1 DNA was detected before and after procedure in 1.7 % (1/57) and 5.3 % (3/57), respectively [dental inspection without anesthesia, 5.3 % (1/19); molar extraction under local anesthesia, 6.7 % (1/15); and molar extraction under general anesthesia, 11 % (1/9)]. None of the controls presented RHL or detectable oral HSV-1 DNA. There was no statistically significant difference between the study groups and controls.
Molar extraction increases the risk of oral HSV-1 shedding but not of RHL. Procedure-related nerve damage probably accounts for HSV reactivation.
Antiviral prophylaxis for RHL is not routinely recommended for dental procedures, regardless of a prior history of RHL.
据报道，拔牙会引发复发性唇疱疹（RHL）。
本研究旨在前瞻性地研究RHL的临床发生率以及不同牙科手术前和术后3天口腔单纯疱疹病毒1型（HSV-1）的病毒脱落情况。
对57名免疫功能正常的患者（平均年龄32.4岁）在下颌牙列进行牙科手术后，通过实时聚合酶链反应（PCR）测量术前和术后3天的口腔HSV-1 DNA。这些患者被选出来并分为四个不同的亚组（未麻醉下的牙科检查，n = 19；局部麻醉下的补牙，n = 14；局部麻醉下的磨牙拔除，n = 15；全身麻醉下的磨牙拔除，n = 9），并与32名健康对照者（平均年龄33岁）进行比较。
在第3天，没有患者发生RHL。手术前和手术后分别有1.7%（1/57）和5.3%（3/57）检测到口腔HSV-1 DNA[未麻醉下的牙科检查，5.3%（1/19）；局部麻醉下的磨牙拔除，6.7%（1/15）；全身麻醉下的磨牙拔除，11%（1/9）]。没有对照者出现RHL或可检测到的口腔HSV-1 DNA。研究组与对照组之间没有统计学上的显著差异。
磨牙拔除会增加口腔HSV-1脱落的风险，但不会增加RHL的风险。与手术相关的神经损伤可能是HSV重新激活的原因。
无论患者既往有无RHL病史，牙科手术一般不常规推荐预防性使用抗病毒药物来预防RHL。
