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普瑞巴林治疗根管封闭剂超充后下牙槽神经感觉异常

Pregabalin in the treatment of inferior alveolar nerve paraesthesia following overfilling of endodontic sealer.

作者信息

Alonso-Ezpeleta Oscar, Martín Pablo J, López-López José, Castellanos-Cosano Lizett, Martín-González Jenifer, Segura-Egea Juan J

机构信息

Associate Professor. Department of Endodontics, School of Dentistry, University of Zaragoza, 22006-Huesca, Spain.

Doctoral fellow. Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009-Sevilla, Spain.

出版信息

J Clin Exp Dent. 2014 Apr 1;6(2):e197-202. doi: 10.4317/jced.51420. eCollection 2014 Apr.

DOI:10.4317/jced.51420
PMID:24790724
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4002354/
Abstract

A case of orofacial pain and inferior alveolar nerve (IAN) paraesthesia after extrusion of endodontic sealer within the mandibular canal treated with prednisone and pregabalin is described. A 36-year-old woman underwent root canal treatment of the mandibular second right premolar tooth. Post-operative panoramic radiograph revealed the presence of radiopaque canal sealer in the mandibular canal. Damage to IAN consecutive to extrusion of endodontic sealer was diagnosed. Non-surgical management was decided, including: 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. Six weeks after the incident the signs and symptoms were gone. The complete resolution of paraesthesia and the control of pain achieved suggest that a non-surgical approach, combining prednisone and the GABA analogue pregabalin, is a good option in the management of the IAN damage subsequent to endodontic sealer extrusion. Key words:Endodontics, inferior alveolar nerve, neuropathic pain, orofacial pain, paraesthesia, pregabalin.

摘要

本文描述了一例下颌管内根管封闭剂挤出后出现口面部疼痛和下牙槽神经（IAN）感觉异常，采用泼尼松和普瑞巴林治疗的病例。一名36岁女性接受了右下第二前磨牙的根管治疗。术后全景X线片显示下颌管内存在不透射线的根管封闭剂。诊断为根管封闭剂挤出导致IAN损伤。决定采用非手术治疗，包括：每日2次，每次1mg/kg泼尼松，每日一次方案，以及每日150mg普瑞巴林，每日2次，通过定期随访监测进展。事件发生六周后，体征和症状消失。感觉异常的完全缓解和疼痛的控制表明，联合使用泼尼松和GABA类似物普瑞巴林的非手术方法是治疗根管封闭剂挤出后IAN损伤的一个良好选择。关键词：牙髓病学；下牙槽神经；神经性疼痛；口面部疼痛；感觉异常；普瑞巴林

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/ae6d76fa4aa2/jced-6-e197-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/2aa3bf4439b2/jced-6-e197-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/81c85119334b/jced-6-e197-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/2dfaca41b765/jced-6-e197-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/ba67e72ff15c/jced-6-e197-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/bd2f453e37ae/jced-6-e197-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/ae6d76fa4aa2/jced-6-e197-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/2aa3bf4439b2/jced-6-e197-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/81c85119334b/jced-6-e197-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/2dfaca41b765/jced-6-e197-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/ba67e72ff15c/jced-6-e197-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/bd2f453e37ae/jced-6-e197-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96eb/4002354/ae6d76fa4aa2/jced-6-e197-g006.jpg

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本文引用的文献

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Evaluation of efficacy of oral pregabalin in reducing postoperative pain in patients undergoing total knee arthroplasty.口服普瑞巴林对全膝关节置换术患者术后疼痛缓解效果的评估。
Indian J Orthop. 2012 Nov;46(6):646-52. doi: 10.4103/0019-5413.104196.
2
No evidence for DNA double-strand breaks caused by endodontic sealers.没有证据表明根管封闭剂会导致 DNA 双链断裂。
J Endod. 2012 May;38(5):636-41. doi: 10.1016/j.joen.2011.12.037. Epub 2012 Feb 11.
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Endodontic-related paresthesia: a case report and literature review.牙髓相关感觉异常：一例报告及文献复习。
单次就诊与多次就诊非手术牙髓治疗后根管充填后疼痛的发生率。
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Int Endod J. 2012 Jan;45(1):98-104. doi: 10.1111/j.1365-2591.2011.01939.x. Epub 2011 Aug 23.
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Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles.两种旋转系统和冲洗针的碎屑及冲洗液挤出可能性
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Differential diagnosis of endodontic-related inferior alveolar nerve paraesthesia with cone beam computed tomography: a case report.根管治疗相关下牙槽神经感觉异常的锥形束 CT 鉴别诊断：病例报告。
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The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model.针插入深度对根管冲洗液流的影响：使用非定常计算流体动力学模型评估。
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J Can Dent Assoc. 2010;76:a61.