因紧急或急救行气管插管导致的牙齿脱落意外。
Tooth avulsion accidents due to urgent and emergency orotracheal intubation.
机构信息
Universidade Cruzeiro do Sul Rua Constantino de Sousa, 454, apto 141 zip code: 04605-001, São Paulo - SP, Brazil
出版信息
Med Oral Patol Oral Cir Bucal. 2020 May 1;25(3):e353-e358. doi: 10.4317/medoral.23375.
BACKGROUND
Intubation is necessary during critical situations to reduce the risk of death. In Brazil, a need exists to determine the prevalence of tooth avulsions in emergency and urgent care. The objective of this study was to identify the causes of orotracheal intubation (OTI), the number of tooth avulsions, and the avulsed teeth that result from urgent and emergency intubation.
MATERIAL AND METHODS
The sample consisted of 116 patients (total group) in intensive care units (ICUs) distributed across Group 1 (G1), which was composed of 71 patients from an urgent-care hospital, and Group 2 (G2), which was composed of 45 patients from an emergency hospital. Clinical examinations showed dental alveolus with signs of recent exodontia in the upper and lower anterior regions. Sociodemographic data and the reason for intubation were evaluated. The Shapiro-Wilk normality test, chi-square test, Fisher's exact test, Mann-Whitney U test, and univariate logistic regression were performed with a significance level of 5%.
RESULTS
The avulsion prevalence was 4.3%, with more cases receiving emergency intubation (n=4). All avulsions occurred in adults, and a significant difference (p=0.011) was observed with regard to the elderly. A 1-year reduction in age increased the chance of tooth avulsion during intubation by 1.09 times; being female increased the chance by 2.88 times.
CONCLUSION
Pulmonary problems were the major causes of intubation, with the highest tooth avulsion prevalence observed during emergency intubation. The avulsed teeth were 11, 12, 13, 22, 32, and 33 across all cases.
背景
在危急情况下进行插管是必要的，以降低死亡风险。在巴西，需要确定急诊和紧急护理中牙齿脱落的发生率。本研究的目的是确定经口气管插管（OTI）的原因、牙齿脱落的数量以及紧急和急救插管导致的脱落牙齿。
材料和方法
该样本由重症监护病房（ICU）的 116 名患者（总组）组成，分布在第 1 组（G1）和第 2 组（G2）中。G1 组由来自急症医院的 71 名患者组成，G2 组由来自急诊医院的 45 名患者组成。临床检查显示，在上、下前牙牙槽有近期拔牙的迹象。评估了人口统计学数据和插管原因。采用 Shapiro-Wilk 正态性检验、卡方检验、Fisher 确切检验、Mann-Whitney U 检验和单因素逻辑回归进行分析，显著性水平为 5%。
结果
牙齿脱落的发生率为 4.3%，更多的患者接受紧急插管（n=4）。所有的脱落都发生在成年人身上，并且在老年人中观察到显著差异（p=0.011）。年龄每减少 1 岁，插管时牙齿脱落的几率增加 1.09 倍；女性增加 2.88 倍。
结论
肺部问题是插管的主要原因，紧急插管时牙齿脱落的发生率最高。所有病例中脱落的牙齿分别为 11、12、13、22、32 和 33。
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