The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada.
J Endod. 2020 Jun;46(6):730-735. doi: 10.1016/j.joen.2020.04.001. Epub 2020 Apr 10.
In late 2019, an outbreak of a new coronavirus named severe acute respiratory syndrome coronavirus 2 was detected in Wuhan, China. A great percentage of patients with this disease developed symptoms of dry cough, malaise, and a high fever. During this time, several patients requiring assessment and treatment of endodontic emergencies were directed to the School and Hospital of Stomatology at Wuhan University, Wuhan, China. We examined the characteristics of these patients.
A total of 96 patients with a mean age of 42.24 ± 18.32 years visited the general and emergency department of the School and Hospital of Stomatology at Wuhan University because of endodontic emergencies during the peak period of February 22 to March 2, 2020. Patient information was collected and organized by date of visit, sex, age, and systemic disease history. Body temperature was measured and acquired for each patient, a coronavirus disease 2019 (COVID-19) epidemiologic investigation questionnaire was given to each patient, an endodontic diagnosis was determined for the offending tooth, and a verbal numerical rating scale (VNRS) was used to record pain levels.
Of the total patient visits during this period, 50.26% of visits were for endodontic treatment. No patients had a fever (>37.2°C). One patient with a confirmed COVID-19 history was admitted after recovery. Three admitted patients had been exposed to confirmed or suspected COVID-19 patients. Twelve admitted patients (12.5%) with a mean age of 62.42 ± 13.77 years had a history of systemic diseases. The most common age group for endodontic emergencies was 45-64 years (30.21%), and patients of this group showed a significantly higher mean VNRS score compared with that of the 6- to 19-year age group and the 20- to 34-year age group (P < .05). The majority of endodontic emergency diagnoses were diseases of symptomatic irreversible pulpitis (53.10%). Patients who were diagnosed with symptomatic irreversible pulpitis, symptomatic apical periodontitis, and acute apical abscess showed a significantly higher mean VNRS score than that of other groups (P < .05).
Endodontic emergencies, with symptomatic irreversible pulpitis being the most common, consist of a much higher proportion of dental emergencies in a COVID-19 high-risk area than normally. Vital pulp therapy can advantageously reduce treatment time, resulting in a reduced risk of infection for vital pulp cases. Rubber dams, personal protective equipment, and patient screening are of great importance during the COVID-19 outbreak in protecting clinicians.
2019 年末，在中国武汉发现了一种新型冠状病毒，命名为严重急性呼吸综合征冠状病毒 2。很大比例的该病患者出现干咳、不适和高烧等症状。在此期间，有几位需要评估和治疗牙髓急症的患者被转到中国武汉大学口腔医学院和医院。我们检查了这些患者的特征。
共有 96 名平均年龄为 42.24 ± 18.32 岁的患者因 2020 年 2 月 22 日至 3 月 2 日期间的牙髓急症前往武汉大学口腔医学院的普通和急诊部门就诊。根据就诊日期、性别、年龄和系统病史收集和整理患者信息。为每位患者测量并记录体温，每位患者都收到了一份 2019 冠状病毒病（COVID-19）流行病学调查问卷，确定了患牙的牙髓诊断，并使用口头数字评分量表（VNRS）记录疼痛程度。
在此期间的总就诊患者中，50.26%的就诊是为了进行牙髓治疗。没有患者发热（>37.2°C）。一名有确诊 COVID-19 病史的患者在康复后入院。三名住院患者曾接触过确诊或疑似 COVID-19 患者。12 名（12.5%）住院患者（平均年龄 62.42 ± 13.77 岁）有系统疾病史。牙髓急症最常见的年龄组是 45-64 岁（30.21%），该组患者的 VNRS 评分明显高于 6-19 岁年龄组和 20-34 岁年龄组（P<.05）。大多数牙髓急症诊断为症状性不可复性牙髓炎（53.10%）。诊断为症状性不可复性牙髓炎、症状性根尖周炎和急性根尖脓肿的患者的 VNRS 评分明显高于其他组（P<.05）。
在 COVID-19 高危地区，牙髓急症比平时包含更高比例的牙科急症，其中以症状性不可复性牙髓炎最为常见。活髓治疗可显著缩短治疗时间，从而降低活髓病例感染的风险。在 COVID-19 疫情期间，橡皮障、个人防护设备和患者筛查对于保护临床医生非常重要。
