Altun Busra Dilara, Sümen Selin Gamze, Dumlu Asim
Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul, Turkey.
Corresponding author: Dr Busra Dilara Altun, Marmara Üniversitesi Başıbüyük Sağlık Yerleşkesi, Diş Hekimliği Fakültesi, Başıbüyük Yolu 9/3 34854 Başıbüyük, Maltepe, İstanbul, Turkey,
Diving Hyperb Med. 2022 Mar 31;52(1):63-65. doi: 10.28920/dhm52.1.63-65.
Previous cases of dental barotrauma have been reported in pilots and divers. We report a case of dental barotrauma and barodontalgia in a diving physician accompanying patients during hyperbaric oxygen treatment, and due to pressure changes in the hyperbaric chamber. The physician developed sharp pain localised to the right maxillary molars but radiating to the face, ear and head during decompression from 243 kPa (2.4 atmospheres absolute). The pain intensified following completion of decompression and was consistent with irreversible pulpitis. Clinical examination and panoramic radiography suggested fracture of a heavily restored tooth due to barotrauma. This was managed by tooth extraction. The physician subsequently discontinued accompanying the patients during their hyperbaric oxygen treatment sessions. Dentists and maxillofacial surgery specialists suggest waiting for a minimum of four weeks or until the tooth socket and/or oral tissue has healed sufficiently to minimise the risk of infection or further trauma before exposure to further pressure change. Although seemingly rare, and despite the comparatively slow pressure changes, dental barotrauma can occur in hyperbaric chamber occupants.
此前曾有飞行员和潜水员发生牙气压伤的病例报告。我们报告一例在高压氧治疗期间陪伴患者的潜水医生发生牙气压伤和气压性牙痛的病例，病因是高压舱内的压力变化。该医生在从243千帕（绝对压力2.4个大气压）减压过程中，右上颌磨牙出现剧痛，疼痛放射至面部、耳部和头部。减压结束后疼痛加剧，符合不可逆牙髓炎的症状。临床检查和全景X线片显示一颗经过多次修复的牙齿因气压伤而折断。对此进行了拔牙处理。该医生随后停止在患者高压氧治疗期间陪伴。牙医和颌面外科专家建议至少等待四周，或直到牙槽窝和/或口腔组织充分愈合，以尽量降低再次暴露于压力变化时感染或进一步创伤的风险。尽管牙气压伤看似罕见，且高压舱内压力变化相对缓慢，但仍可能发生在舱内人员身上。
