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氯喹诱导的史蒂文斯-约翰逊综合征中短根畸形的锥形束计算机断层扫描特征 - 病例报告。

Cone Beam Computed Tomographic Cone beam computed tomographic characterization of short root anomaly in chloroquine-induced Stevens-Johnson Syndrome - a case report.

机构信息

All India Institute of Medical Sciences, New Delhi, India.

出版信息

Folia Med (Plovdiv). 2022 Feb 28;64(1):169-175. doi: 10.3897/folmed.64.e58178.

Abstract

Stevens-Johnson syndrome (SJS) is a rare medical condition with severe mucocutaneous reaction due to infection or adverse drug reaction. The present case reports the impact of chloroquine-induced SJS on the tooth root development. A 20-year-old Indian male reported to conservative dentistry and endodontics speciality clinic with the chief complaint of food lodgement and sensitivity in maxillary and mandibular posterior teeth. He had a past medical history of severe cutaneous reaction after taking Tab. Lariago (chloroquine) for treatment of malarial fever at the age of 8 years. The acute inflammatory immune response was managed by hospitalization and administration of steroids and anti-inflammatory drugs. Clinical examination revealed dry mucosa, carious teeth with adequate oral hygiene. Panoramic X-ray showed multiple teeth with short roots. A detailed cone beam computed tomographic scan (CBCT) demonstrated a healthy bone trabecular pattern with the absence of any periapical radiolucency. Short, blunt roots with immature apex were seen in many teeth. Based upon the measurement of root to the crown ratio on the CBCT scan and correlating the development status of teeth with the medical history, a diagnosis of short root anomaly (SRA) after chloroquine-induced SJS was made. This is the first report to describe the three-dimensional features of teeth with SRA in a patient with SJS. Diagnostic, restorative, and endodontic implications of SJS are highlighted.

摘要

史蒂文斯-约翰逊综合征(SJS)是一种罕见的医学病症,由于感染或药物不良反应导致严重的黏膜皮肤反应。本病例报告了氯喹引起的 SJS 对牙根发育的影响。一名 20 岁的印度男性因上颌和下颌后牙食物嵌塞和敏感而到牙髓病学和修复牙科专科诊所就诊。他在 8 岁时因疟疾发热服用 Tab. Lariago(氯喹)后出现严重皮肤反应的既往病史。急性炎症免疫反应通过住院和给予类固醇和抗炎药物进行管理。临床检查显示黏膜干燥,龋齿,口腔卫生良好。全景 X 光片显示多颗牙齿根短。详细的锥形束 CT 扫描(CBCT)显示健康的骨小梁模式,没有任何根尖周透光区。许多牙齿可见短而钝的根尖,根尖未成熟。根据 CBCT 扫描上的根冠比测量值,并将牙齿的发育状况与病史相关联,诊断为氯喹诱导的 SJS 后的短根畸形(SRA)。这是首例描述 SJS 患者 SRA 牙齿的三维特征的报告。强调了 SJS 的诊断、修复和牙髓学意义。

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