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针对复杂病情患者的非手术牙髓治疗管理——给全科牙医的提示与技巧

Non-surgical endodontic management for the medically complex - hints and tips for the general dental practitioner.

作者信息

Finn Kathryn, Kasperek Dariusz, Aljamani Sanaa, Wilson-Dewhurst Charlotte

机构信息

Specialist Dentist, Special Care Dentistry, Special Care Dentistry Department, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK.

Academic Clinical Fellow in Endodontics, Restorative Dentistry Department, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK.

出版信息

Br Dent J. 2025 Apr;238(7):551-557. doi: 10.1038/s41415-025-8561-2. Epub 2025 Apr 11.

DOI:10.1038/s41415-025-8561-2
PMID:40217038
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11991901/
Abstract

The management of patients with additional medical complexities is challenging and can cause apprehension when considering if dental treatment is able to be provided in primary care. Non-surgical endodontic treatment is generally a low-risk procedure for many patient cohorts. This paper describes commonly seen medical conditions, the impact on bleeding and infection, and where extraction would preferably be avoided. It explores the risk assessment of these conditions and provides 'hints and tips' for the provision of endodontic treatment, allowing for the safe and effective provision of dental care, in the appropriate setting, by the appropriate specialty.

摘要

对患有其他复杂疾病的患者进行管理具有挑战性，在考虑能否在初级医疗保健中提供牙科治疗时可能会引起担忧。对于许多患者群体而言，非手术牙髓治疗通常是一种低风险的程序。本文描述了常见的医疗状况、对出血和感染的影响，以及最好避免拔牙的情况。它探讨了这些状况的风险评估，并为牙髓治疗的实施提供了“提示和技巧”，以便在适当的环境中由适当的专业人员安全有效地提供牙科护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/c6f573d0ac72/41415_2025_8561_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/fd226543cab1/41415_2025_8561_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/27b2032a0167/41415_2025_8561_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/03306690ab19/41415_2025_8561_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/1b818b29e7af/41415_2025_8561_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/1f9a979ff4bd/41415_2025_8561_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/c6f573d0ac72/41415_2025_8561_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/fd226543cab1/41415_2025_8561_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/27b2032a0167/41415_2025_8561_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/03306690ab19/41415_2025_8561_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/1b818b29e7af/41415_2025_8561_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/1f9a979ff4bd/41415_2025_8561_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/779c/11991901/c6f573d0ac72/41415_2025_8561_Fig6_HTML.jpg

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Correction to: Non-surgical endodontic management for the medically complex - hints and tips for the general dental practitioner.对《医学复杂病例的非手术牙髓治疗管理——普通牙科医生的提示与技巧》的勘误
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本文引用的文献

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Dental Management Considerations for Patients with Cardiovascular Disease-A Narrative Review.心血管疾病患者的牙科管理考量——一篇叙述性综述
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The heart of it: dental care and cardiothoracic surgery.核心科室：口腔科和心胸外科。
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Prevention of infective endocarditis in at-risk patients: how should dentists proceed in 2024?2024 年，如何为高危患者预防感染性心内膜炎：牙医应如何操作？
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Risk factors for dental findings of the development of medication-related osteonecrosis of the jaw: Investigation of 3734 teeth in cancer patients receiving high dose antiresorptive agents.颌骨药物相关性骨坏死发生时牙齿表现的危险因素：对接受高剂量抗吸收剂的癌症患者的3734颗牙齿的调查。
J Dent Sci. 2024 Jan;19(1):203-210. doi: 10.1016/j.jds.2023.04.026. Epub 2023 May 10.
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Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline.牙髓病和根尖周病的治疗：欧洲牙髓病学会（ESE）S3级临床实践指南。
Int Endod J. 2023 Oct;56 Suppl 3:238-295. doi: 10.1111/iej.13974. Epub 2023 Sep 29.
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2023 ESC Guidelines for the management of endocarditis.2023年欧洲心脏病学会感染性心内膜炎管理指南。
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Single versus multiple visits for endodontic treatment of permanent teeth.单次就诊与多次就诊治疗恒牙牙髓病的效果比较。
Cochrane Database Syst Rev. 2022 Dec 13;12(12):CD005296. doi: 10.1002/14651858.CD005296.pub4.
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Osteoradionecrosis of the jaw: A mini review.颌骨放射性骨坏死：一篇综述
Front Oral Health. 2022 Jul 28;3:980786. doi: 10.3389/froh.2022.980786. eCollection 2022.
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Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis.口腔或口咽癌患者颌骨放射性骨坏死的危险因素：使用倾向评分匹配分析验证放疗前拔牙的效果。
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American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update.美国口腔颌面外科学会关于药物相关性颌骨坏死的立场文件-2022 更新。
J Oral Maxillofac Surg. 2022 May;80(5):920-943. doi: 10.1016/j.joms.2022.02.008. Epub 2022 Feb 21.