Luchetti W, Cohen R B, Hahn G V, Rocke D M, Helpin M, Zasloff M, Kaplan F S
Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Jan;81(1):21-5. doi: 10.1016/s1079-2104(96)80141-7.
To determine the relationship of dental procedures to immediate ossification and ankylosis of the jaw in patients who have fibrodysplasia ossificans progressiva.
A mail survey was conducted of the 60 patient-members of the International Fibrodysplasia Ossificans Progressiva Association. All 41 patients (18 males, 23 females) who responded were examined. Instantaneous exact hazard rates for ossification of the jaw were calculated by the Weibull model.
Thirty-six patients had dental procedures performed. Twenty-one (58%) patients had received an injection of local anesthetic. Five (24%) patients had an immediate flare-up of fibrodysplasia ossificans progressiva with ossification and permanent ankylosis of the jaw (expected occurrence, 0.031; p < 0.0001). None of the 12 patients who had comparable dental work without injections developed heterotopic ossification (expected occurrence, 0.019; not significant).
Injections of local anesthetic during dental procedures pose serious and immediate risk for inciting heterotopic ossification and ankylosis of the jaw in patients who have fibrodysplasia ossificans progressiva and should be assiduously avoided.
确定在进行性骨化性纤维发育不良患者中，牙科手术与颌骨即刻骨化和关节强硬之间的关系。
对国际进行性骨化性纤维发育不良协会的60名患者会员进行了邮件调查。对所有回复的41名患者（18名男性，23名女性）进行了检查。采用威布尔模型计算颌骨骨化的即时精确风险率。
36名患者接受了牙科手术。21名（58%）患者接受了局部麻醉剂注射。5名（24%）患者出现进行性骨化性纤维发育不良即刻发作，并伴有颌骨骨化和永久性关节强硬（预期发生率为0.031；p<0.0001）。在12名未注射局部麻醉剂而进行类似牙科治疗的患者中，无一例发生异位骨化（预期发生率为0.019；无显著性差异）。
在进行性骨化性纤维发育不良患者进行牙科手术时注射局部麻醉剂，会引发颌骨异位骨化和关节强硬的严重且即刻风险，应极力避免。
