■软组织损伤是正畸治疗的已知并发症。大部分的伤势都是轻微的,但是,严重的并发症可能是由于托架和其他异物更深地穿透或移位到口咽和颞下窝的周围组织中。
■病人,在他父母的陪同下,提交给儿童急诊科,关注的是逐渐限制张口和最终的关口,发生在2周的时间里。
■患者在左颊区域出现了三口肌和轻微的不适。他报告了2周前张口逐渐受限的病史。他戴着上下固定的正畸矫治器,发现上颌弓丝的左远端已迁移到左颞下窝。
■左内侧翼状肌炎症,或者出血和血肿的形成,或颞下区域内的感染。
■在儿童急诊科移除上颌弓丝,随后进行计算机断层扫描(CT)扫描证实诊断为左侧内侧翼状肌炎症。患者开始接受静脉注射(IV)抗生素和2天的静脉注射地塞米松疗程,以减轻肌肉炎症。
■到第二天,患者能够实现6毫米的张口,到了第二周,张口已经恢复正常。
■正畸治疗的软组织损伤和并发症的潜在风险通常是轻度且有限的。软组织损伤可以通过操作者的精心管理并采取适当的预防措施来避免。临床医生应熟悉周围的软组织解剖结构,并意识到可能发生更严重的并发症,并相应地提供管理或转诊给适当的专业。
UNASSIGNED: Soft tissue injuries are known complications of orthodontic treatment. Most of the injuries are mild, but severe complications can arise from deeper penetration or dislodgement of brackets and other foreign bodies into the surrounding tissues of the oropharynx and infratemporal fossa.
UNASSIGNED: The patient, accompanied by his parents, presented to the Children\'s Emergency Department with the concern of gradual limitation of mouth opening and eventual trismus, which occurred over a span of 2 weeks.
UNASSIGNED: The patient presented with trismus and slight discomfort at the left cheek region. He reported a history of gradual limitation to his mouth opening 2 weeks prior. He was wearing upper and lower fixed orthodontic appliances and the left distal end of the maxillary archwire was found to have migrated into the left infratemporal fossa.
UNASSIGNED: Left medial pterygoid muscle inflammation, or bleeding and haematoma formation, or infection within the infratemporal region.
UNASSIGNED: The maxillary archwire was removed in the Children\'s Emergency Department and a computed tomography (CT) scan performed subsequently confirmed the diagnosis of left medial pterygoid muscle inflammation. The patient was started on an intravenous (IV) antibiotic and a 2-day course of IV dexamethasone to reduce the muscle inflammation.
UNASSIGNED: By the second day, the patient was able to achieve a mouth opening of 6 mm, and by the second week, the mouth opening had returned to normal.
UNASSIGNED: The potential risk of soft tissue injury and complications from orthodontic treatment is generally mild and limited. Soft tissue injuries can be avoided with careful management by the operator with the proper precautions taken. Clinicians should be familiar with the surrounding soft tissue anatomy and be aware of the potential for more severe complications and provide management or referral to the appropriate specialty accordingly.