背景:本病例系列的目的是评估一组头颈部癌症患者下颌骨切开术或下颌骨切除术部位附近牙齿的坏死情况。
方法:14例患者行节段下颌骨切除术或旁正中下颌骨切开术,该病例系列包括口咽或主要唾液腺癌和总共23颗牙齿。12例患者接受了头颈部辅助放疗。对下颌骨切除术边缘的牙齿和手术后下颌骨切开术附近的牙齿进行冷敏感性牙髓测试和/或电牙髓测试。“积极”的反应被认为是健康的状态,“阴性”被认为是牙齿的病变状态。
结果:接受下颌骨切开术的10例患者有12颗牙齿呈阴性反应。接受下颌骨切除术治疗的4例患者对冷和电髓测试有2个阳性和3个阴性反应。23颗牙齿中有15颗(65.2%)对敏感性测试呈阴性反应。
结论:牙齿坏死似乎是下颌骨切除术和下颌骨切开术后的常见事件。
结论:为了避免术后并发症,在手术前对手术部位附近的牙齿进行根管治疗可能是一种合适的策略。
The aim of this case series was to evaluate the necrosis of teeth adjacent to the site of mandibulotomy or mandibulectomy in a cohort of patients suffering from head and neck cancers.
Fourteen patients who underwent segmental mandibulectomy or paramedian mandibulotomy for oral, oropharynx or major salivary gland cancer and a total of 23 teeth were included in this case series. Twelve patients underwent adjuvant head and neck radiotherapy. Cold sensitivity pulp testing and/or electric pulp testing were performed on teeth at the margin of mandibulectomy and on teeth adjacent to mandibulotomy after surgery. A \"positive\" response was considered the healthy state, and \"negative\" was considered the diseased state of the tooth.
The 10 patients who underwent mandibulotomy had 12 teeth with a negative response. The 4 patients treated by mandibulectomy had two positive and three negative responses to cold and electric pulp tests. Fifteen out of 23 teeth (65.2%) showed a negative response to sensitivity testing.
Tooth necrosis seems to be a common event after mandibulectomy and mandibulotomy.
To avoid post-surgery complications, performing root canal therapy before surgery on the teeth adjacent to the surgical site could be an appropriate strategy.