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我们收集4例三氧化二砷牙髓失活剂所致的龈坏死.例1,男,56岁.因14颊颈楔形缺损致牙髓炎作牙髓失活.砷剂距龈缘仅2mm,丁氧膏暂封.第3日复诊见14颊缘龈2.5mm宽灰白坏死区.例2,男,25岁.因46远中颌面深龋致牙髓炎作牙髓失活.封砷剂约米粒量,丁氧膏暂封.第3日复诊见46远颊缘龈灰白坏死区约2mm宽.例3,女,46岁.因37近中合面深龋致牙髓炎作牙髓失活,牙胶封砷剂.第3日见37近颊缘龈约1.5mm宽灰白坏死区.例4,男,42岁.因35颊颈楔形缺损致牙髓炎作牙髓失活,丁氧膏封砷剂.第3日夏诊见丁氧膏已脱落,35颊缘龈灰白坏处区约4×2mm大小.三氧化二砷有剧毒.发生砷性龈坏死是由于:失活剂量过大;失活剂距龈缘近, 封洞不严密;或暂封体脱落.预防砷性龈坏死应强调:严格控制砷剂量;忌用牙胶封砷剂;丁氧膏稠度应调拌适中;邻面洞应先作假壁.砷剂失活牙暂勿咀嚼,勿刷此牙,可用0.2%洗必太液在口腔中转漱.
We collected 4 cases of gingival necrosis caused by arsenic trioxide-in-pulp dental inactivation agent.Example 1, male, aged 56. The dental pulp was inoperable due to 14 pulpogenic deformities caused by wedge-shaped defects in the buccal neck.The arsenic dose was only 2 mm from the gingival margin, Ointment temporarily closed on the 3rd visit see the 14 cheek margin gingival margin of 2.5mm wide gray necrotic area .Example 2, male, 25 years of age due to distal maxillofacial caries caused by pulpitis for dental pulp inactivation. The amount of rice grains, butane oxide temporarily closed .Refer to see the 3rd day 46 far cheek edge gingival gray necrosis area about 2mm wide. Example 3, female, 46 years old. Live, tooth gel arsenic.On the third day 37 near the gingival margin of approximately 1.5mm wide gray necrotic area.Example 4, male, 42 years old.As a result of 35 neck and neck lesions caused by dental pulp demyelination, Oxygen paste seal arsenic .Day 3 Ding Xiaoxu cream has been off, 35 cheek edge gingival gray damage area about 4 × 2mm size. Arsenic trioxide is highly toxic. Aging gingival necrosis is due to: inactivation dose is too large; Inactivation agent from the gingival margin, the closure is not tight; or temporary closure body shedding. Prevention of aging gingival necrosis should be emphasized: strict control of arsenic dose; Avoid using tooth gel arsenic; butyrite consistency should be mixed with moderate; Surface hole should be false wall. Arsenic inactivation of the teeth temporarily do not chew, do not brush this tooth, available 0.2% chlorhexidine Transit in the mouth rinse.