Gamze KÜÇÜKOSMAN, Bengü Gülhan AYDIN, Mehmet BEREKET, Tuğba NALE, Hilal AYOĞLU

Entübasyon sırasında oluşan dental travmaya yaklaşım: olgu sunumu

Genel anestezi sırasında bildirilen diş travması insidansı % 0.06-12.3’dir. Perioperatif dental travmaların çoğu laringoskopi ile entübasyon sırasında ortaya çıkarken, airway, endotrakeal tüp ya da larengeal maske çıkarılması için aşırı kuvvet uygulandığında da görülmektedir. Dental yaralanmalar basit kırıktan restorasyon kaybı veya avulsiyona (dişin soketinden çıkması) kadar değişebilir. Dental yaralanma genellikle üst ön bölgede meydana gelir ve laringoskopun konumu nedeniyle sol orta kesici diş en sık etkilenir. Genel anestezi uygulamalarında karşılaşılabilecek dental travmalara yaklaşımımızı olgu üzerinden aktarmayı amaçladık.

Approach to dental trauma occurring during intubation: case report

The incidence of dental trauma reported during general anesthesia is 0.06-12.3%. The majority of perioperative dental trauma occurs during laryngoscopy and intubation, it may be observed when excessive force is applied to remove the airway, endotracheal tube or laryngeal mask. Dental injury may vary from simple fracture to restoration loss or avulsion (removal of tooth from the socket). Dental injury generally occurs in the upper front region and the left central incisor is most frequently affected due to the position of the laryngoscope. We aim to share an approach to dental trauma that may be encountered during general anesthesia administration in this case report.

Keywords:

Avulsion, Dental Trauma, Intubation,

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1. Gaudio RM, Feltracco P, Barbieri S, Tiano L, Alberti M, Delantone M et al. Traumatic dental injuries during anaesthesia: part I: clinical evaluation. Dent Traumatol. 2010;26:459-65.
2. Gaudio RM, Barbieri S, Feltracco P, Tiano L, Galligioni H, Uberti M et al. Traumatic dental injuries during anaesthesia. Part II: medico-legal evaluation and liability. Dent Traumatol. 2011;27:40-5.
3. Warner M, Benenfeld S, Warner M, Schroeder D, Maxson P. Perianesthetic dental injuries: frequency, outcomes, and risk factors. Anesthesiology. 1999;90:1302-5.
4. Owen H, Waddell-Smith I. Dental trauma associated with anesthesia. Anaesth Intensive Care 2000;28:133-45.
5. Mourão J1, Neto J, Viana JS, Carvalho J, Azevedo L, Tavares J. A prospective non-randomised study to compare oral trauma from laryngoscope versus laryngeal mask insertion. Dent Traumatol. 2011;27:127-30.
6. Chen JJ, Susetio L, Chao CC. Oral complications associated with endotracheal general anesthesia. Anaesth Sinica. 1990;28:163-9.
7. Newland MC, Ellis SJ, Peters KR, Simonson JA, Durham TM, Ullrich FA et al. Dental injury associated with anesthesia: a report of 161,687 anesthetics given over 14 years. J Clin Anesth. 2007;19:339-45.
8. Bucx M, Snijders C, van Geel R, Robers C, van de Giessen H, Erdmann W. Forces acting on the maxillary incisor teeth during laryngoscopy using the Macintosh laryngoscope. Anaesthesia. 1994;49:1064-70.
9. Vogel C. Dental injuries during general anaesthesia and their forensic consequences. Anesthetist. 1979;28:347-9.
10. Yasny JS. Perioperative dental considerations for the anesthesiologist. Anesth Analg. 2009;108:1564-73.
11. Givol N, Gershtansky Y, Halamish-Shani T, Taicher S, Perel A, Segal E. Perianesthetic dental injuries: analysis of incidence reports. J Clin Anesth. 2004;16:173-6.
12. Sowmya B, Raghavendra P.Management of dental trauma to a developing permanent tooth during endotracheal intubation. J Anaesthesiol Clin Pharmacol. 2011;27:266-8.
13. Huang YF, Ting CK, Chang WK, Chan KH, Chen PT. Prevention of dental damage and improvement of difficult intubation using a paraglossal technique with a straight Miller blade. J Chin Med Assoc. 2010;73:553-6.
14. Bizzarri D, Giuffrida J. Improved laryngoscope blade designed for ease of manipulation and reduction of trauma. Anesth Analg. 1958;37:231-2.
15. Chen JJ, Susetio L, Chao CC. Oral complications associated with endotracheal general anesthesia. Anaesth Sinica. 1990;28:163-9.
16. Deppe H, Reeker W, Horch HH, Kochs E. Tooth injury during intubation--diagnostic and therapeutic aspects. Anasthesiol Intensivmed Notfallmed Schmerzther. 1998;33:722-5.
17. Chadwick RG, Lindsay SM. Dental injuries during general anaesthesia: can the dentist help the anaesthetist? Dent Update. 1998;25:76-8.
18. Nakahashi K, Yamamoto K, Tsuzuki M, Tatebayashi S, Morimoto Y, Hirai K et al. Effect of teeth protector on dental injuries during general anesthesia. Masui. 2003;52:26-31.
19. Chidyllo SA, Zukaitis JA. Dental examinations prior to elective surgery under anesthesia. NY State Dent J. 1990;56:69-70.
20. Gatt SP, Aurisch J, Wong K. A standardized, uniform and universal dental chart for documenting state of dentition before anaesthesia. Anaesth Intensive Care. 2001;29:48-50.
21. Rosenberg MB. Anesthesia-induced dental injury. Int Anesthesiol Clin. 1989;27:120-5.
22. Milton TM1, Hearing SD, Ireland AJ. Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management. Br Dent J. 2001;190:592-6.
23. Al-Wahadni A1, Al Hamad KQ, Al-Tarawneh A. Foreign body ingestion and aspiration in dentistry: a review of the literature and reports of three cases. Dent Update. 2006;33:561-2, 564-6, 569-70.
24. Kainuma M, Yamada M, Miyake T. Early application of the cross-suture splint to teeth avulsed at tracheal intubation. Anesthesiology. 1996;84:1516.
25. Windsor J, Lockie J. Anaesthesia and dental trauma. Anaesth İntensive Care 2008;9:355-7.
26. Johnson A, Lockie J. Anaesthesia and dental trauma. Anaesth İntensive Care 2005;6:271-2.