Severe restriction in jaw movement after routine injection of local anesthetic in patients who have fibrodysplasia ossificans progressiva
Severe restriction in jaw movement after routine injection of local anesthetic in patients who have fibrodysplasia ossificans progressiva
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DOI：
10.1016/s1079-2104(96)80141-7
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发表时间：
1996-01-01
期刊：
影响因子：
--
通讯作者：
Kaplan, FS
中科院分区：
文献类型：
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作者：
Luchetti, W;Cohen, RB;Kaplan, FS
Objective.确定进行性骨化性纤维发育不良患者的牙科手术与颌骨即刻骨化和强直的关系。研究设计。对国际进行性骨化性纤维发育不良协会的60名患者成员进行了邮件调查。所有41例患者（18例男性，23例女性）进行了检查。通过威布尔模型计算颌骨骨化的瞬时精确风险率。36名患者接受了牙科手术。21例（58%）患者接受了局部麻醉剂注射。5例（24%）患者发生了进行性骨化性纤维发育不良伴骨化和永久性颌关节强直的即刻发作（预期发生率，0.031; p < 0.0001）。12名接受类似牙科工作但未注射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）。在牙科手术中注射局部麻醉剂会对患有进行性骨化性纤维发育不良的患者造成严重和直接的风险，从而诱发异位骨化和颌骨强直，应尽量避免。
Objective. To determine the relationship of dental procedures to immediate ossification and ankylosis of the jaw in patients who have fibrodysplasia ossificans progressiva.Study design. 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.Results. 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).Conclusion. 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.