隐匿性牙髓炎临床误诊原因及预防措施分析OA

Objective To analyze the causes of clinical misdiagnosis of occult pulpitis and methods to correct the misdiagnosis.Methods A retrospective analysis was conducted on the clinical data of 6 patients with misdiagnosed occult pulpitis who were admitted from December 2021 to December 2023.Results This study included 6 patients with diverse clinical manifestations,mainly presenting with head and face pain that was aggravated at night,and radiating pain.Several patients also had hypertension or perimenopausal symptoms.They were misdiagnosed as having cerebrovascular accidents(n=2),neurotic headaches(n=2),and trigeminal neuralgia(n=2).The duration of misdiagnosis was(7.31±2.79)d.After ineffective symptomatic treatment,they were finally diagnosed with pulpitis(including types such as cracked teeth and pulp stone compression)following an oral medicine consultation,in conjunction with pulp vitality tests and X-ray examinations.All 6 patients underwent root canal treatment,2 of them received additional full crown restoration and symptoms resolved in 3 after removal of pulp stones.All patients were followed up for 12 months without recurrence.Conclusion Occult pulpitis is often misdiagnosed as cerebrovascular accidents,neural headaches,trigeminal neuralgia and other diseases due to its atypical symptoms.The causes of misdiagnosis include insufficient understanding of atypical symptoms,over-reliance on imaging examinations and neglect of specialized oral examinations.It is suggested that clinicians should enhance their awareness of the atypical manifestations of pulpitis,and improve the differential diagnosis system,thereby improving the quality of diagnosis and treatment.