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Piggy kaže:
Ti i tvoja stomatologija! Imate svaki medicinski predmet po nešto sitno. Nemoj sada pomislit da podcjenjujem tvoju branšu, ali brate mili ti se puno preseraješ! Osim toga, studenti su najinovativnija populacija za savjete, stoga molim lijepo ne želim još jednu provokaciju sličnu tvojem kolegi koji govori potpuno isto kao i ti.
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Ja bih samo molio da ne pljuje po stomatolozima. Za ilustraciju vam proslijeđujem e-mail jednog kolege ("općeg stomatologa") koji je spasio pacijenticu od nepotrebnih i rizičnih operacija sinusa (zbog kroničnih sinuitisa kojima spec. otorinolaringolozi nisu znali pronaći uzrok). Toliko o raznoraznim specijalizacijama iz medicine. I da budem jasan, imam barem jedan ovakav slučaj mjesečno u svojoj praksi - dakle, dolaze pacijenti s kroničnim sinuitisom, kroničnim glavoboljama, prošli sve moguće pretrage itd. i nitko im nije znao reći što je uzrok. Uzrok je "banalna" infekcija zubne pulpe, a drugovi medicinari od šume ne vide drvo, čak i niti ne pomišljaju na njega. Stvar nije ni najmanje bezazlena jer se takva infekcija u imunološki oslabljenom i iscrpljenom organizmu vrlo lako proširi u lubanjsku jamu "per continuitatem".
Evo maila:
Begin forwarded message:
From: "Rod Tataryn" <
[email protected]>
Date: October 29, 2006 12:29:03 AM EDT
To: "ROOTS" <
[email protected]>
Subject: [roots] 12 month MSDO Recall (iCat)
Reply-To: "ROOTS" <
[email protected]>
This 56 year old female patient presented last year with primary symptoms of a chronic, long-standing (two years) left maxillary sinusitis and vague dental pain in her ULQ. �She had been on multiple rounds of antibiotic regimens and was considering functional endoscopic sinus surgery at the recommendation of her ENT.
Percussion of both #13 and #15 were positive which were difficult to interpret being joined by the bridge and in such close proximity to the sinus. Also, multiple radiographs were difficult to read due to the zygoma and low palatal vault. Furthermore, I was not comfortable relying on the negative cold response in #15 through the ceramic restoration, as her other crowned teeth were also barely responsive to cold stimuli with endo ice.
I sent this patient for an iCat (digital CT scan) requesting specific cuts of tooth #15. The image shows significant mucosal edema in the floor of her left maxillary sinus and faint evidence of a periapical radiolucency on the palatal root of #15 which was difficult to recognize on her PA radiograph. I suspected MSDO (maxillary sinusitis of dental origin).
Root canal therapy was recommended for tooth #15 and the access cavity was performed without anesthesia as a test. There was minimal response to drilling and a necrotic pulp was found upon access. Root canal therapy was completed.
The patients sinusitis symptoms resolved within just a few days after endodontic treatment and have not returned. I recently sent her back for a one-year follow up iCat image to compare to her original.
The floor of the sinus shows healthy mucosal tissue with no evidence of edema. She has remained symptom free since her root canal therapy. No further adjunctive sinus treatment has been performed.
Rod