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目的 探究隐裂牙所致牙髓炎误诊三叉神经痛的临床特点，并对误诊原因进行分析。方法 对2021年1月至2025年3月收治的3例隐裂牙所致牙髓炎患者的临床资料进行回顾性分析。结果 3例均以阵发性颌面部疼痛就诊，初步诊断为三叉神经痛，予以卡马西平口服治疗无效。后经详细病史采集、口腔检查，结合X线、2.5%碘酊染色确诊为隐裂牙所致牙髓炎。误诊时间为3.5个月～2年。确诊后行根管治疗、全冠修复术后疼痛症状完全消失。随访3～6个月，患牙功能良好，无疼痛复发，修复体稳固。结论 隐裂牙所致牙髓炎早期症状不具有典型性，易误诊为三叉神经痛；疾病特征、临床诊断存在局限性、患者自身因素等均为隐裂牙所致牙髓炎诊疗过程中发生误诊的原因。构建系统性防范策略、规范鉴别诊断流程、开展多学科协作是及时明确诊断、减少或避免误诊误治的关键。
Abstract：Objective To explore clinical features of pulpitis caused by cracked teeth and to analyze the causes of misdiagnosis. Methods A retrospective analysis was performed on clinical data of 3 patients who had pulpitis caused by cracked teeth and were admitted to the hospital from January 2021 to March 2025. Results All of the three patients visited the hospital due to paroxysmal maxillofacial pain and were initially diagnosed with trigeminal neuralgia, without response to treatment with oral Carbamazepine. They were diagnosed with pulpitis caused by cracked teeth after analysis of detailed medical history and oral examination combined with X-ray and staining with 2.5% tincture of iodine. The duration of misdiagnosis ranged from 2 weeks to 3 months. After confirmed diagnosis, pain symptoms completely disappeared after root canal therapy and full crown restoration. During the 3-6 months of follow-up, affected teeth functioned well, with no recurrence of pain but stable restoration. Conclusion Early symptoms of pulpitis caused by cracked teeth are not typical, which is more likely to be misdiagnosed as trigeminal neuralgia. Features of the disease, limitations in clinical diagnosis, and patient factors are reasons for misdiagnosis of pulpitis caused by cracked teeth. Generating a systematic prevention strategy, standardizing the differential diagnosis process, and carrying out interdisciplinary collaboration are key to timely and clear diagnosis, reducing or avoiding misdiagnosis and mistreatment.
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基本信息:
中图分类号:R781.31
引用信息:
[1]梁金,刘彦.隐裂牙所致牙髓炎临床特点及误诊原因分析[J].临床误诊误治,2026,39(02):21-24.
基金信息:
战略支援部队特色医学中心科研课题(19ZX73)
2026-01-27
2026-01-27