“ Sodium Hypochlorite Accident ”
ﻣﻦ ﺍﻟﺤﻮﺍﺩﺙ ﺍﻟﺘﻲ ﺗﺤﺪﺙ ﺩﺍﺧﻞ ﻋﻴﺎﺩﺓ ﺍﻷﺳﻨﺎﻥ
ﺣﺪﻭﺙ ﻭﺭﻡ ﺩﻣﻮﻱ ﻭﻛﺪﻣﺔ ﻋﻠﻰ ﺍﻟﻮﺟﻪ ﺃﺛﻨﺎﺀ ﺳﺤﺐ ﺍﻟﻌﺼﺐ
ﻟﻸﺳﻨﺎﻥ ﺧﻼﻝ ﻋﻤﻠﻴﺔ
( Root Canal Treatment )
ﺑﺴﺒﺐ ﺗﺴﺮﺏ ﻣﺤﻠﻮﻝ ﺍﻟﺼﻮﺩﻳﻮﻡ ﻫﺎﻳﺒﻮﻛﻠﻮﺭﺍﻳﺖ NaOCl ﺍﻟﻰ
ﻣﺎ ﻭﺭﺍﺀ ﺍﻟﺠﺬﻭﺭ Root Apex
ﺃﺛﻨﺎﺀ ﻋﻤﻠﻴﺔ ﻏﺴﻞ ﺍﻟﻘﻨﻮﺍﺕ
Irrigation Of Canals
ﺣﻴﺚ ﻳﻌﺘﺒﺮ ﻣﻦ ﺃﻛﺜﺮ ﺍﻟﻤﺤﺎﻟﻴﻞ ﻓﻌﺎﻟﻴﺔ ﻓﻲ ﺍﺯﺍﻟﺔ ﺍﻟﻘﻴﺢ ﻭﺑﻌﺾ
ﺃﻧﻮﺍﻉ ﺍﻟﺒﻜﺘﻴﺮﻳﺎ ﻣﻦ ﺧﻼﻝ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻌﻘﻴﻢ
Anti Inflammatory Actions
ﻭﺍﻟﺴﺒﺐ ﺍﻟﺮﺋﻴﺴﻲ ﻟﺨﺮﻭﺝ ﺍﻟﻤﺤﻠﻮﻝ ﻣﻦ ﻗﻤﻢ ﺍﻟﺠﺬﻭﺭ ﻫﻮ
ﺇﺳﺘﺨﺪﺍﻡ
ﺇﺑﺮﺓ ﻛﺒﻴﺮﺓ ﺧﺼﻮﺻﺂ ( 3ml )
ﻣﻘﺎﺭﻧﺔ ﻣﻊ ﺣﺠﻢ ﺗﻮﺳﻴﻊ ﺍﻟﻌﺼﺐ !!
ﻭﺩﻓﻊ ﺍﻟﻤﺤﻠﻮﻝ ﺑﻘﻮﺓ ﺩﺍﺧﻞ ﺍﻟﺴﻦ
( Force The Irrigant In The Canal )
ﻣﻤﺎ ﻳﺆﺩﻱ ﺍﻟﻰ ﺣﺪﻭﺙ ﺑﻠﻮﻙ ﻟﻺﺑﺮﺓ ﺩﺍﺧﻞ ﺍﻟﺴﻦ ﻭﻋﺪﻡ ﻭﺟﻮﺩ
ﻃﺮﻳﻖ ﻟﺨﺮﻭﺝ ﺍﻟﺼﻮﺩﻳﻮﻡ ﺍﻟﻬﻴﺒﻮﻛﻠﻮﺭﺍﻳﺖ ﺇﻻ ﻟﻤﻨﻄﻘﺔ
ﺍﻝ Apical Foramen
ﺑﺎﻟﺘﺎﻟﻲ ﺍﻟﻰ ﺧﺎﺭﺝ ﺟﺬﺭ ﺍﻟﺴﻦ !!
ﻣﻤﺎ ﻳﺆﺩﻱ ﺍﻟﻰ ﺣﺪﻭﺙ ﻭﺭﻡ ﺩﻣﻮﻱ ﻭﻛﺪﻣﺔ ﻋﻠﻰ ﺍﻟﻮﺟﻪ
( Edema+Ecchymosis ) ..
ﺑﺎﻹﺿﺎﻓﺔ ﻟﺤﺪﻭﺙ ﺗﻨﻤﻞ (paresthesia ) ﻭﺗﺸﻨﺞ !
ﻓﻲ ﻫﺬﻩ ﺍﻟﺤﺎﻟﻪ ﻳﺠﺐ ﻋﻠﻰ ﺍﻟﻄﺒﻴﺐ ﺍﻥ ﻳﻘﻮﻡ ﺍﻟﻄﺒﻴﺐ ﺑﻤﺎ
ﻳﻠﻲ -:
1 ) ﻣﺮﺍﻋﺎﺓ ﺍﻟﻌﺎﻣﻞ ﺍﻟﻨﻔﺴﻲ ﻟﻠﻤﺮﻳﺾ ﻭﻃﻤﺄﻧﺘﻪ ﺑﺄﻥ ﻫﺬﺍ ﺍﻟﺤﺎﺩﺙ
ﺑﺴﻴﻂ ﻭﻣﻦ ﺍﻟﻤﺘﻮﻗﻊ ﺣﺪﻭﺛﺔ ﺩﺍﺧﻞ ﺃﻱ ﻋﻴﺎﺩﺓ ﺃﺳﻨﺎﻥ .
2 ) ﺍﻟﺸﺮﺡ ﻟﻠﻤﺮﻳﺾ ﻋﻦ ﺃﺳﺒﺎﺏ ﺣﺪﻭﺙ ﺍﻟﻜﺪﻣﺔ ﻭﺍﻟﻮﺭﻡ ﺍﻟﺪﻣﻮﻱ
ﻭﺃﻧﻪ ﺃﻣﺮ ﻣﺆﻗﺖ ﻭﺳﺘﺰﻭﻝ ﻛﻞ ﺍﺛﺎﺭ ﺍﻟﻮﺭﻡ ﻭﺍﻟﻜﺪﻣﺔ ﺧﻼﻝ
ﺍﺳﺒﻮﻉ ﻝ ١٠ ﺍﻳﺎﻡ
ﺍﻣﺎ ﺍﻟﺘﻨﻤﻞ ﻭﺍﻟﺘﺸﻨﺞ ﻗﺪ ﻳﺴﺘﻤﺮ ﻟﻔﺘﺮﻩ ﺃﻃﻮﻝ .
3 ) ﻭﺿﻊ ﻛﻤﺎﺩﺍﺕ ﺛﻠﺞ ﻋﻠﻰ ﻣﻨﻄﻘﺔ ﺍﻟﻮﺭﻡ
( Application Of IcePacks )
4 ) ﺇﻋﻄﺎﺀ ﺍﻟﻤﺮﻳﺾ ﻣﻀﺎﺩﺍﺕ ﺣﻴﻮﻳﺔ "Antibiotics" +
ﻣﺴﻜﻦ ﻟﻸﻟﻢ "analgesics" ﺑﺎﻹﺿﺎﻓﺔ ﺍﻟﻰ
Antihistaminic's ..
< ﺃﻣﺎ ﺍﺫﺍ ﻛﺎﻥ ﺍﻷﻟﻢ ﻗﻮﻱ ﻳﺠﺐ ﺻﺮﻑ
Opoid Analgesics ﻟﻠﻤﺮﻳﺾ ﻣﺜﻞ " ﺍﻟﻤﻮﺭﻓﻴﻦ"
5 ) ﺗﺮﻙ ﻗﻨﺎﺓ ﺍﻟﺴﻦ ﻣﻔﺘﻮﺣﺔ ﻓﻲ ﺣﺎﻟﺔ ﺃﻥ ﻭﺭﻡ ﺍﻟﻮﺟﻪ ﻛﺒﻴﺮ ﻣﻊ
ﻋﻤﻞ Irrigation With Warm saline ﻛﻞ ﻳﻮﻡ ﻟﻐﺎﻳﺔ ﺍﻥ
ﻳﺨﻒ ﺍﻟﻮﺭﻡ .
6 ) ﺑﻌﺪ ﺧﺮﻭﺝ ﺍﻟﻤﺮﻳﺾ ﻣﻦ ﺍﻟﻌﻴﺎﺩﺓ ﻳﺠﺐ ﻋﻠﻴﻪ ﺃﻥ ﻳﻘﻮﻡ
ﺑﻮﺿﻊ ﻛﻤﺎﺩﺍﺕ ﺩﺍﻓﺌﺔ
( Warm Compresses )ﺑﻌﺪ 24 ﺳﺎﻋﺔ ﻣﻦ ﺍﻟﺤﺎﺩﺙ ..
ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻄﺒﻴﺐ ﻟﺘﺠﻨﺐ ﺍﻟﻮﻗﻮﻉ ﺑﻬﺬﻩ ﺍﻟﺤﻮﺍﺩﺙ ﻳﺠﺐ
ﻋﻠﻴﻪ -:
1 ) ﻟﻌﻤﻞ irrigation ﻳﺤﺐ ﺍﺳﺘﺨﺪﺍﻡ ﺍﺑﺮﺓ ﺻﻐﻴﺮﻩ ﻣﻨﺎﺳﺒﻪ
ﻟﺤﺠﻢ ﺗﻮﺳﻴﻊ ﺍﻟﻌﺼﺐ ﻭﺍﻷﻓﻀﻞ ﺃﻥ ﺗﻜﻮﻥ ﻣﻐﻠﻘﻠﺔ ﺍﻟﻨﻬﺎﻳﺔ
" With Closed End "
ﻭﻣﻔﺘﻮﺣﺔ ﻣﻦ ﺍﻟﺠﺎﻧﺐ " lateral vents .."
2 ) ﺃﻥ ﺗﻜﻮﻥ ﺍﻹﺑﺮﺓ ﺃﻗﺼﺮ ﻣﻦ ﺍﻝApex ﺗﻘﺮﻳﺒﺂ 2ml .
3 ) ﻋﺪﻡ ﺩﻓﻊ ﺍﻟﻤﺤﻠﻮﻝ ﻣﻦ ﺍﻻﺑﺮﺓ ﺑﻘﻮﺓ ﺑﺈﺗﺠﺎﻩ ﺍﻟﺠﺬﺭ
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