sexta-feira, 5 de março de 2010

Abscesso Periapical Agudo

Olhando a radiografia periapical a seguir o que você imagina?





Um dente assintomático necesitando de um tratamento endodôntico? Um paciente com uma leve queixa de dor a percussão? Ou um paciente apresentando queixa de dor à palpação em região apical?









Pelo menos nesse caso, nenhuma das apostas citadas anteriormente apresenta-se correta. Esta radiografia retrata um caso de abscesso periapical agudo em fase evoluída, com o paciente apresentando fortes dores, edema e envolvimento sistêmico.






Esse caso alerta o quanto é incorreto a realização de diagnóstico apenas com radiografia periapical.





Realizamos a drenagem do abscesso e medicação com antibióticos, o paciente retornou com 24 e 48 horas para reavaliação. Em 21 dias realizamos a conclusão do caso.



Caso realizado por Tatyana Ximenes.

18 comentários:

  1. Belo caso, típico caso que nos depararemos em nosso di-dia no velho, didático e bom PSF...quanto aos caso dos diagnósticos por Rx vale ressaltar que sempre o clínico é soberano na fechamento de uma hipótese diagnóstica...sabemos que as tomadas radiográficas nos guiam entre os diag diferenciais para daí junto ao clínico instituirmos o tto adequado para cada pact!
    Quanto as fotos de controle de caso...sugiro que as fotos sejam sempre feitas com o pact em posição de tronco ereto, em pé ou sentado, com olhar fixo para para o horizonte, com um fundo padrão. Sugiro tb as fotos em norma frontal (tipo AP), em norma caudo-cranial (tipo Waters), tm norma lateral dos 2 lados (tipo laterais de face ou OPN), norma crânio-caudal (tipo Hirtz) e todas as intra-orais para todos os pcts...Creio que a rotina faz a capacidade de reprodução de protocolos essenciais para um tto mais rápido e eficaz para nossos pacts!!
    Sugiro que os prox casos sejam tb colocados que tipo de drenagem e a técnica utilizada com fotos dos passos se possível, visto que seria uma forma de chamar mais gente de mais áreas para as discussões do fórum deste blog!!
    grande abraço e vamos fazer ciência

    PARABÉNS PELO CASO!

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  2. Um clássico caso em que a multidisciplinaridade se faz necessária...

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  3. A intenção do caso era apenas mostrar como o exame radiográfico pode pregar surpresas!!!

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  4. Como vimos, o tratamento endodôntico por si só foi suficiente.

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