Limits of prosthetic rehabilitation of cocaine-induced midline destructive lesions: Time to change the paradigm.

IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Chloé Mense, Vincent Romao, Frédéric Silvestri, Romain Lan
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Abstract

The steady rise in cocaine consumption, particularly in its snorted form, has led to the increased incidence of cocaine-induced midline destructive lesions (CIMDLs), a severe condition resulting from chronic cocaine use that leads to significant tissue destruction in the nasal and palatal regions. Four patients with CIMDLs are presented, all characterized by nasopalatine perforation. Each patient reported a spontaneous onset of tissue loss in the hard palate near the midline, with the affected area ranging from 2.3 to 5.1 cm². All patients had a history of psychiatric conditions, including depressive episodes but without other significant medical conditions, which contributed to an average delay of 9 months before seeking initial medical consultation. Treatment, which included the use of palatal obturators to improve quality of life, remains nonstandardized and, combined with the patients' continued cocaine use and refusal of addiction care, led to poor follow-up and persistent tissue damage. This clinical report underscores the need for a paradigm shift in managing CIMDLs, emphasizing the integration of addiction treatment and psychological support with prosthetic rehabilitation to optimize long-term outcomes and prevent relapse.

可卡因诱发的中线破坏性病变修复的局限性:是改变模式的时候了。
可卡因消费量的持续上升,尤其是吸食形式的可卡因,导致了可卡因诱发的中线破坏性病变(CIMDLs)发病率的上升,这是一种因长期吸食可卡因导致鼻腔和腭部组织严重破坏的严重病症。本报告介绍了四名 CIMDLs 患者,他们均以鼻腭穿孔为特征。每名患者均自发出现硬腭中线附近的组织缺损,受影响面积从 2.3 平方厘米到 5.1 平方厘米不等。所有患者都有精神病史,包括抑郁症发作,但没有其他严重的病症,这导致患者平均推迟了9个月才就诊。治疗方法包括使用腭钝器来提高生活质量,但这种治疗方法仍未标准化,再加上患者持续吸食可卡因并拒绝成瘾治疗,导致随访效果不佳,组织损伤持续存在。这份临床报告强调,有必要转变 CIMDLs 的管理模式,强调将成瘾治疗和心理支持与假体康复相结合,以优化长期疗效并防止复发。
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来源期刊
Journal of Prosthetic Dentistry
Journal of Prosthetic Dentistry 医学-牙科与口腔外科
CiteScore
7.00
自引率
13.00%
发文量
599
审稿时长
69 days
期刊介绍: The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.
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