Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/5880192e7f8c9d0a098b500d
Revista de Odontologia da UNESP
Original Article

In flight barodontalgia and the differential diagnosis of odontogenic pain: a case report

A barodontalgia em voo e o diagnóstico diferencial de dor odontogênica: relato de caso

Marceliano-Alves, Marilia Fagury Videira; Miranda, Rosana Belchior; Macedo, Renata Perez Vianna Silva; Marceliano, Eduardo Fagury Videira; Fidel, Sandra Rivera; Fidel, Rivail Antônio Sérgio

Downloads: 3
Views: 1124

Abstract

The barodontalgia is an acute condition due to the air pressure difference that affects the health and the well being of pilots during flight. Military pilots are more susceptible to pressure differences due to quick maneuvering, the extreme situations in flight, or due the lack of pressure into aircraft cabin. Such occurrence can lead to dizziness and premature end of the flight. Its origin may be in the tooth, related to some pre-existing condition or not, and also in other structures of the face, especially in the maxillary sinus. Of the cases reported, 70% came from pulpitis related to deep restorations, and most cases (81%) appeared in the aircraft taking off. Aim: To report a clinical case of a T-29 Brazilian Air Force pilot, who came to Santos-Dumont Air Force Dental Clinic, immediately after landing. The patient interview pointed out barodontalgia as a cause of his acute toothache. After the diagnosis of necrotic pulp, the tooth was endodontically treated in single session by using the Protaper Universal rotary system, and filling with Hybrid Tagger thermoplasticized technique. In the query of reevaluation, the patient reported no further episodes of dental pain in flight. Conclusion: It is evident the relevance of knowledge of this condition by military and civilian dentists, to conduct proper diagnosis and treatment of airmen.

Keywords

Occupational dentistry, atmospheric pressure, aviation, toothache.

Resumo

A barodontalgia é uma condição aguda que ocorre pela diferença de pressão atmosférica e que afeta a saúde e o bem-estar dos pilotos durante o voo. Os pilotos militares estão mais suscetíveis às diferenças de pressão em razão das manobras rápidas e situações extremas que enfrentam ou por não haver cabine pressurizada na aeronave. Tal ocorrência pode levar a vertigem, incapacitação do profissional e finalização prematura do voo. Sua origem pode estar no dente, relacionada a alguma patologia pré-existente ou não, e ainda em outras estruturas da face, principalmente no seio maxilar. Dos casos relatados na literatura, 70% decorreram de pulpite relacionada a restaurações profundas e a maior parte (81%) ocorreu na decolagem da aeronave. Objetivo: Apresentar um caso clínico de um piloto de T-29 da Força Aérea Brasileira, atendido na Odontoclínica de Aeronáutica Santos-Dumont, imediatamente após o pouso. Relato de caso: A anamnese apontou a diferença de pressão como fator desencadeador da dor dentária aguda. Após o diagnóstico de necrose pulpar, o dente foi submetido ao tratamento endodôntico em sessão única, pelo uso de sistema rotatório Protaper Universal® e obturação com técnica termoplastificada Híbrida de Tagger. Na consulta de reavaliação, o paciente não relatou qualquer outro episódio de dor dentária em voo. Conclusão: Torna-se evidente a relevância do conhecimento desta condição por cirurgiões-dentistas civis e militares, para a correta condução do diagnóstico e do tratamento de aeronavegantes.

Palavras-chave

Odontologia do trabalho, pressão atmosférica, aviação, odontalgia.

References



1. Clark JB. Risk assessment and clinical aeromedical decision-making. Aviat Space Environ Med. 1993;64:741-7. PMid:8368988.

2. Zadik Y. Barodontalgia: what have we learned in the past decade? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:65-9. PMid:20303049. http://dx.doi.org/10.1016/j.tripleo.2009.12.001

3. Marceliano-Alves MFV, Medeiros UV, Fidel SR, Fidel RAS. Barodontalgia em voo e diagnóstico diferencial de dor odontogênica. FULL Dentistry in Science. 2011; 2: 449-54.

4. Kennebeck R, Knudtzon KF, Goldhush AA, et al. Symposium on problems of aviation dentistry. J Am Dent Assoc. 1946; 33:827-44. PMid:20989532.

5. Kollmann W. Incidence and possible causes of dental pain during simulated high altitude flights. J Endod. 1993; 19:154 -9. http://dx.doi. org/10.1016/S0099-2399(06)80512-1

6. Zadik Y, Chapnick L, Goldstein L. In-flight barodontalgia: analysis of 29 cases in military aircrew. Aviat Space Environ Med. 2007;78:593‑6. PMid:17571660.

7. Gonzalez-Santiago MM, Martinez-Sahuquillo Marquez A, Bullon-Fernandez P. Incidence of barodontalgias and their relation to oral/ dental condition in personnel with responsibility in military flight. Med Oral. 2004;9:98-105. PMid:14990875.

8. Hutchins HC, Reynolds OE. Experimental investigation of the referred pain of aerodontalgia. J Dent Res. 1947; 26:3- 8. PMid:20287949. http://dx.doi.org/10.1177/00220345470260010401

9. Donovan TE, Becker W, Brodine AH, Burgess JO, Cagna DR, Summitt JB. Annual review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent. 2008;100:110-41. http://dx.doi. org/10.1016/S0022-3913(08)60159-6

10. Harvey W. Dental pain while flying or during decompression tests. Br Dent J. 1947;82:113-8. PMid:20294242.

11. Shiller WR. Aerodontalgia under hyperbaric conditions. Oral Surg Oral Med Oral Pathol. 1965;20:694-7. http://dx.doi.org/10.1016/0030- 4220(65)90118-0

12. Rauch JW. Barodontalgia - dental pain related to ambient pressure change. Gen Dent. 1985;33:313-5. PMid:2863194.

13. Rayman RB. Aircrew health care maintenance. In: DeHart RL, editor. Fundamentals of aerospace medicine. Philadelphia: Lea and Febiger; 1985. p. 407.

14. Ellingham HK. Dentistry in the military. Br Dent J. 2003;194:5 PMid:12540929.

15. Ferjentsik E, Aker F. Barodontalgia: a system of classification. Mil Med. 1982;147:299-304. PMid:6815558.

16. Robichaud R, McNally ME. Barodontalgia as a differential diagnosis: symptoms and findings. J Can Dent Assoc. 2005;71:39-42. PMid:15649340.

17. Mjör IA, Ferrari M. Pulp-dentin biology in restorative dentistry. Part 6: reactions to restorative materials, tooth-restoration interfaces, and adhesive techniques. Quintessence Int. 2002; 33:35-63. PMid:11887534.

18. Verunac JJ. Recurrent severe facial emphysema in a submariner. J Am Dent Assoc. 1973;87:1192-4. PMid:4521578.

19. Seltzer S, Bender IB. Pulpitis from operative procedures. In: Seltzer S, Bender IB. The dental pulp. 3rd ed. Philadelphia: J.B. Lippincott; 1984. p. 252-73.

20. Murray PE, Windsor LJ, Smyth TW, Hafez AA, Cox CF. Analysis of pulpal reactions to restorative procedures, materials, pulp capping and future therapies. Crit Rev Oral Biol Med. 2002;13:509-20. http://dx.doi.org/10.1177/154411130201300607

21. Levy BM. Aviation dentistry. Am J Orthodont Oral Surg. 1943; 29:92-5. http://dx.doi.org/10.1016/S0096-6347(43)90064-X

22. Zadik Y. Aviation dentistry: current concepts and practice. Br Dent J. 2009;206:11-6. PMid:19132029. http://dx.doi.org/10.1038/ sj.bdj.2008.1121

23. Martins CS, Mello J, Martins CC, António M, Ginjeira A. Comparação da obturação endodôntica pelas técnicas de condensação lateral, híbrida de Tagger e Thermafil: estudo piloto com Micro-tomografia computorizada. Rev Port Estomatol Med Dent Cir Maxilofac. 2011; 52:59-69.

24. Rossi DG. Health Policy Directive no. 411: Aviation and diving-dental considerations. Surgeon General, Australian Defence Force; 1995.
5880192e7f8c9d0a098b500d rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections