Stručni rad

Dental Discoloration and Erosion Resulting from Addiction to Compound Analgesics

Vedrana Petrovečki ; Zavod za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu, Hravtska
Mirela Čarapina ; Opća bolnica Zabok, Odjel za patologiju i citologiju, Zabok, Hrvatska
Davor Strinović ; Zavod za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu, Hravtska
Zdravko Kovačić ; Zavod za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu, Hravtska
Marina Nestić ; Zavod za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu, Hravtska
Davor Mayer ; Zavod za sudsku medicinu i kriminalistiku Medicinskog fakulteta Sveučilišta u Zagrebu, Hravtska
Hrvoje Brkić ; Katedra za forenzičku stomatologiju, Zavod za dentalnu antropologiju Stomatološkog fakulteta Sveučilišta u Zagrebu, Hrvatska

Sažetak

Dental erosion is currently the most common non-carious change on the tooth resulting from longterm effects of acidic chemical (pH<7) factors on the tooth surface without the intervention of bacteria. These factors can be divided into intrinsic and extrinsic factors (1-3). The intrinsic chemical factors include acidic gastric contents reaching the oral cavity as a result of vomiting, whereas the extrinsic factors are any acidic substances taken into the mouth, primarily some types of foods and beverages and some medicines. The aim of this report was to show potential effects of a compound drug with analgesic properties (active ingredients - paracetamol, propyphenazone, codeine phosphate and caffeine) on changes occurring in the teeth. This paper describes very specific erosions on the labial portions of the teeth and the occurrence of purple-bluish tooth color found at autopsy of a 35-year-old severely malnourished man who died at admission to hospital treatment. Hetero-anamnestic information about a long-term dependence on a compound analgesic was provided. In addition to tooth changes, the autopsy showed erosions of the gastric mucosa, chronic ulcer in the duodenal region, chronic liver inflammation, and bone marrow hypoplasia. The cause of death was bilateral purulent inflammation of the lungs with an extensive gangrenous focus in the left lobe. Chemical toxicology analysis revealed the presence of all pharmacologically active ingredients in urine, bile fluid, liver and kidney tissues, gastric contents and teeth extracts. Long-term dependence on the compound analgesic as a probable mechanism for the development of tooth and other organ changes has been discussed. The paper stresses the importance of the tooth that in our example proves to be an adequate organ for toxicology analysis by gas chromatography, and the importance of interdisciplinary collaboration in solving forensic cases. Additionally, isolation of analgesic from the tooth is suggested to be a helpful diagnostic method in cases of suspected abuse of medicinal drugs.

Ključne riječi

Tooth Erosion; Vomiting; Analgestics, Forensic Toxicology; Forensic Dentistry

Hrčak ID:

76025

URI

https://hrcak.srce.hr/76025

Datum izdavanja:

20.12.2011.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.618 *