术后早期种植体感染的特点及对策

Successful Management of Postsurgical Peri-implant Infection During Initial Bone Healing Period

背景:种植体术后感染的发生率虽然很低,但是一旦发生,就很可能导致种植失败,应该引起足够的重视。目的:探讨种植体术后感染的的临床表现、特点和治疗方法。临床病例及研究方法:本文通过对5例种植体术后感染的病例进行回顾性研究,着重分析了致病风险因素、临床表现特点以及治疗措施。结果:所有五例病例都发生在种植体植入手术后的早期几周内,临床表现为局部肿胀可伴有局部疼痛或者发射状头痛,种植体无松动,X线片无明显异常,治疗手段包括全身广谱抗生素抗感染治疗以及脓肿形成时的局部切开引流,双氧水、生理盐水冲洗等。经过及时有效的治疗,所有感染病例治愈并成功进行修复。结论:种植体术后感染多发生于术后2-3周,只要医患双方对这种风险足够了解和重视,并对相应感染症状采取及时有效的处理,完全可以治愈而不影响最终的修复效果。对于确诊的种植体术后感染病例,建议及时足量的全身应用抗生素并在脓肿形成时切开引流。

Background:Postoperative peri-implant infection,even though reported incidence rates are low,may result in possible implant failure due to delayed healing or resultant wound dehiscence,and therefore should not be neglected.Objective:To identify the presenting clinical symptoms or characteristics and suggest treatment methods for management of postoperative peri-implant infection.Materials and Methods:Five cases of postoperative peri-implant infection are presented and discussed,with special focus on risk factors,clinical characteristics and management modalities.Results:All five reported infections occurred in the early weeks after surgical placement of dental implants.For confirmed postoperative peri-implant infection cases,administration of a broad-spectrum systematic antibiotic is suggested and when fluctuance or purulent discharge is noted,antibiotic administration combined with local incision and drainage for these cases is recommended.All five cases of early infection resolved and all implants were found to have successfully integrated and loaded as a result of timely and effective management.Conclusions:Patients should be well informed and warned of the possible risk of postoperative infection,and the surgeon should observe the patient closely to detect the infection in early stages of healing.For those infectious cases,systematic antibiotics should be administered,and in severe infections via intravenous route along with incision and drainage of the infected area when purulent discharge is noted.