拔牙导致上颌窦瘘22例报告

Clinical analysis of 22 cases oroantral fistula by teeth extraction

目的 :探讨拔牙导致上颌窦瘘的原因、治疗方法及预防措施。方法 :收集 1994-2 0 0 2年间我科门诊拔牙导致上颌窦瘘病例 2 2例 ,进行回顾性分析。结果 :2 2例中 ,拔除上颌埋伏尖牙 4例 ,拔除上颌第一磨牙 8例 ,拔除上颌第二磨牙 4例 ,拔除上颌第三磨牙 5例 ,拔除上颌第二前磨牙 1例。术后即时发现者 2 0例 ,立即进行了保守治疗 ,其中 17例处理后瘘口 1周左右愈合 ,3例换药后行瓦合瓣修复。另外 2例于术后发现 ,1例换药后瘘口愈合 ,1例行瓦合瓣修复。保守治疗有效率 90 %。结论 :拔除上颌后牙及埋伏尖牙 ,均可能出现上颌窦瘘 ,正确及时的保守治疗多数可以一期愈合。

Objective:To discuss causes and treatments of oroantral fistula after teeth extraction so as to bring forward prevention methods.Method: 22 cases oroantral fistula happened from 1994 to 2002 after teeth extraction was reviewed by retrospective analysis.Result: Among 22 cases of oroantral fistula after teeth extraction, 4 cases were embedded maxillary tusk, 8 cases were maxillary first molar, 4 cases were maxillary second molar, 5 cases were maxillary third molar and one case was extraction of maxillary second premolar for othodontal reasons. 20 cases of fistula were discovered after teeth extraction and dealt with immediately, among them, 17 cases were cured in a week after conservative treatments and 3 cases cured by surgical flap restoration. 2 cases were discovered after the operation, among them, 1 case was cured after dressing replacement and the other one case was treated surgically. The efficiency rate of conservative treatments was arrived to 90%.Conclusion: Oroantral fistula could happen after extraction of embedded tusk and retromaxillary teeth. Most cases could be cured at first stage by exact conservative treatments in time.