下颌阻生第三磨牙拔除术后感染原因分析及处理

Analysis and Treatment of Infection after Extraction of Mandibular Impacted Third Molar

目的:寻找下颌阻生第三磨牙拔除术后感染的预防措施,总结术后感染的处理方法。方法:对40例下颌阻生第三磨牙拔除术后感染患者临床资料进行分析。结果:术后伤口部位感染18例,前颊部感染9例,咽峡前间隙感染5例,干槽症8例。拔牙窝内残留牙根2例及牙冠1例,残留碎骨片3例,异常肉芽组织7例,龈瓣松弛9例,邻牙未处理2例,舌侧骨壁膨出及骨折4例,拔牙窝空虚8例,原因不明者4例。所有患者经对症处理后,感染症状逐渐消退。结论:(1)下颌阻生第三磨牙拔除适应证选择得当、术前准备较完善,拔牙方式合理、拔牙创处理及时,术后感染机会将大幅度下降;(2)及时有效处理术后感染可很快减轻患者痛苦。

Objective： To find out the precautions for postoperative infection of mandibular third molar extraction, and summarize the treatments of postoperative infection.Methods： Analyzed the clinical data of 40 postoperative infection patients with extraction of mandibular impacted third molar. Results： There were 18 cases of surgical site infection （SSI）, 9 cases of pre-buccal site infection, 5 cases of anterior isthmus faucium space infection,and8 cases of alveolar osteitis （AO）. There were 2 cases of residual roots and1 case of crown in the extraction socket, 3 cases of residual bone fragments, 7 cases of abnormal granulation tissue, 9 cases of gingival flap relaxation,2 cases of untreated adjacent teeth, 4 cases of lingual side bone wall bulging and fractures. There were8 cases of emptiness in tooth extraction socket, and 4 cases were unexplained. After symptomatic treatment in all patients, the symptoms of infection gradually subsided. Conclusion： （1）Appropriate choice of extraction of impacted mandibular third molars, better preoperative preparation, reasonable extraction methods and timely treatment of tooth extraction socket can greatly reduce postoperative infection; （2）Timely and effective treatment of postoperative infections can quickly reduce the suffering of patients.