不同填充物填塞致青年下颌智齿拔除术拔牙创关闭不全、干槽症三例误诊分析

Misdiagnosis of Incomplete Healing of the Tooth Extraction Wound and Dry Socket Caused by Different Fillings after Mandibular Wisdom Teeth Extraction in the Young Patients

目的探讨不同填充物填塞致青年下颌智齿拔除术拔牙创关闭不全、干槽症误诊为术后肿痛的原因。方法回顾性分析不同填充物填塞致青年下颌智齿拔除术拔牙创关闭不全、干槽症误诊为术后肿痛的3例病例资料。结果 3例青年下颌智齿拔除术患者术后早期均出现明显自发性疼痛,均误诊为术后肿痛,予常规抗感染治疗无明显好转并出现放射痛。后均经病原学检查明确诊断为干槽症,给予清创术联合敏感抗生素治疗,患者均痊愈。结论下颌智齿拔除术后干槽症的发生,可能与填充材料致拔牙创关闭不全,未能有效阻断微生物感染途径致牙槽骨壁急性感染有关。干槽症早期易误诊为术后肿痛,早期行病原学检查,并结合临床表现,可避免误诊的发生。

Objective To explore the reasons for incomplete healing of the tooth extraction wound and dry socket misdiagnosed as postoperative swelling and pain, which were caused by different fillings after mandibular wisdom teeth extraction in young patients. Methods Clinical data of 3 young patients with incomplete healing of the tooth extraction wound and dry socket that were misdiagnosed as postoperative swelling and pain and caused by different fillings after mandibular wisdom tooth extraction were retrospectively analyzed. Results After mandibular wisdom tooth extraction, three patients had obvious spontaneous pain in the early postoperative period. All of them were misdiagnosed as postoperative swelling and pain. The conventional anti-infective treatment led to no obvious improvement but radiation pain. After the pathogen examination, the diagnosis of dry socket was confirmed. The patients were cured after debridement combined with sensitive antibiotic treatment. Conclusion The occurrence of dry socket following the extraction of mandibular wisdom teeth may be related to the acute infection of the alveolar bone wall due to the incomplete healing of the tooth extraction using different fillings, which was not effective in blocking the microbial infection. Dry socket in the early stage is more likely to be misdiagnosed as postoperative swelling and pain. Therefore, early pathogen examination and clinical manifestations can help avoid misdiagnosis.