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拔除第三磨牙或其他牙齿患者并发症的发生率及治疗情况

Incidence and treatment of complications in patients who had third molars or other teeth extracted.

作者信息

Miclotte I, Agbaje J O, Spaey Y, Legrand P, Politis C

机构信息

Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.

Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.

出版信息

Br J Oral Maxillofac Surg. 2018 Jun;56(5):388-393. doi: 10.1016/j.bjoms.2018.02.001. Epub 2018 Apr 16.

Abstract

The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) - 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (<1%), and oroantral communication (<1%). Patients who had M3 extracted were at increased risk of complications compared with those who had other teeth extracted (Odds ratio (OR) 1.5, p=0.024), particularly for infection (OR 5.9, p<0.001) and hypoaesthesia (OR 8.4, p=0.027). Half of all patients with a complication were treated with antibiotics orally. The incidence of postoperative bleeding was 0.6% as a result of suboptimal management of antithrombotic drugs in extractions of teeth other than M3. Finally, optimal treatment of the complications was compared with the available evidence. Prevention and treatment of these complications could reduce the incidence, particularly of bleeding.

摘要

本研究的目的是比较第三磨牙(M3)或其他牙齿拔除术后并发症的发生率,并描述其处理方法。我们对接受M3或其他牙齿拔除术的患者进行了一项回顾性队列研究,并记录了长达两年随访期内的并发症情况。在2355例手术(6%)后共出现142例并发症——M3拔除术后为7%,而其他牙齿拔除术后为5%(p = 0.024)。三种最常见的并发症为伤口感染(2%)、无明显原因的疼痛(<1%)和口腔上颌窦交通(<1%)。与拔除其他牙齿的患者相比,拔除M3的患者出现并发症的风险更高(优势比(OR)为1.5,p = 0.024),尤其是感染(OR为5.9,p < 0.001)和感觉减退(OR为8.4,p = 0.027)。所有出现并发症的患者中有一半接受了口服抗生素治疗。由于在拔除除M3以外的其他牙齿时对抗血栓药物管理欠佳,术后出血的发生率为0.6%。最后,将并发症的最佳治疗方法与现有证据进行了比较。预防和治疗这些并发症可降低发生率,尤其是出血的发生率。

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