Park Won-Jong, Park Il Kyung, Shin Kyung Su, Choi Eun Joo
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan, Korea.
Wonkwang Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea.
J Dent Anesth Pain Med. 2019 Aug;19(4):201-208. doi: 10.17245/jdapm.2019.19.4.201. Epub 2019 Aug 30.
After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar.
Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups.
A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C.
Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.
拔牙后,干槽症引起的疼痛以及邻牙疼痛很常见。本研究的目的是回顾性分析下颌第三磨牙手术拔除后邻牙的疼痛情况。
存在因干槽症引起的术后疼痛、邻牙疼痛以及其他原因引起的疼痛。A组仅包括患有干槽症的患者;B组仅包括患有邻牙疼痛的患者;C组包括同时患有两者的患者。记录症状持续时间。此外,将疼痛的预后分为完全改善、改善、维持、恶化和完全恶化组。
分别从A组、B组和C组的13例、60例和10例患者中拔除了312颗下颌第三磨牙。A组和B组症状的平均持续时间为5天,C组为15.2天。A组与C组以及B组与C组之间症状持续时间存在统计学上的显著差异。
第三磨牙拔除后邻牙疼痛可能由炎症反应和对该牙的压力引起。牙周膜和牙槽骨受压引起的疼痛是由破骨细胞释放的细胞因子导致的,破骨细胞负责骨破坏。然而,过大压力导致的牙周膜损伤引起的疼痛可能会被误解为牙髓疼痛。无意识的副功能习惯,如紧咬牙和磨牙症,也可能与拔牙后疼痛有关。