Kaposvári István, Körmöczi Kinga, Csurgay Kata, Horváth Ferenc, Ashourioun Amir Hossein, Buglyó Alida, Turai Adrienn Réka, Joób-Fancsaly Árpád
Department of Oro-Maxillofacial Surgery and Stomatology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Department of Oro-Maxillofacial Surgery and Stomatology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Dec;132(6):641-647. doi: 10.1016/j.oooo.2021.04.052. Epub 2021 Apr 30.
Delayed-onset infection is defined as infectious swelling and trismus accompanied by pain or the presence of suppuration starting approximately 30 days after surgery. This study aimed to describe the occurrence and potential predisposing factors of delayed-onset infection.
A retrospective case-control study of 223 lower third molar surgeries was performed. Participants were selected from among 1102 outpatients who underwent surgery between January 2013 and June 2018 at Semmelweis University. The inclusion criterion for the case group was inflammation of the operated area after suture removal. Patients in the control group were healthy nonsmokers <26 years old who healed without complication. Statistical analysis was performed using the Shapiro-Wilk test, the Mann-Whitney U test, and Fisher's exact test.
Complications occurred only in patients <26 years old approximately 29.5 days after surgery. A significantly higher risk was observed for younger age, total soft tissue coverage, deeper impaction, lower Nolla stage (P < .001), mesioangular direction (P = .002), and full bone coverage (P < .05). Distal space was inversely correlated with complications (P < .001).
Lower Nolla stage, total soft tissue coverage, lack of distal space, deeper impaction, or mesioangular tilt may promote delayed-onset infection. Follow-up of at-risk patients and the maintenance of oral hygiene are recommended.
迟发性感染定义为术后约30天出现的伴有疼痛的感染性肿胀和牙关紧闭或有化脓现象。本研究旨在描述迟发性感染的发生率及潜在的诱发因素。
对223例下颌第三磨牙手术进行回顾性病例对照研究。研究对象选自2013年1月至2018年6月在塞梅尔维斯大学接受手术的1102名门诊患者。病例组的纳入标准为拆线后手术区域出现炎症。对照组为年龄小于26岁、愈合无并发症的健康非吸烟者。采用夏皮罗-威尔克检验、曼-惠特尼U检验和费舍尔精确检验进行统计分析。
并发症仅发生在年龄小于26岁的患者中，术后约29.5天出现。年龄较小、软组织完全覆盖、阻生较深、诺拉分期较低（P <.001）、近中倾斜方向（P =.002）和完全骨覆盖（P <.05）的患者发生并发症的风险显著更高。远中间隙与并发症呈负相关（P <.001）。
诺拉分期较低、软组织完全覆盖、远中间隙不足、阻生较深或近中倾斜可能会促进迟发性感染。建议对高危患者进行随访并保持口腔卫生。
