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在先进影像技术的引导下进行彻底清创,并频繁监测,是治疗兔牙源性脓肿和颌骨骨髓炎的有效方法:200 例病例回顾(2018-2023 年)。

Radical debridement guided by advanced imaging and frequent monitoring is an effective approach for the treatment of odontogenic abscesses and jaw osteomyelitis in rabbits: a review of 200 cases (2018-2023).

机构信息

Jekl & Hauptman Veterinary Clinic - Focused on Exotic Companion Mammal Care, Brno, Czech Republic.

Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czech Republic.

出版信息

J Am Vet Med Assoc. 2023 Oct 9;261(S2):S52-S61. doi: 10.2460/javma.23.06.0332. Print 2023 Dec 1.

DOI:10.2460/javma.23.06.0332
PMID:37793634
Abstract

OBJECTIVE

To report the prevalence and document the treatment and outcome of odontogenic abscesses and associated jaw osteomyelitis in pet rabbits.

ANIMALS

200 client-owned rabbits.

METHODS

Pet rabbits surgically treated using extraoral teeth extraction with marsupialization for abscesses of dental origin and jaw osteomyelitis were included in the study (February 2018 to February 2023). A case must have had pre- and postoperative computed tomographic study and a follow-up period of at least 4 months.

RESULTS

In total, 113 male and 87 female rabbits were treated surgically. The mean age at the time of the diagnosis at the authors' clinic was 3 years and 11 months. Male rabbits suffered from odontogenic abscesses significantly more often than females. The mean surgical time varied from 25 to 95 minutes, based on the severity of the pathology and location. The wound healed completely in an average of 39.7 days (range, 14 to 145 days; 95% CI, 36.9 to 42.5 days). Major complications detected in 18.5% (37/200) cases were associated with prolonged healing time mostly due to the formation of a bone sequestrum and gingival suture failure. The disease-free time following abscess resolution was on average 29 months (range, 4 to 60 months). The recurrence of the odontogenic infection was 8% (16/200 cases).

CLINICAL RELEVANCE

The radical surgical technique with the extraction of all the infected teeth with the removal of all affected tissue and osteomyelitic bone and regular follow-up wound management is an effective method for the treatment of odontogenic abscesses with jaw osteomyelitis.

摘要

目的

报告宠物兔源性牙源性脓肿和相关颌骨骨髓炎的患病率,并记录其治疗和转归。

动物

200 只患畜兔。

方法

本研究纳入了 2018 年 2 月至 2023 年 2 月期间接受过经口外牙齿拔除术联合袋形术治疗牙源性脓肿和颌骨骨髓炎的患畜兔。病例必须有术前和术后的计算机断层扫描研究,并随访至少 4 个月。

结果

共对 113 只雄性和 87 只雌性患兔进行了手术治疗。在作者诊所诊断时,这些患兔的平均年龄为 3 岁 11 个月。雄性兔患牙源性脓肿的频率明显高于雌性兔。根据病变的严重程度和位置,手术时间平均为 25 至 95 分钟。平均愈合时间为 39.7 天(范围 14 至 145 天;95%可信区间为 36.9 至 42.5 天)。在 18.5%(37/200)的病例中发现了主要并发症,主要与愈合时间延长有关,原因多为骨块形成和牙龈缝线失败。脓肿消退后无疾病时间平均为 29 个月(范围 4 至 60 个月)。牙源性感染的复发率为 8%(16/200 例)。

临床相关性

对于伴有颌骨骨髓炎的牙源性脓肿,采用彻底的外科手术方法,拔除所有感染牙齿,清除所有受影响的组织和骨坏死组织,并进行定期的随访伤口管理,是一种有效的治疗方法。

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