Postextraction infections, prevention, and treatment.

Yubin Cao, Li Ye, Jian Pan
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Abstract

Postoperative infection is one of the most common complications of tooth extraction. It may manifest as localized infection or develop to systemic infection. Clinically, oral surgeons can prevent postoperative infections by urging patients to strengthen oral hygiene, applying antibiotics in a rational and compliant manner, and choosing appropriate surgical methods for tooth extraction. For the treatment of infection, the oral surgeon should formulate a response strategy on the basis of different diagnoses. For local infections such as dry socket, delayed alveolar osteitis, gap infection, and marginal osteomyelitis of the jaws, the infection can be controlled by local debridement, therapeutic use of antibiotics, and incise and drain if necessary. For patients suspected of necrotizing fasciitis, timely extensive debridement should be made to reduce the area of tissue necrosis. For those who have received radiotherapy or anti-resorptive drugs, tooth extraction should follow the recommendations of the relevant clinical guidelines or expert consensus to minimize the risk of osteonecrosis of the jaws. For patients with poor systemic health or dysfunction of the immune system, attention should be paid to identifying infective endocarditis and intracranial infection to ensure the life safety of patients. In this study, the author intends to combine literature review and clinical experience to tackle postextraction infection and its prevention to provide a reference for colleagues on oral and maxillofacial surgery.

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拔牙后感染、预防和治疗。
术后感染是拔牙最常见的并发症之一。它可能表现为局部感染,也可能发展为全身感染。临床上,口腔外科医生可通过督促患者加强口腔卫生、合理合规应用抗生素、选择合适的拔牙手术方式等方法预防术后感染。对于感染的治疗,口腔医生应根据不同的诊断制定应对策略。对于干槽症、迟发性牙槽骨炎、间隙感染、颌骨边缘骨髓炎等局部感染,可通过局部清创、抗生素治疗,必要时切开引流等方法控制感染。对于疑似坏死性筋膜炎的患者,应及时进行大面积清创,以减少组织坏死面积。对于接受过放疗或抗吸收药物治疗的患者,拔牙时应遵循相关临床指南或专家共识的建议,以尽量减少颌骨坏死的风险。对于全身健康状况较差或免疫系统功能紊乱的患者,应注意识别感染性心内膜炎和颅内感染,以确保患者的生命安全。在本研究中,笔者拟结合文献综述和临床经验,探讨拔牙后感染及其预防,为口腔颌面外科同仁提供参考。
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