第三下磨牙位置解剖与牙窝牙槽炎发生的关系

M. I. Suchilina, I. Alyoshkin, I. Seminskiy
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引用次数: 0

摘要

牙槽炎是拔牙手术中最令人不快和最常见的并发症。根据大量的研究数据,它最常发生在拔除下颌第三磨牙后。拔牙窝发炎的原因是众所周知的。它们包括手术后立即形成的血块的缺失(“干眼窝”)或血块的腐烂,在眼窝的生理愈合过程中起保护和修复作用。引起“干窝”形成或血凝块纤溶的危险因素有:窝的机械损伤、局部麻醉溶液中高浓度肾上腺素的使用、窝刮除不充分、术后出血、技术复杂的手术过程等。然而,上述所有导致牙槽炎的因素同样会影响任何拔出的牙齿(包括下第三磨牙)窝内的炎症活动。因此,下智齿的解剖位置、胚芽和形成都有一定的特殊性。数据分析的互联网资源为:eLibrary, Cyberleninka, disserCat, National Library of Medicine, ResearchGate(48个来源,时间为1967 - 2021年)。本文综述了拔牙后、第三下磨牙后发生牙槽炎的不同研究资料,并对引起牙槽炎的主要原因进行了综述;本文介绍了第三磨牙的位置、起源和形成的解剖学特征。结论:下颌智齿窝牙槽炎的发生率最高,可能与其血供特点、周围脂肪组织多、结缔组织疏松、破裂困难等解剖生理参数有关,为炎症过程的发展创造了条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship Between Anatomy of the Third Lower Molar Location and Incidence of Alveolitis of Its Socket
INTRODUCTION: Socket alveolitis is the most unpleasant and frequent complication of the tooth extraction operation. According to the data of numerous studies, it most often occurs after extraction of the third mandibular molar. The causes of inflammation of the extracted tooth socket are well known. They include absence (“dry socket”) or decay of a blood clot which forms immediately after the operation and performs protective and reparative function during physiological healing of the socket. In turn, the risk factors provoking “dry socket” formation or blood clot fibrinolysis are mechanical injury of the socket, use of high concentration of adrenaline in local anesthetic solution, inadequate socket curettage, bleeding in the postoperative period, technically complicated surgical procedure and many others. However, all the mentioned factors leading to alveolitis, equally influence the inflammatory activity in the socket of any extracted tooth, including the lower third molar. Consequently, the anatomical location of the lower wisdom tooth, its germ and formation, have some peculiarities. The data analysis was carried out in the following Internet resources: eLibrary, Cyberleninka, disserCat, National Library of Medicine, ResearchGate (48 sources for the time period from 1967 to 2021). In the review article, the collected data of different studies on the frequency of alveolitis after tooth extraction, after the third lower molar extraction, on the main causes of the socket inflammation are given; generalized information of the anatomical characteristics of third molar location, its germ and formation is presented. CONCLUSION: The highest incidence of alveolitis of the mandibular wisdom tooth socket is probably associated with peculiarities of its supply with blood, the existence of high quantity of adipose tissue and loose connective tissue around it, difficult rupture and other anatomical and physiological parameters, which create conditions for development of intensive inflammatory process.
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