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ʻO ke kumu maloʻo (Alveolar Osteitis) vs ka maʻi ma hope o ka wehe ʻana: ka lā 3 a i ka 5 e hoʻomālamalama i ka pepeiao a me ka mālama.

He ʻokoʻa nā helu ulia pōpilikia ma ka ʻāina. Hoʻohana kēia ʻaoʻao i ka 911, ka helu no ʻAmelika a me Kanada. Nui nā ʻāina ʻē aʻe i hoʻohana i ka 112, 999, a i ʻole ka helu ʻē aʻe. E huli i ka helu no kou ʻāina.

Ma hope o ka unuhi ʻia ʻana o nā niho, ʻoi aku ka hopena o ka mola haʻahaʻa haʻahaʻa (niho akamai), hoʻōla ke kumu iwi ʻole o ka iwi ā ke hoʻopiha ʻia ke kumu e kahi ʻāpana koko fibrin ʻulaʻula maikaʻi a paʻa mau ʻia ma ke ʻano he scaffold ola no ka ʻiʻo granulation hou a me ka ulu iwi. Ma waena o La 3 a me ka lā 5 ma hope o ka unuhi ʻana, akā naʻe, ʻelua mau pilikia ʻokoʻa loa e hiki ke loaʻa: alveolar osteitis (kahi maloʻo), kahi hoʻoheheʻe fibrinolytic non-infectious a i ʻole ka hemo ʻana o ke koko i waiho ʻia, ʻano maʻalahi ** alveolar a me ka iwi maʻi ma hope o ka hoʻoheheʻe ʻia ʻana o ka ea ma hope o ka hoʻoheheʻe ʻia ʻana. ʻO ka maʻi ākea fascial** (subperiosteal, submandibular, pterygomandibular, a i ʻole ʻO ka angina o Ludwig). Loaʻa ka poʻe maʻi me ke kumu maloʻo i kahi ʻano hoʻomaʻamaʻa maopopo ʻole: 2 a 4 mau lā o ka ho'ōla maʻamau a ukali ʻia e ka hoʻomaka koke ʻana o ʻeha nui, hohonu, ʻeha 10/10 neuralgic e hoʻomālamalama ana i ka ʻāwae i loko o ka pepeiao, ka luakini, ka maka, a me ka ʻāʻī, hele pū ʻia me ka ʻono ʻino a me ka ʻala (halitosisreyish-iwi) me ka ʻole o ke kuni, ka pus, a i ʻole ka pehu ʻana o ka maka. ʻO ka hoʻokaʻawale ʻana, ʻo ka maʻi bacterial fascial maoli ke kumu ** ka holomua ʻana o ka pāpālina waho a i ʻole ka pehu ʻana ma lalo o ka ʻauwae, ke kuni, ka hemo ʻana o ka purulent, ka paʻakikī o ka ʻai ʻana, a me ka ʻinoʻino o ka lockjaw (trismus)** hiki ke hoʻololi i ke ea i loko o nā hola. Inā loaʻa ka pehu ma lalo o ka ʻauwae a i ʻole ke alelo paha kekahi ma hope o ka unuhi ʻana o nā niho, pilikia ka ʻai ʻana i ka kohu, ka leo puʻupuʻu, a i ʻole pilikia ka hanu ʻana, e kelepona i kou wahi. helu pilikia koke. E nānā pū i kā mākou alakaʻi kaikaina ma ʻO Ludwig's angina a me nā maʻi niho hohonu, nā niho kuʻi a me ka ʻeha niho, a sepsis a me ka ha'alulu ma'i.

ʻO kāu mea nui koke ka nānā ʻana i ** nā hōʻailona bacterial hae ʻulaʻula (ke kuni, ka hoʻonui ʻana o ka ʻāʻī a i ʻole ka pehu o ka papahele o ka waha, ka pus, a i ʻole ka trismus koʻikoʻi), lawe ** i hui pū ʻia ka ibuprofen waha (400 a 600 mg) me ka acetaminophen (500 a 1,000 mg) inā hoʻomaloʻo ʻia i kou ʻaoʻao me ka wai maʻemaʻe. (mai kuha me ka ikaika, mai omo i ka mauu a me ka vape, a mai wili i ka syringe irrigation plastic i loko o ke kumu hou i na la 5 mua), a e kelepona aku i kou kauka lapaau waha a niho no kahi 5 minute eugenol medicated dressing placement e hoopau ai i ka eha maloo maloo iloko o na minuke.

E hana i kēia i kēia manawa

  1. E nānā koke i nā hae ʻulaʻula o ka Deep Neck Space Infection e hoʻoweliweli ana i ke ola a kāhea aku i kāu helu ulia pōpilikia kūloko a i ʻole e hele i kahi haukapila Emergency Department inā aia. Kāhea iā 911 ma United States a me Kanada, 999 ma United Kingdom, 112 ma waena o ka European Union, 000 ma Australia, a i ʻole e nānā i kā mākou papa kuhikuhi honua o helu pilikia ina he ** ka pehu e laha ana ma lalo o ka auwae a me ka auwae (submandibular space), ke kiekie a paa paha o ka papahele o ka waha malalo o ke alelo, droo a paakiki paha i ka ale ana i ke kohu, he leo uala pumehana, ka paa paa (waha ka waha malalo o 1 a 2 ka laula manamana).
  2. E nānā i loko o ke kumu hoʻoheheʻe me ke kukui uila (me ka ʻole o ke kuʻi ʻana i kekahi mea i loko o ka lua) a nānā i ka lā ma hope o ka hana. Inā ʻoe ma La 3, La 4, a i ʻole La 5 ma hope o ka unuhi ʻana, ** ʻaʻohe kuni a ʻaʻole e hoʻonui ʻia ka pehu ʻana o ka maka o waho**, akā ua ulu koke ʻoe ** ka ʻeha ʻeha nui e ʻike ʻia i loko o kou pepeiao a i ʻole ka lua**, a me ka ʻono a i ʻole ka ʻeha ** iwi keʻokeʻo hina-hina** ma kahi o ka ʻeleʻele ʻeleʻele, ʻaneʻane loaʻa iā ʻoe ka ** kumu maloʻo (alveolar osteitis)**.
  3. **MAI ʻole e hoʻopololei i ka pulupulu pulupulu, nā niho niho, nā kui lima, nā papa aspirin, a i ʻole ka ʻaila clove i hoʻokahe ʻole ʻia e hāʻule pololei i loko o kahi kumu wehe wehe, a ʻaʻole loa e hoʻohana i ka syringe hoʻoheheʻe wai i loko o nā lā mua 5. a me ka waiho ʻana i ka ʻaila aspirin i ʻoki ʻia a i ʻole ka ʻaila clove i hoʻokahe ʻole ʻia ma luna o ka iwi alveolar ʻaʻohe mea e hoʻoulu ai i ka osteonecrosis kemika a me ke kuni mucosal.
  4. E lawe i ka analgesia waha lua-hana (Ibuprofen + Acetaminophen / Paracetamol) i ka manawa e hoʻonohonoho ai i ka lā hoʻokahi e kipa aku i kou niho a i ʻole kauka lapaʻau waha. No ka mea, ʻo ka ʻeha kumu maloʻo e alakaʻi ʻia e ka kinin a me ka prostaglandin synthesis kūloko i loko o ka iwi i wehe ʻia, e hui pū ana i kahi anti-inflammatory NSAID (**ibuprofen 6000000 mau hola me ka meaʻai 6000000 mg). contraindicated) me acetaminophen / paracetamol (500 a 1,000 mg) hāʻawi i ka hōʻoluʻolu ikaika loa ma mua o nā lāʻau lapaʻau wale nō (a ʻoi aku ka maikaʻi o ka codeine waha a i ʻole hydrocodone no ka ʻeha iwi niho).
  5. E hana i ka ʻauʻau ʻauʻau ʻauʻau me ka wai paʻakai mehana (No Swishing, No Spitting) no ka hoʻomaʻemaʻe ʻana i nā ʻōpala meaʻai popopo mai ke kumu. E inu, huli mālie i kou poʻo i ka ʻaoʻao unuhi i poʻe ka wai paʻakai mahana ma luna o ke kumu no 30 kekona, a laila ** e hilinaʻi i mua ma luna o ka lua a hāmama i kou waha i hāʻule ka wai i waho ma ka umekaumaha. Mai puhi ikaika i kou mau papalina a kuha paha, no ka mea, e omo ana ke kaomi intraoral maikaʻi ʻole i ke koena clot.
  6. E kelepona i ke kauka niho a i ʻole ke kauā waha nāna i unuhi i ka niho no 5 mau minuke Medicated Dry Socket Paste / Dressing placement. ʻAʻole ** hoʻōla ʻia ke kumu maloʻo e nā lāʻau antibiotic waha; ʻO ka lāʻau paʻa, he kipa keʻena pōkole a ʻeha ʻole kahi e hoʻolei mālie ai ka niho niho i ka meaʻai i paʻa i waho o ke kumu me ka paʻakai sterile mahana a waiho i kahi eugenol/guaiacol/benzocaine medicated paste (Alveogyl, Alvogyl, a i ʻole Zinc-Oxide Eugenol gauze strip) e pani pono i ka ʻeha i loko o 5 mau minuke.

No ke aha ʻaʻole ʻoe e haʻalele i ka pehu ʻana o ka ʻāʻī a me ka laka i ka lā 3 a 7

He nui nā poʻe maʻi e hoʻomohala ana i kahi abscess ākea submandibular, buccal, a i ʻole pterygomandibular fascial space abscess 3 a 7 mau lā ma hope o ka unuhi ʻana i nā niho naʻauao haʻahaʻa, manaʻo hewa lākou he kumu maloʻo wale nō lākou a noho i ka home me ka lawe ʻana i nā lāʻau ʻeha. E hoʻomanaʻo i kēia lula lapaʻau loa: ** ʻAʻole loa e hoʻoulu i ka wela nui, ʻaʻole loa e hoʻoheheʻe ʻia ka naʻau melemele mānoanoa mai ka ʻāʻī, a ʻaʻole loa e hoʻoulu i ka pehu ma lalo o ka ʻauwae, ma lalo o ka ʻāʻī, a ma lalo paha o ke alelo. ʻO ka ** hou a i ʻole ka pehu hou, ke kuni, a i ʻole ka hiki ʻole ke wehe i ka waha ma hope o ka lā 3 a hiki i ka 4 ** he maʻi maʻi maʻi maʻi e koi ana i ka hoʻokaʻawale ʻana i ka wai a me nā lāʻau antibiotic.

Ka lāʻau hoʻoholo: ʻeha ma hope o ka unuhi ʻana i ka lā 1 a 10 (hoʻōla maʻamau vs kumu maloʻo vs abscess fascial)

flowchart TD
    A["ʻEha, ʻono ʻino, kahe koko, a pehu paha ma hope o ka unuhi ʻana o nā niho"] --> B{"ʻO ke ala ea a i ʻole nā Hae Ula Fascial Deep? (Pehu ma lalo o ka ʻauwae, hoʻokiʻekiʻe ʻia ka papahele alelo, drooling, wela, trismus koʻikoʻi)"}
    B -->|Yes: Deep Fascial Space Infection or Ludwig's Angina| C["E kelepona iā EMS a i ʻole e hele koke i ka Halemai ED: IV antibiotic + pale ea + hoʻokahe wai"]
    B -->|No airway signs, no high fever, no expanding neck swelling| D{"He aha ka lā ma hope o ka unuhi ʻana a he aha kāu e ʻike ai?"}
    D -->|Day 1 to 2: Moderate soreness, mild pink saliva oozing, soft cheek swelling peaking at 48 hrs| E["ʻO ka maʻi maʻamau ma hope o ka hana ʻana: nahu ʻia i ka gauze maʻemaʻe a i ʻole ʻeke kī ʻeleʻele no ka oozing; pahu hau mua 24 hola; NSAID + acetaminophen"]
    D -->|Day 2 to 5: White or yellowish-cream soft film covering the socket WITH IMPROVING pain| F["ʻAʻohe ʻupena, ʻaʻole kumu maloʻo: waiho wale ia"]
    D -->|Day 3 to 5: Sudden 10/10 throbbing pain radiating to ear and temple + foul odor + empty socket / bare bone| G["ʻO ke kumu maloʻo (Alveolar Osteitis): nalo fibrinolytic o ke koko koko"]
    D -->|Day 4 to 10: Localized gum swelling, throbbing pain, yellow pus discharge, low-grade fever| H["ʻO Subperiosteal a i ʻole Vestibular Abscess ma hope"]
    D -->|Weeks 1 to 4: Small sharp white bone sliver poking through healing gum| I["ʻO Bony Sequestrum / Alveolar Spicule: hoʻomaʻemaʻe ke keʻena liʻiliʻi a i ʻole kipaku ʻia"]
    G --> J["ʻauʻau ʻauʻau ʻauʻau me ka wai paʻakai mahana (ʻaʻohe kuha); ibuprofen + acetaminophen; Mai hoʻohana mua i ka syringe"]
    J --> K["Ke kipa ʻana i ke kauka niho / Oral Surgeon i ka lā hoʻokahi: paʻakai maʻemaʻe + Alveogyl / Eugenol lāʻau lapaʻau."]
    H --> L["Ke kipa ʻana i ka Dentist / OMFS: ʻoki ʻoki a me ka hoʻoheheʻe ʻana i loko o ka waha + curettage socket + amoxicillin oral/metronidazole"]

Hoʻokaʻawale ʻokoʻa: ʻŌnaehana Hoʻōla maʻamau vs Socket Māloʻo vs Maʻi Bacterial Post-Extraction

Hōʻikeʻike lapaʻau Socket Hoʻōla Maʻamau ʻO ke kumu maloʻo (Alveolar Osteitis / Fibrinolytic Osteitis) Ma hope o ka wehe ʻana i ka maʻi maʻi maʻi / maʻi ākea fascial
Ka puka makani hoʻomaka maʻamau Piʻi ka ʻeha a me ka ʻoki ʻana i ka pāpālina ma 24 a 72 mau hola, a laila e hoʻomaikaʻi mau i kēlā me kēia lā mai ka lā 3 a hiki i mua. Maikaʻi 3-Day Latent Window: Maikaʻi ka maʻi no 2 a 3 lā, a laila ma La 3 a hiki i ka lā 5 (95% ma waena o ka lā 2 a me ka lā 5) pahū koke ka ʻeha. Hoʻomaka maʻamau ma waena o La 3 a me La 10 ma hope o ka unuhi ʻana (a i ʻole ma mua inā i unuhi ʻia ka niho i ka wā o ka abscess nui).
Ka helu helu helu 95% i ka 98% o nā unuhi maʻamau; 70% a 90% o nā niho naʻauao i hoʻopilikia ʻia. 1% a hiki i ka 4% o ka unuhi ma'a mau niho; 15% a i ka 30% o ka mandibular (lalo) kolu mola (niho akamai). 1% a i ka 5% o ka wehe ʻana i ke kaʻi.
** ʻAno ʻeha a me ka ʻula** ʻO ka ʻeha o ka ʻokiʻoki ʻia ʻana ma ka wahi e hoʻokō maikaʻi ai i ka ibuprofen a me ka acetaminophen maʻamau. ** ʻO ka ʻeha neuralgic ʻehaʻeha, hoʻomau ʻole, hohonu 9/10 a hiki i ka 10/10 ka ʻeha ʻeha ** e ʻā ana ma ke aʻalolo trigeminal (CN V3) i loko o ka pepeiao ipsilateral, ka luakini, ka maka, a me ka ʻāʻī **, kū ʻole i nā lāʻau ʻeha maʻamau. Hohonu, ʻehaʻeha, ʻūhā, ʻeha ʻeha kūloko e ʻoi aʻe ana ke kaomi ʻana i ka papalina pehu a i ʻole ka iwi āwae.
Hōʻikeʻike i loko o ka Socket Nā lā 1 a hiki i ka 2: ʻO ke koko ʻulaʻula ʻulaʻula like me ke koko.; Nā lā 3 a i 7: Uhi ʻia e kahi ʻeleʻele keʻokeʻo-keʻokeʻo a i ʻole melemele-hinahina o ka fibrin olakino a me ka ʻiʻo granulation (ke kuhi pinepine ʻia ʻo ka pus). Ka lua hakahaka a hapa hapa paha (ua hoʻoheheʻe ʻia a hemo paha ka ʻāʻī), e hōʻike ana i ka ** iwi alveolar hina keʻokeʻo keʻokeʻo** ma ka paia a i ʻole ke kumu, i hoʻopiha pinepine ʻia me nā ʻāpana meaʻai popopo. ʻIke ʻia ke kumu a me ka ʻaʻa a puni ** ʻulaʻula ʻulaʻula, ʻawaʻawa, pehu, a palupalu**, e hoʻoheheʻe ʻia ana i ka wai mānoanoa melemele a i ʻole ka pus ʻōmaʻomaʻo** ke kaomi ʻia.
Pehu ʻana o ka maka a me ka ʻāʻī o waho ʻO ka pehu ʻana o ka pāpālina palupalu haʻahaʻa a hiki i ka liʻiliʻi ** piʻi i ka 48 a 72 hola** a emi iho ma hope o ka lā 3. ZERO hou i waho o ka maka a i ʻole ka ʻāʻī ʻāʻī (kekahi ʻōpuʻu haʻahaʻa mai ka lā 2 e iho ana i lalo). Pehu hou, hoʻonui ʻia, wela, paʻa a ʻano ʻano paha o ka pāpālina, ka iwi āwae, ka hakahaka o lalo (ma lalo o ka auwae), a i ʻole ka papahele o ka waha ma hope o ka lā 3.
** ʻO ke kuni, nā ʻōpū Lymph, a me ka Trismus** ʻAʻohe kuni; ʻo ka ʻoʻoleʻa ʻāʻī e hoʻomaikaʻi i kēlā me kēia lā. Aole kuni (afebrile); i kekahi manawa, ʻoluʻolu ʻoluʻolu submandibular lymph node; ʻeha ʻeha o ka iwi āpau. ** ʻO ke kuni (ʻoi aku ma mua o 38.0 degere Celsius / 100.4 degere Fahrenheit), ke anu**, nā ʻāʻī ʻāʻī ʻāʻī ʻāʻī a me ka ** trismus koʻikoʻi holomua (lockjaw)**.
ʻala a me ka ʻono (Halitosis) Ka ʻono koko metala maʻemaʻe ma ka lā 1 wale nō. He ʻala fetid maopopo ʻole (malodor / halitosis) a me ka ʻono necrotic ʻino ma muli o ka fermentation anaerobic o nā ʻōpala meaʻai ma ka iwi ʻole. ʻO ka ʻono o ka purulent, ka paʻakai, a i ʻole ka pus ʻino ke hoʻokahe ʻia ka abscess.
Hoʻomaʻamaʻa Definitive E hoʻomau i ka ʻauʻau wai paʻakai mālie ma hope o 24 mau hola; ʻai palupalu; analgesics maʻamau OTC. ** ʻO ka wai paʻakai mahana maʻemaʻe + Intra-socket Eugenol Medicated Dressing (Alveogyl / ZOE paste)** + NSAIDs. (ʻAʻole hōʻike ʻia nā lāʻau antibiotic pūnaewele.) ** ʻO ka ʻoki ʻana a me ka hoʻoheheʻe ʻana (I&D)** + debridement + Systemic Antibiotics (amoxicillin-clavulanate a i ʻole penicillin + metronidazole) + Ka mālama ʻana i ke ea ICU o ka Halemai inā pili kahi hohonu.

Pathophysiology: ʻO Birn's Fibrinolytic Theory a no ke aha he 10x ʻoi aku ka maʻalahi o nā niho naʻauao haʻahaʻa.

ʻOiai ʻo ka hoʻomohu ʻana i ka mīkini (ka puhi ʻana, ka puhi ʻana, ka kuha ʻana, a i ʻole ka hoʻokuʻu ʻana i ka syringe mua) he mea nui ia, ua hōʻike ʻia e ka noiʻi a Dr. H. Birn ʻo ke kumu kumu o alveolar osteitis ʻo biochemical localized fibrinolysis:

1. ʻO Birn's Fibrinolytic Cascade Maloko o ka Iwi Alveolar

  1. Ka Hoʻokumu ʻana o Clot (La 1): Ma hope koke o ka huki ʻia ʻana o ka niho, hoʻopiha ke koko i ke kumu iwi (alveolus) a hoʻololi ka prothrombin i ka fibrinogen i kahi fibrin meshwork i hoʻopaʻa ʻia e paʻa ana i nā ʻāpana koko ʻulaʻula a me nā platelets, e hoʻopaʻa ana i ka iwi maka.
  2. Hoʻokuʻu ʻia o nā Tissue Activators mai Bone Trauma and Bacteria (Days 2 a 4): Ke koi ʻia kahi unuhi ʻana i ka iwi ʻokiʻoki (osteotomy me ka drill), hoʻokiʻekiʻe ikaika ʻia ke aʻa, a i ʻole ke kū ʻana i mua o ka pericoronitis a i ʻole ka bacteria periodontal (e like me Treponema denticolas) a me P. hoʻokuʻu ʻia nā pūnaeʻa momona a me nā hua bacteria oral anaerobic ** nā mea hoʻoulu plasminogen tissue (tPA) a me nā fibrinolysins bacterial*.
  3. Ka hoʻololi ʻana o Plasminogen i Plasmin (Clot Dissolution): Hoʻololi nā mea hoʻonā Plasminogen i ka plasminogen ʻole (hoʻopaʻa ʻia i loko o ka ʻōpū) i loko o ka enzyme proteolytic ikaika plasmin, nāna e hoʻoheheʻe i nā kaula fibrin e paʻa pū ana i ke koko. Ma ka La 3 a hiki i ka lā 4, holoi ʻia ka ʻōpala wai i loko o ke kohu, a waiho ʻia ka cribriform plate (lamina dura) o ka iwi alveolar me ka ʻōlohelohe loa i ka wai waha, ka ea, a me ka meaʻai.
  4. No ke aha i ʻeha ai ka pepeiao o ka iwi i hōʻike ʻia (Hoʻokumu ʻia Kinin): ʻO ka enzyme plasmin like ʻole i hoʻoheheʻe i ka fibrin clot e hoʻokaʻawale hoʻi i ke kininogen i bradykinin, kekahi o nā molekole e hoʻoulu ai i ka ʻeha i loko o ke ola kanaka. Hoʻoulu pololei ʻo Bradykinin a me prostaglandins i nā hopena o ke aʻalolo alveolar inferior (CN V3)** ʻaʻohe myelinated e holo ana ma ka pā iwi i ʻike ʻia. No ka mea, ʻo ka auriculotemporal nerve (e hāʻawi ana i ka manaʻo i ka puka pepeiao o waho, ka eardrum, a me ka luakini) i nā lālā like ʻole mahele ʻaoʻao o ke aʻalolo trigeminal (CN V3) ** me ke aʻalolo alveolar inferior, ʻike ka lolo o ka mea maʻi i ka hōʻailona o ka iwi ma ke ʻano he ** ʻeha ʻeha e pana pololei i loko o ka pepeiao, ka luakini, a me ka ʻeha ʻeha pololei i loko o ka pepeiao, ka luakini, a me ka ʻeha ʻeha pololei i loko o ka pepeiao, ka luakini*, a me ka ʻeha ʻeha.

2. No ke aha e emi iho ai ka mooolelo niho naauao no ka 80% o na kumu maloo a pau

ʻO ke kumu maloʻo he 10 manawa ʻoi aku ka maʻamau ma ka iwi ā lalo (mandible), ʻo ia hoʻi ka molar kolu o lalo (niho akamai), ma mua o nā niho luna no ʻekolu kumu anatomical: - Iwi Cortical Paʻa me ke Koko ʻino: Aia ka iwi ā luna (maxilla) me ka iwi spongy, vascular cancellous iwi e kahe nui ana ke koko a hānai i ka ʻōpū. Aia ka iwi āwae haʻahaʻa hope (mandible ma ke kuamoʻo oblique waho) he iwi iwi koʻikoʻi mānoanoa, mānoanoa, me ka liʻiliʻi loa o nā aʻa koko e heleuma a hānai i ka ʻōpū. - Ka wehe ʻana i ka iwi a me ka noʻonoʻo ʻana: ʻO nā niho naʻauao haʻahaʻa i hoʻopilikia pinepine ʻia e koi pinepine i ka hoʻokiʻekiʻe ʻana i ka mucoperiosteal flap elevation, ka ʻeli ʻana o ka iwi, a me ka ʻāpana niho, kahi e hoʻokuʻu ai i nā kiʻekiʻe kiʻekiʻe o nā mea hoʻoikaika plasminogen iwi. - Gravity Food-Trap Geometry: E huli ana ke kumu niho o luna i lalo, no laila, hoʻokahe maoli ka ʻumekaumaha i nā ʻāpana meaʻai. He kīʻaha e kū pono ana i luna ma ke kihi hope o ka papa ʻaina, kahi i nau ʻia ai ka ʻai a me ka wai kohu ma luna pono o ka clot a me ka hoʻoheheʻe ʻana i ka maʻi bacteria fibrinolytic.

3. ʻO 6 mau mea pilikia nui e hoʻonui ai i ka pilikia socket maloʻo

  1. Uhi paka, Vaping (Nicotine E-Cigarettes), a i ʻole Cannabis i loko o 72 a i 120 Houra (Hoʻonui i ka pilikia 3-paʻi i ka 5-pāpaʻi): ʻO Nicotine vasoconstricts gingival a me ka iwi iwi capillaries, nā kinoea cytotoxic e pepehi i nā fibroblasts a me nā osteoblasts, a me ka huki ʻana ma ka cigarette a i ʻole ka vape e hoʻopuka ai i ka puʻe i loko o ka vape.
  2. Oral Contraceptive Pills (Estrogen) and Menstrual Cycle Time (Hoʻonui i ka pilikia i 2-fold a 3-fold): Exogenous estrogen i hui pū ʻia nā contraceptives waha e hoʻoikaika i ka hana o ka plasminogen hepatic a hoʻonui i ka fibrinolytic activity (hoʻoheheʻe wikiwiki i ka clot). He 20% a hiki i 30% ka helu o ke kumu maloʻo nā wāhine e lawe ana i nā lāʻau lapaʻau waha ma hope o ke oki ʻana i nā niho akamai haʻahaʻa, hiki ke hoʻemi ʻia ma ka hoʻonohonoho ʻana i nā unuhi koho i ka Nā lā 23 a 28 o ka pōʻai papa (ke haʻahaʻa ka pae o ka estrogen).
  3. Plastic Syringe Irrigation (Ma mua o ka lā 5 a 7): Hāʻawi pinepine nā kauka lapaʻau waha i ka poʻe maʻi i kahi syringe plastic curved-tip (Monoject 412) e holoi i ka meaʻai mai loko mai o nā lua niho naʻauao. ** I loko o nā lā 5 mua, ʻaʻole i hoʻololi ʻia ka clot i loko o ka ʻiʻo granulation fibrous paʻakikī; ʻO ke kuʻi ʻana i kahi pahu syringe i loko o ke kumu ma mua o ka lā 5 a hiki i ka lā 7 e puhi i ke koko i waho a hoʻomaka i kahi kumu maloʻo koke.**
  4. ** ʻO ka kuha ikaika ʻana, ka holoi waha ikaika, a i ʻole ka inu ʻana ma o kahi mauʻu i loko o nā hola 72 mua: ** hana i ke kaomi hydraulic maikaʻi ʻole ma ke kumu.
  5. ** ʻO nā waha wai ʻona (Listerine) a i ʻole Hydrogen Peroxide Holoi i ka Hebedoma 1:** ʻO ka ethanol kiʻekiʻe a me ka hydrogen peroxide e hoʻoheheʻe ai i nā pūnaʻi koko ʻulaʻula a hoʻoheheʻe i nā ʻōpala fibrin mua.
  6. Pericoronitis a i ʻole Periodontal Infection ma mua o ka niho naʻauao: ʻO nā haʻahaʻa kiʻekiʻe o ka anaerobic Treponema denticola e hūnā pololei i nā enzyme fibrinolytic i loko o ke kumu.

ʻO kēlā mea keʻokeʻo he Dry Socket, Pus, a i ʻole Normal Healing Granulation Tissue?

Ma ka lā 3 a i ʻole lā 4 ma hope o ka unuhi ʻana, ʻike pinepine ka poʻe maʻi i ka keʻokeʻo palupalu, ʻulaʻula, a i ʻole melemele-hinahina e hoʻopiha ana i ke kumu a manaʻo ʻia he iwi keʻokeʻo keʻokeʻo (ke kumu maloʻo) a i ʻole ka pus.

Pehea e haʻi aku ai i ka Tissue White Granulation Tissue mai Bare Bone a i ʻole Pus i 10 kekona

  1. Fibrin Keʻokeʻo maʻamau a me ka Tissue Granulation (The Wet Scab of the Mouth):
  2. E like me ka lilo ʻana o ke kuli i ʻoki ʻia i keʻokeʻo a palupalu ke ʻū ʻoe i loko o ka ʻauʻau ʻauʻau, ua nalowale ke koko hoʻōla i loko o ka huʻa pulu o kou waha i kona puaʻa ʻulaʻula ma hope o 48 mau hola, e waiho ana ma hope o ka keʻokeʻo keʻokeʻo fibrin meshwork a me ka ** granulation tissue ** me nā cell epithelial i hoʻokahe ʻole ʻia.
  3. Ka Ho'āʻo: Inā hoʻopiha ʻia kou kumu i kahi ** ʻeleʻele ʻoluʻolu, ʻulaʻula-keʻokeʻo a melemele paha ** A ʻOi aku ka maikaʻi o kou ʻeha (a i ʻole ka ʻeha ʻeha haʻahaʻa) me ka ʻole o ke kuni a i ʻole ka ʻeha pepeiao, ** ʻo ia ʻano keʻokeʻo he 100% mea ola olakino. MAI ʻokiʻoki, palaki, a i ʻole ka syringe.**
  4. Pūnae Māloʻo (Iwi Alveolar ʻAʻohe):
  5. I loko o kahi kumu maloʻo, ua ʻalo ʻia ka ʻōpū palupalu, waiho ʻia kahi puka hohonu i ʻike ʻia e ʻike i ka paʻa ʻana o nā paia iwi keʻokeʻo keʻokeʻo paʻakikī o ka ʻāwae, a ua loaʻa iā ʻoe ka ʻeha 9/10 a hiki i 10/10 me ka pilau ʻeha i loko o kou pepeiao a me ka luakini.**
  6. Maʻi maʻi bacteria (Pus):
  7. ʻO ka Pus ka wai: ʻohu a puka mai i waho o ka pehu ʻulaʻula ʻulaʻula i ka wā e kaomi ai ʻoe i ka pāpālina, a hele pū ʻia me ka e ʻoi aku ka ʻino o ka pāpālina waho a i ʻole ka pehu ʻana o ka ʻāʻī, ke kuni, a me ka ʻāwae laka.

ʻO ka hoʻokele olakino a me ka mālama home o Dry Socket

1. No ke aha ʻoe e kāhea aku ai i kāu Kauka Niho a i ʻole Kauka Oral (The 5-Minute Cure)

  • He aha ka hana a ke kauka niho: ʻAʻole liʻiliʻi ma mua o 5 mau minuke ke koho ʻana a koi pinepine ʻia ** ʻaʻohe nila a ʻaʻohe wili**.
  • Ke hoʻohana nei ke kauka niho a i ʻole ka lāʻau lapaʻau waha i ka cannula blunt curved e holoi mālie i nā ʻāpana meaʻai popopo mai ke kumu me mehana (37 degere Celsius / 98.6 degere Fahrenheit) sterile 0.9% saline a i ʻole 0.12% chlorhexidine. ʻO nā alakaʻi AAOMS a me Cochrane o kēia manawa ke ʻōlelo ikaika nei ** e kūʻē i ka curettage ʻoki kino (ka ʻoki ʻana i ka iwi ʻole e hoʻāʻo e hoʻokahe hou i ke koko)**, no ka mea, ʻo ke ʻoki ʻana i ka iwi ʻaʻa ʻole ke kumu e ʻeha nui ai, e luku ai i nā osteoblast e ola ana, a e hoʻopaneʻe i ka hoʻōla ʻana.
  • A laila, hoʻopili mālie ke kauka lapaʻau i ke kumu me kahi sedative obtundent dressing, ka mea maʻamau Alveogyl / Alvogyl (he pāpaʻi fibrous e hoʻopau iā ia iho i loko o ka eugenol [analgesic], butamben [toical anesthetic], a me iodoform [antimicrobial colugenol], a i ʻole aipreonged modern. i uhi ʻia i loko o Zinc Oxide Eugenol + Benzocaine).
  • Hōʻoluʻolu koke: No ka mea, hoʻopaʻa kino ka ʻaʻahu ʻana i ka iwi ʻaʻohe mai ka ea a me ka ʻauʻau i ka wā e ʻauʻau ai i nā aʻalolo trigeminal i hōʻike ʻia i loko o ka eugenol a me ka maʻi anesthetic kūloko, 80% a hiki i ka 95% o ka ʻeha pepeiao a me ka ʻāwae e nalowale i loko o 5 a 15 mau minuke.
  • Inā hoʻohana ʻia kahi kāwele hiki ʻole ke resorbable, wehe a hoʻololi paha ka niho ma hope o 48 a 72 hola; ʻO nā pāpaʻi hoʻopau iā ia iho e like me Alveogyl holoi mālie iā lākou iho i ka ulu ʻana o ka ʻiʻo granulation ma lalo o 7 a 10 mau lā.

2. Kokua mua i ka home i kēia pō (Ke pani ʻia ke keʻena niho a hiki i ke kakahiaka)

Inā kū mai ka ʻeha o ke kumu maloʻo i ka pō a ua hōʻoia ʻoe ʻaʻole ** ʻaʻohe hae ʻulaʻula bacteria** (ʻaʻohe kuni, ʻaʻohe pehu ma lalo o ka ʻauwae, ʻaʻohe ala ea a i ʻole ka ʻai ʻana):

  1. E lawe i ka Dual-Pathway Oral Analgesia (NSAID + Acetaminophen): E lawe i ka Ibuprofen 400 a i ka 600 mg (a i ʻole Naproxen 220 a i 500 mg) me ka meaʻai PLUS Acetaminophen (Paracetamol) 500 a 1,000 mg i hui pū ʻia (a i ʻole he maʻi maʻi ʻaʻa ʻole i loaʻa i ka maʻi maʻi peptic i kēlā me kēia manawa) ka maʻi, ka hoʻohana ʻana i ka anticoagulant, a i ʻole ka allergy NSAID.
  2. Passive Warm Saline Head-Tilt Bath: Hoʻohui i ka hapalua teaspoon o ka paʻakai i loko o 240 mL (8 oz) o ka wai mehana (a i ʻole e hoʻohana i ka ʻōlelo kuhikuhi 0.12% a i ka 0.2% Chlorhexidine Gluconate mouthwash inā kauoha ʻia e kāu kauā). Sip, hoʻoluliluli i kou poʻo i ʻauʻau ka wai mehana i ke kumu no 30 kekona e lana ai i waho o nā ʻōpala meaʻai ʻawaʻawa, a e hoʻokuʻu i ka wai me ka kuha ʻole.
  3. Mahele Makaala ʻO Eugenol (Aila ʻAila) pulupulu Pellet: ʻOiai ** ʻaʻole pono e ninini ʻia ka ʻaila clove maʻemaʻe i loko o kahi kumu**, inā loaʻa iā ʻoe kahi kekini niho OTC sterilile e komo pū ana me ka eugenol a me nā pulu pulupulu i hoʻoheheʻe ʻia (a i ʻole e hui pū ʻia ** 1 kulu o ka ʻaila clove me 3 a 4 kulu o ka ** aila ʻoliva sterile**), hiki iā ʻoe ke hoʻomaloʻo māmā i ka ʻaila ʻoliva sterile**. wehe ʻia ke kumu** a hoʻomaha mālie ma luna o ke kumu no ka 15 a 30 mau minuke e hoʻopau i ke aʻalolo, a laila e wehe ma mua o ka hiamoe ʻana a ʻike i kou niho niho i ke kakahiaka.
  4. Pūmi Kūwaho vs. Pumehana a me ke Kiʻekiʻe Poʻo: I loko o ** 24 a 48 hola mua** ma hope o ka unuhi ʻana, e hoʻohana i ka paʻi hau (20 mau minuke, 20 mau minuke ma waho) ma waho o ka pāpālina. E hoʻomaka ana ma La 3 a hiki i ka lā 5 (inā wale nō ** ʻaʻohe maʻi bacterial a pehu paha **), ʻo ka ʻaʻahu maʻemaʻe maʻemaʻe maʻemaʻe ma waho o ka ʻiʻo āwae e kōkua i ka hoʻomaha ʻana i ka spasm masseter lua. Moe me kou poʻo i hoʻokiʻekiʻe ʻia ma luna o 2 mau uluna no ka hoʻemi ʻana i ka paʻi iwi.

ʻElua mau ulia pōpilikia ma hope o ka unuhi ʻana: Secondary Bleeding (Liver Clots) a me Sharp Bone Spicules

1. ʻO ka maʻi koko ma hope o ka wehe ʻana a me nā ʻōpū o ke akepaʻa (nā hola 4 a 24 a i ʻole lā 5 a 7)

  1. ** ʻAla ʻulaʻula vs. True Active Bleeding:** ʻO ka ʻula ʻulaʻula māmā no 24 a 48 mau hola he mea maʻamau. ʻO ke koko ikaika maoli, ʻo ia hoʻi, ʻo ke koko ʻulaʻula ʻulaʻula e hui pū ana a hoʻopiha i ka waha i loko o nā kekona o ka holoi ʻana i ke kumu.
  2. He aha ke ʻano o ka Liver Clot (Currant-Jelly Clot)? I kekahi manawa e puka mai ana ka nui, ʻeleʻele ʻeleʻele, ʻāwīwī, e like me ke akepaʻa (e like me ka ate maka, 1 a 3 kenimika ka laulā) i waho o ke kumu e like me ka pāpale haʻihaʻi ʻoiai e hoʻomau ana ke kahe ʻana o ke koko ʻulaʻula ma lalo o kona mau ʻaoʻao. ʻO kēia kahi puʻupuʻu fibrin venous piha ʻole (** ʻaʻai koko**) hiki ʻole ke hoʻopaʻa i nā capillaries iwi lalo.
  3. Pehea e ho'ōki ai i ke koko ke loaʻa ka ʻōpū o ke akepaʻa: E holoi mālie i ka ʻili o ka jelly e puka ana i lalo a hiki i ka pae o ke kumu kumu me ka ʻāpana maʻemaʻe o ka gauze maʻemaʻe** (ʻaʻole e ʻeli i loko o ke kumu iwi ponoʻī), a kau koke i kahi ** i ʻōwili paʻa ʻia, pulu maʻemaʻe maʻemaʻe paʻa paʻa pono a i ʻole ** i 45 mau minuke piha**.
  4. ** No ke aha e hana ai ka ʻeke kī ʻeleʻele maʻemaʻe:** ʻO ke kī ʻeleʻele maʻamau (Camellia sinensis, ʻaʻole ke kī lāʻau) he waiwai nui i tannic acid (tannins), e hana ana ma ke ʻano he astringent kūloko ikaika e hoʻopaʻa i nā capillaries a hoʻolalelale i ka hoʻokumu ʻana o ka platelet plug.
  5. Inā hoʻokahe ke koko i ka gauze ma hope o ʻelua mau pōʻaiapili 30-minuke (a i ʻole inā lawe ka mea maʻi i warfarin, apixaban, rivaroxaban, dabigatran, clopidogrel, a i ʻole aspirin), e hoʻi koke i ke kaukō waha a i ʻole ka haukapila ED no ** 2% lidocaine kūloko me 1:100,000 epine, 100,000 epine infiltration ** (Gelfoam) a i ʻole oxidized regenerated cellulose (Surgicel) packing**, figure-of-8 sutures, a me 5% tranexamic acid (TXA) gauze compression.

2. Nā Iwi Maikaʻi (Alveolar Bone Sequestra) Poking through the Gums (Weeks 1 to 6)

Ma waena o 1 a me 6 pule ma hope o ka unuhi ʻana i nā niho, ʻike pinepine ka poʻe maʻi i kahi ʻaoʻao keʻokeʻo liʻiliʻi liʻiliʻi liʻiliʻi, ʻoi aʻe, ʻoi keʻokeʻo ma ka ʻaoʻao o ka lāʻau lapaʻau** (ʻo ka pinepine ma ka ʻaoʻao o loko o kahi kumu mola haʻahaʻa) e haki ana i ke alelo. Ma kahi o 95% o nā hihia, ** ʻaʻole kēia he aʻa niho**; he ʻāpana liʻiliʻi ʻo ia o ka ** iwi pā o ke kumu alveolar (he iwi iwi ʻaoʻao a i ʻole sequestrum)** i hoʻokuke maoli ʻia e ka ʻiʻo ʻaʻa hoʻōla. E uhi i ka lae ʻoi me ka orthodontic wax inā e hamo ia i kou alelo, a i ʻole e hoʻokuʻu i kāu kauka niho i ka iwi i wehe ʻia i loko o 30 kekona ma lalo o ka gel numbing topical.

Nā helu ulia pōpilikia āpana a me nā protocols oihana

  • ** ʻAmelika Hui Pū ʻIa a me Kanada: ** Kāhea koke i ka 911 no ka pehu ʻana o ka ʻāʻī ma hope o ka unuhi ʻana, piʻi ka papahele o ka waha, paʻakikī ke ale ʻana, a i ʻole ka pilikia hanu. No ka ʻeha maloʻo a i ʻole ka ʻeha ma hope o ka wehe ʻana i ka ʻāina, e kelepona i ka helu kelepona 24-hola o kāu kauka lapaʻau a i ʻole e hahai i ka American Association of Oral and Maxillofacial Surgeons (AAOMS) a me ADA mau kuhikuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau ma ke keʻena (Alveogyl / ZOE) a me NSAID analgesiao multimodal.
  • United Kingdom: Kāhea i ka 999 no ke ala ea a i ʻole ka hoʻolaha ʻana i ka pehu ʻāʻī o ka pilikia pilikia. No ka lā koʻikoʻi o ka lā 3 a 5 i ka ʻeha kumu maloʻo a i ʻole ke koko ma hope o ka unuhi ʻana, e kelepona i ka hana niho nāna i hana i ka unuhi a i ʻole e kelepona iā NHS 111 no ka mālama niho koʻikoʻi o ka lā hoʻokahi. E hahai i nā kuhikuhi NICE / SDCEP (Scottish Dental Clinical Effectiveness Program): mālama ʻia ke kumu maloʻo (alveolar osteitis) me ka **0.9% irrigation saline a me Alveogyl ʻaʻahu obtundent me ka paracetamol a me ka ibuprofen, ʻaʻole nā ​​​​antibiotic systemic maʻamau ** ke ʻole ka hoʻolaha ʻana i ka maʻi bacterial a i ʻole ke kuni.
  • European Union: Kāhea i ka 112 no ka pilikia o ka ʻāʻī hohonu, a i ʻole e kelepona i ka Emergency Dental Service no ka lā hoʻokahi Alveogyl kāhiko lole.
  • Australia a me New Zealand: Kāhea i ka 000 ma Australia a i ʻole 111 ma New Zealand no nā pilikia ea. E hahai i Nā Aʻoaʻo Therapeutic: Oral and Dental (Australia): e hoʻoheheʻe mālie i nā kumu maloʻo me ka paʻakai sterile mahana, e kau i kahi lole obtundent kūloko, a mālama i nā lāʻau antibiotic (phenoxymethylpenicillin a i ʻole amoxicillin + metronidazole) no ka hoʻolaha ʻana i nā maʻi odontogenic me nā hōʻailona ʻōnaehana.
  • India, Iapana, South Korea, a me Asia-Pacific: Kāhea i ka 112 / 108 ma India, 119 ma Iapana a me South Korea, 995 ma Singapore, a i ʻole 999 ma Malaysia a me Hong Kong no nā maʻi maʻi hohonu, a i ʻole e kipa i ke keʻena o ka Oral and Maxillofacial Surgery no ka hoʻokomo ʻana i ka zinc-oxide eugenol socket dressing.

Nīnau pinepine

Pehea e hiki ai iaʻu ke haʻi i ka ʻokoʻa ma waena o kahi Dry Socket a me kahi maʻi bacterial post-extraction?

E nānā i ʻekolu mau mea: ka lā post-op, ka pehu o waho, a me ke kuni. Paʻa ka puna maloʻo (alveolar osteitis) ma waena o ka lā 3 a me ka lā 5 ma hope o ka unuhi ʻana i nā niho, e hōʻeha ana i ka ʻeha ʻeha 10/10 e kupu aʻe i loko o kou pepeiao a me ka luakini, he ʻala ʻino, a me kahi kumu hakahaka me ka iwi hina-hinahina-keʻokeʻo, akā ʻaʻole loa ia e hoʻoulu i ke kuni kiʻekiʻe, ka ʻāʻī melemele mānoanoa o kou ʻāʻī, a i ʻole ka mānoanoa o ka ʻāʻī melemele a i ʻole ka ʻāʻī. ʻO ka maʻi maʻi bacteria maoli ke kumu o ka pehu hou a i ʻole ma lalo o ka ʻauwae ma hope o ka lā 3, ke kuni, ke anu, ke kahe ʻana o ka wai mai nā ʻāʻī pehu ʻulaʻula, a me ka ʻeha o ka lockjaw (trismus) a i ʻole ka paʻakikī o ka ʻai ʻana.

No ke aha wau e ʻike ai i nā mea keʻokeʻo a melemele paha i loko o kaʻu lua unuhi i ka lā 3: ʻo ia ka namu a i ʻole kahi kumu maloʻo?

Inā nānā ʻoe i loko o kāu kumu hoʻōla hoʻōla ma ka lā 2 a hiki i ka lā 6 a ʻike ʻoe i kahi papa palupalu, ʻulaʻula-keʻokeʻo a i ʻole melemele-hinahina e uhi ana i ka lua i ka wā e hoʻomaikaʻi mau ana kou ʻeha a ʻaʻohe kuni ʻoe, mai hopohopo a ʻaʻole e ʻoki i waho. ʻO kēlā papa keʻokeʻo palupalu he fibrin maikaʻi a me ka ʻiʻo granulation, ʻo ia hoʻi he ʻōpala pulu i loko o ka kohu o kou waha ma hope o ka holoi ʻana o ka puaʻa ʻulaʻula mai ke koko. He kūʻē pololei ia o kahi kumu maloʻo a pono e waiho ʻole ʻia me ka ʻole.

No ke aha i hāʻawi mai ai kaʻu kauka lapaʻau waha iaʻu i kumu maloʻo?

Hoʻouna pinepine nā kauā waha i nā poʻe maʻi i ka home me ka curved-tip plastic syringe (Monoject syringe) e holoi i ka meaʻai i paʻa i waho o nā kumu niho naʻauao haʻahaʻa, akā kuhi hewa pinepine ka poʻe maʻi i ka hoʻohana ʻana i ka lā 1, ka lā 2, a i ʻole ka lā 3. I loko o nā lā 5 mua ma hope o ke ʻoki ʻana, ʻo ke koʻokoʻo koko i loko o ka iwi iwi he jelly palupalu; ʻO ke kuʻi ʻana i kahi pahu wai kaomi i loko o ke kumu ma mua o ka lā 5 a hiki i ka lā 7 e puhi i ke koko mai loko o ka iwi a hoʻomaka i kahi kumu maloʻo koke. I nā lā 2 a hiki i ka 5, e hoʻoluli mālie i kou poʻo me ka wai paʻakai mahana a hoʻokuʻu i waho i loko o ka lua me ke kuha ʻole; e kali a hiki i ka lā 5 a i 7 (a i ʻole ka lā hoʻomaka pololei o kāu kaukō) ma mua o ka hoʻohana ʻana i ka syringe.

E ho'ōla anei ka lawe ʻana i nā lāʻau antibiotic i kahi kumu maloʻo?

ʻAʻole. ʻO nā hoʻokolohua lapaʻau a me nā alakaʻi niho kūhelu ma ka honua holoʻokoʻa (me ka ADA, AAOMS, a me UK NICE/SDCEP) e hōʻike ana ʻaʻole he maʻi bacteria ka puna maloʻo; he mea hoʻoheheʻe kemika ia o ke koko koko (fibrinolysis) e waiho ana i nā iwi ʻole a me nā aʻalolo trigeminal i ʻike ʻia i ka ea a me ka huela. ʻAʻole e hoʻopau nā lāʻau ʻokoʻa waha i ka ʻeha maloʻo. ʻO ka lapaʻau ʻoi aku ka wikiwiki a me ka maikaʻi loa, ʻo ia ka kipa ʻana i 5 mau minuke i kāu kauka niho a i ʻole kauka lapaʻau e hoʻolei i nā ʻōpala meaʻai i hoʻopaʻa ʻia a kau i kahi paʻi lāʻau eugenol ʻoluʻolu (e like me Alveogyl) ma luna pono o ka iwi ʻole, i hui pū ʻia me ka ibuprofen waha a me ka acetaminophen.

No ke aha e ʻeha nui ai koʻu pepeiao, ka luakini, a me koʻu maka ma kahi kumu maloʻo o ka niho naʻauao haʻahaʻa?

Hāʻawi ʻia nā niho haʻahaʻa a me ka iwi iwi e ke aʻalolo alveolar inferior, ʻo ia ka lālā o ka mahele mandibular o ke aʻalolo trigeminal (Cranial Nerve V3). Ke wela ka iwi olohelohe i loko o ke kumu niho naauao haahaa a hoʻokuʻu i nā kinikona ʻeha bradykinin, hele ka hōʻailona pilikia i luna o ke kumu aʻalolo maʻi, ʻo ia ke kumu aʻalolo e hāʻawi ai i ke aʻalolo auriculotemporal e hoʻolako ana i kou ʻāʻau pepeiao, ka pahu pepeiao, a me ka luakini. Ma muli o ka like like o ke ala aʻalolo waena o nā lālā ʻelua, ua wehewehe kou lolo i ka ʻeha o ka iwi āwae ma ke ʻano he ʻeha pepeiao a me ke poʻo o ka luakini ma kēlā ʻaoʻao.

Pehea ka nahu ʻana i ka ʻeke kī ʻeleʻele pulu e hoʻōki i ke koko ma hope o ka unuhi ʻana i nā niho?

Loaʻa i nā lau kī ʻeleʻele maʻamau (Camellia sinensis, ʻaʻole i ka lāʻau peppermint a i ʻole ka chamomile tea) he kiʻekiʻe ka nui o ka tannic acid maoli (tannins). Ke hoohiolo a hoʻomāmā ʻoe i kahi ʻeke kī ʻeleʻele i loko o ka wai mehana, e ʻomi i ke kahe nui, a nahu pono i lalo ma luna o kahi kumu niho koko no 30 mau minuke mau, ʻo ke kaomi mechanical e hoʻopaʻa i nā capillaries a ʻo ka tannic acid e hoʻopaʻa i nā kīʻaha koko kūloko a kōkua i nā platelets a me ka fibrin clot wikiwiki.

Nā kumu a me ke alakaʻi kūhelu

  • ** ʻAhahui ʻAmelika o nā Kauka Oral and Maxillofacial Surgeons (AAOMS) a me American Dental Association (ADA, United States):** Nā Kūlana Hoʻomaʻamaʻa Clinical no ka ʻEkolu Molar Surgery, Alveolar Osteitis (Dry Socket) Prevention and Management, a me Post-Operative Odontogenic Infections.
  • Scottish Dental Clinical Effectiveness Program (SDCEP) a me National Institute for Health and Care Excellence (NICE, United Kingdom): Management of Acute Dental Problems: Alveolar Osteitis (Dry Socket) vs. Spreading Post-Extraction Infection Triage.
  • Cochrane Oral Health Group: Local Interventions for the Management of Alveolar Osteitis (Dry Socket) (Daly et al., Cochrane Database of Systematic Reviews, chlorhexidine prophylaxis and Alveogyl / eugenol obtundent dressings).
  • Alakaʻi Lapaʻau: Oral and Dental (Australia): Ma hope o ka unuhi ʻana: Alveolar Osteitis, Secondary Hemorrhage, a me Odontogenic Deep Space Infections.
  • World Workshop on Oral Medicine and International Association of Oral and Maxillofacial Surgeons (IAOMS): Pathophysiology of Fibrinolytic Alveolitis (Birn's Hypothesis) and Trigeminal Referred Otalgia.

E lawe i kahi papa kōkua mua i hōʻoia ʻia a nīnau aku i nā ʻoihana

Hāʻawi kēia alakaʻi i ka hoʻonaʻauao kōkua mua o nā niho ma hope o ka hana ʻana a ʻaʻole ia e pani i ka mālama ʻoihana mai kahi kauka niho laikini, kaukaʻi waha, a kauka paha. No ke aʻo ʻana i nā mākau hana i ka mālama ʻana i ke koko, nā pilikia ea, a me ke kōkua mua, e lawe i kahi papa kōkua mua i hōʻoia ʻia ma o ke Keʻa ʻulaʻula, St John Ambulance, a i ʻole kahi mea hoʻomaʻamaʻa kūloko.

Nā alakaʻi pili