Sock yumye (Alveolar Osteitis) vs Indwara ya nyuma yo gukuramo: Umunsi wa 3 kugeza 5 Kubabaza ugutwi no kubitaho¶

Nyuma yo gukuramo amenyo, cyane cyane yibasiwe na molar yo hepfo ya gatatu (iryinyo ryubwenge), igufwa ryamagufwa yubusa mumasaya arakira gusa mugihe ubuzima bwiza, bwijimye-butukura ** fibrin yamaraso ** yuzuza sock kandi igakomeza kuba ntangangingo nkibinyabuzima byumubiri mushya no gukura kwamagufwa. Hagati ya ** Umunsi wa 3 nu munsi wa 5 nyuma yo gukuramo **, ariko, ibibazo bibiri bitandukanye rwose birashobora kwibasira: ** alveolar osteitis (sock yumye) **, kwanduza fibrinolytike yanduye cyangwa gutandukana kwa mashini yimitsi isize ubusa, byoroshye cyane ** amagufwa ya alveolar ** yanduye amacandwe hamwe nu mwuka, pterygomandibular, cyangwa Ludwig's angina). Abarwayi bafite sock yumye bahura nubuvuzi budashidikanywaho: iminsi 2 kugeza kuri 4 yo gukira bisanzwe bikurikirwa no gutungurwa gutunguranye kwa ** bikabije, byimbitse, bikomeretsa ububabare bwa neuralgic 10/10 bwerekana urwasaya mumatwi, murusengero, ijisho, nijosi , biherekejwe nuburyohe bubi numunuko ( halitose **) hamwe nigitereko gisa nubusa cyuzuye amagufwa yambaye ubusa. Ibinyuranye, kwandura kwukuri kwa bagiteri gutera ** umusaya wo hanze ugenda utera imbere cyangwa kubyimba munsi yumusaya, umuriro, gusohora ibibyimba, ingorane zo kumira, no gukomera kwa lockjaw (trismus) ** bishobora guhungabanya inzira yumuyaga mumasaha make. Niba hari umuntu nyuma yo gukuramo amenyo afite kubyimba munsi yumusaya cyangwa ururimi, ingorane zo kumira amacandwe, ijwi ryijimye, cyangwa ikibazo cyo guhumeka, hamagara aho utuye nimero yihutirwa ako kanya. Also review our sibling guides on Ludwig angina n'indwara zinyo zinini, amenyo yakuweho no guhahamuka amenyo, na sepsis na septique.

Icyihutirwa cyawe ni ukugenzura ** ibimenyetso byerekana inzira ya bagiteri itukura (umuriro, kwagura ijosi cyangwa hasi-umunwa kubyimba, pus, cyangwa trismus ikabije) **, fata ** ibuprofen yo mu kanwa (400 kugeza 600 mg) wongeyeho acetaminofen (mg 500 kugeza 1.000 mg) ** niba ufite umutekano mubuvuzi, ** utitonda witonze umutwe wumutwe **, ntuzigere unyunyuza ingufu ** Kuvomera inshinge mumashanyarazi mashya muminsi 5 yambere **), hanyuma ubaze umuganga wawe wo kubaga umunwa cyangwa muganga w amenyo kugirango ** iminota 5 ya eugenol yimiti yambara imyenda ** igabanya ububabare bwumye bwumye muminota mike.

Kora ubu¶

1. ** Erekana ako kanya kugirango ubuzima bwugarije ubuzima bwa Deep Neck Space Infection ibendera ry'umutuku hanyuma uhamagare nomero yawe yihutirwa cyangwa ujye mubitaro byihutirwa by’ibitaro niba uhari. nimero yihutirwa niba umurwayi afite ** kubyimba bikwirakwira munsi y'urwasaya cyangwa urwasaya (umwanya wa subandibular), kuzamuka cyangwa gukomera hasi yumunwa munsi yururimi, gutemba cyangwa ingorane zo kumira amacandwe, ijwi rishyushye-ibirayi bivanze, gufunga bikabije (umunwa ufungura munsi yubugari bwintoki 1 kugeza kuri 2), gutera umuriro no gukonja, cyangwa kubyimba gufunga ijisho **.
2. ** Reba imbere muri sock yo gukuramo ukoresheje itara (utarinze ikintu icyo ari cyo cyose mu mwobo) hanyuma urebe umunsi wa nyuma ya op. rwose ufite ** sock yumye (alveolar osteitis) **.
3. ** NTUKIGERE usunika ipamba, amenyo, urutoki, ibinini bya aspirine, cyangwa amavuta ya clove adasukuye neza mumashanyarazi afunguye, kandi ntuzigere ukoresha siringi yo kuvomerera ya pulasitike igoramye muminsi 5. yambere. no gushyira ibinini bya aspirine byajanjaguwe cyangwa amavuta ya clove adasukuye kumagufa ya alveolar yambaye ubusa bitera osteonecrosis ya chimique na mucosal yaka.
4. ** Fata analgesia yo mu kanwa (Ibuprofen + Acetaminophen / Paracetamol) ako kanya mugihe utegura gusura umunsi umwe kwa muganga w’amenyo cyangwa umuganga ubaga mu kanwa. (500 kugeza 1.000 mg) ** itanga ubutabazi bukomeye kuruta ibiyobyabwenge byonyine (kandi biruta codeine yo mu kanwa cyangwa hydrocodone kubabara amagufwa y'amenyo).
5. ** Kora Passive Warm Umunyu-Amazi Umutwe-Uhengamye (Nta koga, nta gucira) kugirango ukureho imyanda y'ibiribwa ibora ivuye mu mufuka. Fata akayoga, ** uhengamishe umutwe witonze werekeza kuruhande rwo gukuramo ** kugirango ibizenga bya saline bishyushye hejuru ya sock kumasegonda 30, hanyuma ** wegamire imbere hejuru yumwobo hanyuma ufungure umunwa kugirango amazi agwe nuburemere **. Ntuzigere usunika imisaya cyangwa ngo ucire amacandwe ku gahato, kuko igitutu kibi cyo munda gikuramo imyenda isigaye.
6. ** Hamagara umuganga w’amenyo cyangwa umuganga wabaga wavanye iryinyo kuminota 5 Yumuti wumye Socket Paste / Kwambara. ubuvuzi busobanutse ni gusura ibiro bigufi, bitababaza aho muganga w amenyo asohora buhoro buhoro ibiryo byafashwe muri sock hamwe na saline sterile ashyushye hanyuma agashyira imiti yisubiraho ** eugenol / guaiacol / benzocaine imiti ivura imiti (* Alveogyl *, * Alvogyl *, cyangwa Zinc-Oxide Eugenol gauze umurongo) ** ugabanya ububabare bwumunwa wa ** kugeza kumatwi 15 kuri radiyo yambaye ubusa.

Igiti cyemezo: ububabare nyuma yo gukuramo kumunsi wa 1 kugeza 10 (gukira bisanzwe vs sock yumye vs fascial abscess)¶

flowchart TD
    A["Kubabara, uburyohe bubi, kuva amaraso, cyangwa kubyimba nyuma yo gukuramo amenyo"] --> B{"Inzira Yose cyangwa Ibendera ryumutuku ryimbitse? (Kubyimba munsi yinini, kubyutsa ururimi, gutemba, umuriro, trismus ikabije)"}
    B -->|Yes: Deep Fascial Space Infection or Ludwig's Angina| C["Hamagara EMS cyangwa ujye mubitaro ED ako kanya: IV antibiotique + kurinda inzira zo guhumeka + imiyoboro yo kubaga"]
    B -->|No airway signs, no high fever, no expanding neck swelling| D{"Nuwuhe munsi wo gukuramo ni uwuhe kandi ubona iki?"}
    D -->|Day 1 to 2: Moderate soreness, mild pink saliva oozing, soft cheek swelling peaking at 48 hrs| E["Ubusanzwe nyuma yubushakashatsi: kuruma kuri gauze itose cyangwa igikapu cyicyayi cyumukara kugirango usohoke; ice ice cyambere amasaha 24; NSAID + acetaminofeni"]
    D -->|Day 2 to 5: White or yellowish-cream soft film covering the socket WITH IMPROVING pain| F["Ubusanzwe Fibrin Granulation Tissue (SI pus, SI sock yumye): ubireke rwose"]
    D -->|Day 3 to 5: Sudden 10/10 throbbing pain radiating to ear and temple + foul odor + empty socket / bare bone| G["Sock yumye (Alveolar Osteitis): gutakaza fibrinolytike yo gutakaza amaraso"]
    D -->|Day 4 to 10: Localized gum swelling, throbbing pain, yellow pus discharge, low-grade fever| H["Ahantu Nyuma-Gukuramo Subperiosteal cyangwa Vestibular Abscess"]
    D -->|Weeks 1 to 4: Small sharp white bone sliver poking through healing gum| I["Bony Sequestrum / Alveolar Spicule: biro ntoya yoroshye cyangwa kwirukana bidatinze"]
    G --> J["Passive ishyushye yumunyu-amazi umutwe-uhengamye (nta gucira); ibuprofen + acetaminofeni; NTUKIGERE ukoresha seringe hakiri kare"]
    J --> K["Umunsi umwe w'amenyo / Gusura mu kanwa gusura: saline yoroheje yoroheje + Alveogyl / Eugenol kwambara imiti"]
    H --> L["Gusura byihutirwa / OMFS gusura: gutembera imbere & drainage + sock curettage + umunwa amoxicillin / metronidazole"]

Itandukaniro rya Clinical: Ubusanzwe Gukiza Socket vs Kuma Socket vs Indwara Yanduye¶

Pathophysiology: Then's Fibrinolytic Theory nimpamvu amenyo yubwenge yo hasi aroroshye 10x¶

Mu gihe gukanika imashini (kunywa itabi, vaping, amacandwe, cyangwa gufata inshinge hakiri kare) ari imbarutso ikomeye, ubushakashatsi bwakozwe na Dr. H. Birn bwerekanye ko uburyo bwibanze bwa ** alveolar osteitis ** ari ** biohimiki ya fibrinolysis **:

1. Birn's Fibrinolytic Cascade Imbere Amagufwa ya Alveolar¶

1. ** Imiterere yimyenda (Umunsi wa 1): ** Ako kanya amenyo amaze gukurwa, amaraso yuzuza igufwa ryamagufwa (* alveolus *) hanyuma prothrombine ihindura fibrinogen mumikorere ihuza ** fibrin meshwork ** ifata selile yamaraso itukura na platine, igafunga amagufwa mbisi.
2. ** Kurekura Abakora Tissue Kuva Ihahamuka Ryamagufwa na Bagiteriya (Umunsi wa 2 kugeza 4): ** Iyo gukuramo bisaba kuvanaho amagufwa yo kubaga (osteotomy hamwe na drill), kuzamura imizi ku gahato, cyangwa bibaye imbere ya pericoronite yabanje kubaho cyangwa bagiteri zidakira (nka * Treponema denticola * na * Porphyromonas gingivalis *) kurekura ** abakoresha plasminogen bakora (tPA) na fibrinolysine ya bagiteri **.
3. ** Guhindura Plasminogene kuri Plasmin (Dissolution Clot): ** Abakora plasminogen bahindura ** plasminogen idakora ** (ifatiwe mumyenda) muri enzyme ya proteolyique ikora ** plasmin **, ikuraho gahunda ya fibrin ifata amaraso hamwe. Kugeza ** Umunsi wa 3 kugeza kumunsi wa 4 **, imyenda yanduye yogejwe mumacandwe, hasigara isahani mbisi ya ** cribriform (lamina dura) yamagufwa ya alveolar ** yambaye ubusa rwose mumazi yo mumanwa, umwuka, nibiryo.
4. ** Impamvu Amagufa Yashyizwe ahagaragara atera ububabare bwamatwi (Imiterere ya Kinin): ** Enzyme imwe ya plasmin imwe yashonga umusemburo wa fibrin nayo ifata kininogen muri ** bradykinin *, imwe muri molekile zitera ububabare bukomeye mubuzima bwibinyabuzima bwabantu. Bradykinin na prostaglandine bikangura mu buryo butaziguye imyakura yambaye ubusa, idasukuye ** ya niveau ya alveolar (CN V3) ** impera zinyura mu rukuta rw'amagufwa yagaragaye. Kuberako imitsi ya ** auriculotemporal ** (itanga ibyiyumvo kumuyoboro wamatwi yo hanze, ugutwi, n urusengero) kumashami amwe amwe ya ** ya mandibular igabanya imitsi ya trigeminal (CN V3) ** nkumutima muto wa alveolar, ubwonko bwumurwayi bubona ibimenyetso byamagufwa nk ** ububabare bubabaza burasa mumatwi, murusengero, nijisho ** ( byitwa otalgia).

2. Kuki Ubwenge Bwubwenge Bwinyo Bwa Kurenga 80% Byose Byumye¶

Sock yumye ni ** inshuro 10 zikunze kugaragara mumasaya yo hepfo (mandible), cyane cyane molar yo hepfo ya gatatu (iryinyo ryubwenge) sock *, kuruta kumenyo yo hejuru kubwimpamvu eshatu zidasanzwe: - ** Amagufa ya Cortical Amagufwa hamwe no gutanga amaraso mabi: ** Urwasaya rwo hejuru ( maxilla ) rugizwe n'amagufwa ya spongy, vasculaire kanseri y'amaraso ava amaraso menshi kandi agaburira imyenda. Urwasaya rwo hepfo yinyuma ( rushobora * kuruhande rwumusozi wo hanze) rugizwe na ** yuzuye, umubyimba, udafite imitsi mibi yamagufwa ya cortical ** hamwe nimiyoboro yamaraso mike cyane kuri ankeri no kugaburira imyenda. - ** Gukuramo amagufwa yo kubaga no Kuzirikana kwa Flap: ** Amenyo yubwenge yo hasi yatewe akenshi bisaba kubagwa mucoperiosteal flap kuzamura, gucukura amagufwa azunguruka, no kugabana amenyo, arekura urwego rwinshi rwimikorere ya plasminogen. - ** Imbaraga za Gravity Ibiryo-Umutego Geometrie: ** Icyinyo cyo hejuru cyinyo kireba hasi, bityo uburemere busanzwe bukuramo ibice byibiribwa. Ubwenge bwo hasi bwinyo yinyo ni igikombe kireba hejuru kuruhande rwinyuma rwameza yo guhekenya, aho ibiryo byononekaye hamwe na pisine ya saliva hejuru yumwenda kandi bigatera bacteri za fibrinolytike.

3. Ibintu 6 byingenzi byingenzi bishobora kugwiza ibyago byumye¶

1. ** Kunywa itabi, Vaping (Nikotine E-Itabi), cyangwa Urumogi mu masaha 72 kugeza 120 (Yongera ibyago inshuro 3 kugeza kuri 5): ** Nikotine vasoconstricts gingival na capillaries ya magufa, imyuka ya cytotoxic yica fibroblast na osteoblasts, kandi ugashushanya igitutu cya soya itwara itabi cyangwa vape.
2. ** Ibinini byo kuboneza urubyaro (Estrogene) hamwe nigihe cyimihango (Yongera ibyago inshuro 2 kugeza kuri 3): ** Exogenous ** estrogene ** muguhuza imiti yo kuboneza urubyaro itera synthesis ya hepatike ya plasminogene kandi ikongera ibikorwa bya fibrinolytike ** (gushonga vuba vuba). Abagore bafata imiti yo kuboneza urubyaro bafite igipimo cya ** 20% kugeza 30% bya sock yumye ** nyuma yo kubagwa ubwenge buke bwo kubaga amenyo, bishobora kugabanywa muguteganya gukuramo ibintu byatoranijwe mugihe cya ** Iminsi 23 kugeza 28 ** yumubyimba wibinini (mugihe urugero rwa estrogene ruri hasi).
3. ** Kuhira imyaka ya plastike ya plastike itaragera (Mbere yumunsi wa 5 kugeza ku wa 7): ** Abaganga babaga mu kanwa bakunze guha abarwayi siringi ya pulasitike igoramye (* Monoject 412 *) kugirango bakure ibiryo mubwenge buke bwo mu menyo. ** Mugihe cyiminsi 5 yambere, umwenda utarahinduka mubice bikomeye bya fibrous granulation; guswera indege ya syringe muri sock mbere yuko umunsi wa 5 kugeza ku wa 7 uturika amaraso ahita atera ako kanya. **
4. ** Amacandwe akomeye, Gukomera mu kanwa Kwoga, cyangwa Kunywa Binyuze mu Cyatsi mu masaha 72 Yambere: ** Bitera umuvuduko mubi wa hydraulic kuruhande.
5. ** Inzoga zirimo umunwa (* Listerine *) cyangwa Hydrogene Peroxide yogeje mucyumweru cya 1: ** Ethanol yibanda cyane hamwe na hydrogène peroxide lyse ingirabuzimafatizo zitukura kandi zigashonga hakiri kare fibrin.
6. ** Indwara ya Pericoronitis cyangwa Indwara ya Periodontal yanduye iryinyo ryubwenge: ** Imizigo myinshi ya anaerobic * Treponema denticola * isohora imisemburo ya fibrinolytike itaziguye.

Ibyo bikoresho byera ni Sock Sock, Pus, cyangwa Tissue isanzwe ikiza?¶

Ku munsi wa 3 cyangwa ku munsi wa 4 nyuma yo gukuramo, abarwayi bakunze kubona ** ibintu byoroheje byera, ibara rya cream, cyangwa umuhondo-imvi zijimye zuzuza sock ** hanyuma bakeka ko bigaragara amagufwa yera (sock yumye) cyangwa pus yanduye.

Intambwe ku ntambwe ivuriro nubuyobozi bwurugo rwumye¶

1. Impamvu Ukwiye Guhamagara Umuganga wawe wamenyo cyangwa umuganga ubaga (Umuti wiminota 5)¶

• ** Ibyo muganga w amenyo akora: ** Gahunda itwara iminota itarenze 5 kandi mubisanzwe bisaba ** nta nshinge kandi nta gucukura **.
• Umuganga w'amenyo cyangwa umuganga wo mu kanwa akoresha urumogi ruvunitse kugira ngo asohokane buhoro buhoro ibiryo byangirika biva muri sock hamwe na ** ubushyuhe (dogere selisiyusi 37 / dogere 98,6 Fahrenheit) sterile 0,9% saline cyangwa 0,12% chlorhexidine **. Amabwiriza ya AAOMS hamwe na Cochrane aragira inama rwose ** kwirinda gukomeretsa kubaga (gukuramo igufwa ryambaye ubusa kugirango ugerageze kongera kuva amaraso) **, kubera ko gukuramo amagufwa yambaye ubusa bitera ububabare bukabije, bikangiza osteoblasts ikiriho, kandi bigatinda gukira.
• Ibikurikira, umuganga apakira buhoro buhoro sock hamwe nu mwambaro wihariye wa ** utuje wa sedative obtundent **, cyane cyane ** Alveogyl / Alvogyl ** (paste fibrous paste irimo ** eugenol ** [analgesic], ** butamben ** yashizwe muri ** Zinc Oxide Eugenol + Benzocaine **).
• ** Gutabarwa ako kanya: ** Kuberako imyambarire ifunga igufwa ryambaye ubusa kure yumuyaga n'amacandwe mugihe wogeje fibre trigeminal nerv fibre yagaragaye muri eugenol na anesthetic yaho, ** 80% kugeza 95% byububabare bwamatwi nububabare bwo mu rwasaya birashira muminota 5 kugeza kuri 15 **.
• Niba hakoreshejwe ikariso idasubirwaho, umuganga w amenyo arayikuraho cyangwa ayisimbuza nyuma yamasaha 48 48 kugeza 72; kwikuramo paste nka * Alveogyl * buhoro buhoro koza bonyine uko tissue granulation ikura munsi yiminsi ** 7 kugeza 10 **.

2. Umutekano murugo Imfashanyo Yambere Iri joro (Iyo Ibiro by amenyo bifunze kugeza mugitondo)¶

Niba ububabare bwumye bwa sock bwibasiye nijoro kandi wemeje ko nta ** nta bendera ritukura rya bagiteri ** (nta muriro, nta kubyimba munsi yinini, nta mwuka uhumeka cyangwa kumira ibibazo):

1. ** Fata Gahunda Yateganijwe Yumunwa Analgesia (NSAID + Acetaminophen): ** Fata ** Ibuprofen 400 kugeza 600 mg ** (cyangwa Naproxen 220 kugeza 500 mg) hamwe nibiryo bya PLUS ** Acetaminophen (Paracetamol) mg 500 kugeza 1.000 mg ** hamwe (cyangwa ukandagira buri mwana windwara ya peptide,) allergie.
2. ** Passive Warm Saline Head-Tilt Bath: ** Vanga igice cyikiyiko cyumunyu muri 240 mL (8 oz) yamazi ashyushye (cyangwa ukoreshe imiti ** 0.12% kugeza 0.2% Chlorhexidine Gluconate yoza umunwa ** niba byateganijwe numubaga wawe). Kunywa, uhengamye umutwe kugirango amazi ashyushye yogeje sock kumasegonda 30 kugirango arekure imyanda ya acide, hanyuma ureke amazi atembera mumwobo ataciriye.
3. ** Witonze byihutirwa Eugenol (Amavuta ya Clove) Pellet Pellet: ** Mugihe ** amavuta meza yindobanure adasukuye ntagomba na rimwe gusukwa mumasoko **, niba ufite ** sterile OTC amenyo yigihe gito ** arimo eugenol ivanze na pelleti (cyangwa kuvanga ** igitonyanga 1 cyamavuta ya kawusi hamwe nigitonyanga cyumubyimba wumye **) gufungura sock ** hanyuma ukaruhuka witonze hejuru ya sock muminota 15 kugeza 30 kugirango ugabanye imitsi, hanyuma uyikureho mbere yo kuryama urebe umuganga w amenyo yawe mugitondo.
4. ** Ubukonje nubushyuhe bwo hanze Kwiyunvira no Kuzamura Umutwe: ** Mugihe cya ** amasaha 24 kugeza 48 yambere ** nyuma yo gukuramo, koresha paki ya ** ** (iminota 20 kuri, iminota 20 kuruhuka) hanze yumusaya. Guhera kuri ** Umunsi wa 3 kugeza kumunsi wa 5 ** (gusa niba ** zeru zeru zanduye cyangwa kubyimba ** zihari), umwenda wa ** woroheje ushyushye wogeje wogosha ** hanze yimitsi yo mumasaya ifasha kuruhura spasitori ya kabiri. ** Sinzira umutwe wawe uzamuye umusego 2 ** kugirango ugabanye umuvuduko w'amagufwa.

Ibindi bibiri bisanzwe byihutirwa nyuma yo gukuramo: Amaraso Yisumbuye (Umwijima Wumwijima) na Spicules Amagufa¶

1. Nyuma yo gukuramo Amaraso hamwe no gufunga umwijima (Amasaha 4 kugeza 24 cyangwa Umunsi wa 5 kugeza 7)¶

1. ** Amacandwe yijimye na Amaraso Yukuri Yukuri: ** Amacandwe yoroheje yijimye yijimye mumasaha 24 kugeza 48 nibisanzwe. Amaraso nyayo akora bivuze ko amaraso yumutuku yuzuye arimo guhuriza hamwe no kuzuza umunwa mumasegonda make yohanagura sock.
2. ** Igitambaro cy'umwijima ni iki (Imyenda ya Jantly-Jelly)? Iyi ni fibrin fibrine ituzuye (** umwijima wumwijima **) unanirwa gufunga capillaries yamagufa.
3. ** Nigute ushobora guhagarika kuva amaraso mugihe umwijima wumwijima uhari: ** Witonze ** guhanagura misa ya jelly isohoka ikamanuka kugeza kurwego rwa soketi ukoresheje igice gisukuye cya gaze ya damp ** (ntucukure imbere ya bony sock ubwayo), hanyuma uhite ushyira ** umuzingo wa ** wiziritse cyane, utose wa sterile ya gazi cyangwa umufuka wicyayi wumukara ** kumanota 30 kugeza kumutwe wa ** wuzuye kugeza kuminota 30 kugeza kumutwe wuzuye.
4. ** Impamvu igikapu cyicyayi cyumukara gikora: ** Icyayi gisanzwe cyumukara (* Camellia sinensis *, ntabwo ari icyayi cyibimera) gikungahaye kuri ** tannic acide (tannine) **, ikora nkigikoresho gikomeye cyaho gikora vasoconstricts capillaries kandi byihutisha gushiraho plaque.
5. ** Niba kuva amaraso byanyuze muri gaze nyuma yiminota ibiri yikurikiranya yiminota 30 ** (cyangwa niba umurwayi afashe ** warfarin, apixaban, rivaroxaban, dabigatran, clopidogrel, cyangwa aspirine **), subira mubaganga bo mumanwa cyangwa ibitaro ED ako kanya kuri ** local 2% lidocaine hamwe na 1: 100.000 ya epinephrine yinjira muri selitifike *. .

2. Spicules Yamagufa atyaye (Alveolar Bone Sequestra) Yinyuze mu menyo (Icyumweru 1 kugeza 6)¶

Hagati ya ** 1 na 6 ibyumweru ** nyuma yo gukuramo amenyo, abarwayi bakunze kumva ** ntoya, urwembe, urwembe, rukomeye rwera rusohokera kuruhande rwikigina gikiza ** (akenshi kuruhande rwururimi rwimbere rwikariso yo hepfo) ikurura ururimi. Kurenga 95% byimanza, iyi ni ** ntabwo imizi yinyo **; ni microscopique sliver yoroheje ** alveolar sock urukuta rwamagufwa (spicule bony spicule cyangwa sequestrum) ** isanzwe isunikwa ninyama zikiza. Gupfuka ingingo ityaye hamwe na ** orthodontique igishashara ** niba ikubise ururimi, cyangwa ureke muganga w amenyo yawe akureho igufwa ryamagufwa ryoroshye mumasegonda 30 munsi ya gel.

Inomero zihutirwa zo mukarere hamwe na protocole yikigo¶

• ** Amerika na Kanada: ** Hamagara ** 911 ** ako kanya kugirango nyuma yo gukururwa nyuma yo gukuramo ijosi ryimbitse, kubyimba hasi kumunwa, ingorane zo kumira, cyangwa guhumeka. Kugira ngo wumuke wumuti cyangwa ububabare bwaho nyuma yo gukuramo, hamagara numuganga wawe wo kubaga umunwa kumasaha 24 yo guhamagara cyangwa ukurikire ** Ishyirahamwe ryabanyamerika ryabaganga bo mu kanwa na Maxillofacial Surgeons (AAOMS) ** na ** ADA ** amabwiriza yo mu biro yambara imiti ya sock (* Alveogyl * / ZOE) na analgesia ya multimodal NSAID + acetaminophen.
• ** Ubwongereza: ** Hamagara ** 999 ** kumuyaga cyangwa gukwirakwiza ibyihutirwa byihutirwa. Kumunsi wa 3 kugeza 5 wumubabaro wumye cyangwa kumena amaraso nyuma yo kuvamo, hamagara imyitozo y amenyo yakoraga cyangwa uhamagare ** NHS 111 ** kugirango ubuvuzi bwihutirwa bwumunsi umwe. Kurikiza ** NICE / SDCEP (Porogaramu ya Scottish Dental Clinical Effectiveness Programme) ** amabwiriza: sock yumye (alveolar osteitis) ivurwa hamwe no kuvomera umunyu wa ** 0.9% na * Alveogyl * kwambara bidasanzwe wongeyeho parasetamol na ibuprofen, ntuzigere usanzwe antibiyotike ya sisitemu ** keretse gukwirakwiza indwara ya bagiteri cyangwa umuriro.
• ** Umuryango w’ubumwe bw’ibihugu by’i Burayi: ** Hamagara ** 112 ** kubintu byihutirwa byanduye mu ijosi, cyangwa ubaze akarere ** Serivise y amenyo yihutirwa yo mukarere ** kumunsi umwe * Alveogyl * kwambara sock.
• ** Australiya na Nouvelle-Zélande: ** Hamagara ** 000 ** muri Ositaraliya cyangwa ** 111 ** muri Nouvelle-Zélande kubera ibihe byihutirwa byo guhumeka. Kurikiza ** Amabwiriza yo kuvura: Umunwa n amenyo (Ositaraliya) **: kuhira sock yumye witonze ukoresheje saline sterile yubushyuhe, shyira imyambaro ya obtundent yaho, hanyuma ubike antibiyotike (phenoxymethylpenicillin cyangwa amoxicillin + metronidazole) kugirango ikwirakwize indwara ya odontogenic hamwe nibimenyetso bya sisitemu.
• ** Ubuhinde, Ubuyapani, Koreya y'Epfo, na Aziya-Pasifika: ** Hamagara ** 112/108 ** mu Buhinde, ** 119 ** mu Buyapani na Koreya y'Epfo, ** 995 ** muri Singapuru, cyangwa ** 999 ** muri Maleziya na Hong Kong kubera indwara zanduye mu kirere, cyangwa usure ivuriro ry’impanuka zo mu kanwa na Maxillofacial kugira ngo zambare zinc-oxyde eugenol.

Ibibazo bikunze kubazwa¶

Nabwirwa n'iki itandukaniro riri hagati ya Sock yumye n'indwara ya bagiteri yanduye nyuma yo gukuramo?¶

Reba ibintu bitatu: umunsi wa post-op, kubyimba hanze, na feri. Sock sock (alveolar osteitis) yibasiye hagati yumunsi wa 3 nu munsi wa 5 nyuma yo gukuramo amenyo, bigatera ububabare bubabaza 10/10 butera hejuru mu gutwi no mu rusengero, impumuro mbi, hamwe nigitereko gisa nubusa gifite amagufwa yera yera yera yera, ariko NTIBIGEZE gutera umuriro mwinshi, ibibyimba byumuhondo byijimye, cyangwa kwaguka kwijosi, umusaya, umusaya. Indwara ya bagiteri yukuri itera isura nshya cyangwa ikabije mumaso cyangwa munsi yumusaya kubyimba nyuma yumunsi wa 3, umuriro, gukonja, ibibyimba byamazi biva mu menyo atukura yabyimbye, no gufunga bikabije (trismus) cyangwa ingorane zo kumira.

Kuki mbona ibintu byera cyangwa umuhondo imbere yumwobo wanjye wo gukuramo kumunsi wa 3: iyo pusi cyangwa sock yumye?¶

Niba ureba imbere muri sock yawe yo gukiza kumunsi wa 2 kugeza kumunsi wa 6 ukabona igorofa ryoroshye, ryera-ryera cyangwa umuhondo-imvi zijimye zipfuka umwobo mugihe ububabare bwawe bugenda burushaho kuba bwiza kandi udafite umuriro, ntugahagarike umutima kandi ntukureho. Urwo rwego rworoshye rwera ni fibrine nziza hamwe na granulation tissue, mubyukuri igisebe gitose kiba mumacandwe yumunwa wawe nyuma yuko pigment itukura yogeje mumaraso. Nibihabanye rwose na sock yumye kandi igomba gusigara idahungabanye rwose.

Ni ukubera iki gukoresha siringi ya pulasitike igoramye yo kuhira imiti yampaye umunwa wumye?¶

Abaganga bo mu kanwa bakunze kohereza abarwayi murugo bafite inshinge zigoramye (Monoject syringe) kugirango basukure ibiryo byafashwe bivuye mu bwenge bwo hasi bw'amenyo, ariko abarwayi bakunze gukora amakosa yo kuyakoresha ku munsi wa 1, ku munsi wa 2, cyangwa ku munsi wa 3. Mu minsi 5 ya mbere nyuma yo kubagwa, amaraso atembera mu rwasaya ni jele yoroheje; kunyeganyeza amazi yumuvuduko mwamazi mbere yumunsi wa 5 kugeza kumunsi wa 7 guturika amaraso ava mumagufwa hanyuma bigahita byuma byumye. Mugihe cyiminsi 2 kugeza 5, komeza umutwe witonze ukoresheje amazi yumunyu ashyushye hanyuma ureke bisohoke mu mwobo udaciriye; tegereza kugeza kumunsi wa 5 kugeza 7 (cyangwa itariki nyayo yo kubaga) mbere yo gukoresha syringe.

Gufata antibiyotike zisigaye bizakiza sock yumye?¶

Oya. Igeragezwa rya Clinical hamwe nubuyobozi bw amenyo yemewe kwisi yose (harimo ADA, AAOMS, na UK NICE / SDCEP) bishimangira ko sock yumye atari infection ya bagiteri; ni imiti isenya amaraso (fibrinolysis) isiga amagufwa yambaye ubusa hamwe na trigeminal nerv end end ihura n'umwuka n'amacandwe. Antibiyotike yo mu kanwa ntishobora guhagarika ububabare bwumye. Ubuvuzi bwihuse kandi bunoze ni ugusura iminota 5 kwa muganga w’amenyo cyangwa umuganga ubaga mu kanwa kugira ngo usohore imyanda y’ibiribwa byafashwe hanyuma ushireho imiti yoroheje ya eugenol (nka Alveogyl) hejuru yamagufa yambaye ubusa, ihujwe na ibuprofen yo mu kanwa na acetaminofeni.

Ni ukubera iki ubwenge bwo hasi bwinyo bwumye bwumye butuma ugutwi, urusengero, nijisho bikomeretsa cyane?¶

Amenyo yo hepfo na jawbone bitangwa nu mwijima wo hasi wa alveolar, akaba ishami ryigabanywa rya mandibular ya nervice trigeminal (Cranial Nerv V3). Iyo igufwa ryambaye ubusa imbere yubwenge buke bwinyo ryinyo ryaka kandi rikarekura imiti yububabare bwa bradykinin, ikimenyetso cyumubabaro kigenda hejuru yumutwe wa mandibular nervice, igice kimwe cyumutima kimwe gitanga imitsi ya auriculotemporal itanga umuyoboro wamatwi, ugutwi, nurusengero. Kubera ko amashami yombi asangiye inzira imwe yo hagati, ubwonko bwawe busobanura ububabare bwa jawbone bwagaragaye nkububabare bwamatwi nububabare bwurusengero kuruhande.

Nigute kuruma kumufuka wicyayi wumukara utose bifasha guhagarika kuva amaraso nyuma yo gukuramo amenyo?¶

Amababi yicyayi asanzwe (Camellia sinensis, ntabwo ari peppermint y'ibyatsi cyangwa icyayi cya chamomile) arimo aside irike ya tannic (tannine). Iyo uhanamye cyangwa ugabanya umufuka wicyayi wumukara mumazi ashyushye, ukuramo igitonyanga kirenze, hanyuma ukaruma hejuru yacyo hejuru yinyo yamenyo yamenetse muminota 30 ikomeza, umuvuduko wubukanishi uhagarika capillaries mugihe acide tannic igabanya imiyoboro yamaraso yaho kandi igafasha platine na fibrin kwihuta.

Inkomoko nubuyobozi¶

• ** Ishyirahamwe ry’abanyamerika ry’abaganga bo mu kanwa na Maxillofacial (AAOMS) n’ishyirahamwe ry’amenyo ry’Abanyamerika (ADA, Amerika): ** * Amabwiriza y’ubuvuzi ku bijyanye no kubaga Molar ya gatatu, Kwirinda no gucunga Alveolar Osteitis (Dry Socket), no kwandura indwara ya Odontogenic *.
• ** Gahunda y’amenyo ya Scottish Dental Clinical Effectiveness (SDCEP) hamwe n’ikigo cy’igihugu gishinzwe ubuzima n’ubuvuzi bwiza (NICE, Ubwongereza): ** * Gucunga ibibazo by’amenyo akomeye: Alveolar Osteitis (Sock Sock) vs Gukwirakwiza Indwara Yanduye *.
• ** Itsinda ryubuzima bwo mu kanwa: ** * Ibikorwa byaho byo gucunga Alveolar Osteitis (Dock Socket) * (Daly et al., * Cochrane Database of Systematic Review *, chlorhexidine prophylaxis na * Alveogyl * / imyambarire ya eugenol).
• ** Amabwiriza yo kuvura: Umunwa n'amenyo (Ositaraliya): ** * Ingorane zimaze gukururwa: Alveolar Osteitis, Amaraso Yisumbuye, na Odontogenic Yanduye Yanduye *.
• ** Amahugurwa ku Isi ku buvuzi bwo mu kanwa n’ishyirahamwe mpuzamahanga ry’abaganga bo mu kanwa na Maxillofacial (IAOMS): ** * Pathophysiology ya Fibrinolytic Alveolitis (Hypothesis ya Birn) na Trigeminal Referred Otalgia *.

Kuyobora¶

• Angina ya Ludwig, amenyo yinyo y amenyo, hamwe no kubyimba inzira ya subandibular
• Yatakaye ikamba ry'amenyo, ikiraro kidakabije, cyangwa cyacitse cyuzuza ubufasha bwambere
• Ibihe byihutirwa by amenyo, iryinyo ryakuweho amenyo, no kubabaza amenyo
• Sepsis na septique ihungabana kumenyekana hamwe na triage yihutirwa
• Imibare yihutirwa ukurikije igihugu