口腔颌面部感染 oral and maxillofacial infectionWord文件下载.docx

口腔颌面部感染 oral and maxillofacial infectionWord文件下载.docx

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1.oralcavity,nasalcavityandparanasalsinusareinterlinkedwiththeoutsideworldforalongtime.Thereareallkindsofbacteria.Theenvironmentofthesepartsisbeneficialtothepropagationofbacteria.Whenthebodyresistancedrops,itispronetoinfection.

2.odontogenicinfectionisauniqueinfectionoftheoralandmaxillofacialregion.Thegrowthofteethinthejaw,caries,pulpitisandperiodontaldiseaserateishigher,ifthediseasecontinuestodevelop,canbyperiapicalandperiodontaltissueinfectionspreadtothejawandjawweekcellulartissue.

3.thereislooseconnectivetissueinthefascialspaceoforalandmaxillofacialregion.Theinfectionresistanceofthesetissuesisweak,andtheinfectioncanspreadandspreadrapidlythroughthisway.

4.,thefacialbloodandlymphcirculationisabundant.Infectioncanfollowblood,causingsepticemiaorsepsis.Thefacialveinvalveisscarceorabsent,especiallytheinnercanthusveinandthepterygoidveinplexusaredirectlycommunicatedwiththeintracranialcavernoussinus,whichistheweaknessofthemaxillofacialvascularanatomy.Whentheseveinsarecrushed,itcanleadtoabloodflow.Thetriangleareaformedfromthenosetomouthonbothsidesofintraconnection,onceinfectionoccurs,thiswaycancauseseriouscomplicationsofcavernoussinusthrombophlebitis,meningitisandbrainabscess,referredtoasthe"

dangerousareaofnoseandlip"

.Theinfectionisvialymphaticspread,resultinginthedrainageareaofthelymphnodeinflammation,especiallythedevelopmentofinfantslymphoreticularsystemisnotperfect,morepronetoglandinfection.

5.,facialsweatglands,hairfolliclesandsebaceousglandsarealsothelocationofbacteria,butalsoexposedtotheoutside,vulnerabletovariouscausesofinjury,bacteriacancauselocalinfectionthroughdamagedskin.

Oralandmaxillofacialinfectionbelongstopyogenicinfection,thepathogenicbacteriaStaphylococcusaureusandhemolyticstreptococcus,followedbyEscherichiacoli,Pseudomonasaeruginosaandoccasionalcorruptionnecrotizinginfectionscausedbyanaerobicbacteria,canalsoseethespecificinfections,suchastuberculosis,syphilisandActinomycestheinfection.Aninfectioncanbeasinglepathogen,butavarietyofbacteriaareinvolved.Infectionassociatedwithmaxillofacialcavitiesisamixedinfectioncausedbyaerobicbacteriaandanaerobicbacteria.

Thediagnosisofinfectionisnotdifficult.Itcanbediagnosedbymedicalhistory,symptoms,typicalsignsofinflammationandspecialexaminationmethods,suchaspuncture,ultrasoundandimagingexamination.Whenthenatureofinfectionisclear,smearsmear,cultureofbacteria,biopsyanddrugsensitivetestcanbecarriedout.

Thetreatmentoforalmaxillofacialinfectionsinotherpartsofthebodywiththesameinfection,shouldfosterandeliminatepathogens,withsupportivetherapyandantibioticstreatment,combinedwithlocaltreatment,promotetheabsorptionofinflammation.Whentheabscessisformed,itshouldbecutanddrained,andthelesion,thedeadboneorforeignbodyshouldberemovedsoastoachievesatisfactorytherapeuticeffect.

SectionsecondofthemandibularthirdmolarPericoronitis

Mandibularthirdmolarpericoronitis（pericoronitisofthethirdmolarofthemandible）,alsoknownaschi（pericoronitisofthewisdompericoronitistooth）,referstothethirdmolarimpactionornotcompletelyadorable,inflammationofthesofttissuearoundthecrown.Commoninthe18-25yearoldyouth,DepartmentofStomatologyisacommondiseaseandfrequentlyoccurringdisease.

[a]causeisbecausehumanbeingsintheevolutionaryprocess,mandibularbodygraduallyshortened,resultinginalackofthirdmolarsadorableenoughspaceandnotthenormalpositiondeviationisadorable,onlysomeadorableorcrownteeth,atoothiscompletelyambushinthebone,whichimpactedthirdmolars.Two,becauseoftheimpactionoreruptionofthethirdmolar,thecrownofthegumispartiallyorcompletelycovered,formingadeepblindbag,fooddebrisintotheblindbagisnoteasytoremove.Thetemperatureandhumidityinthepocketofthecoronalpocketarefavorableforthegrowthandreproductionofbacteria.Whenthesofttissueofthecrownisattackedbytheeruptionofthetooth,orbittenbytheteethduringchewing,itcancausethelocalblooddisorder,andthebacteriacaninvade.Whenthebodyresistanceisstrong,thelocalsymptomsarenotobvious,

Whenbecauseofworkfatigue,lackofsleep,menstrualperiod,afterchildbirthorsomeinjuriestothebodyresistancetodecline,butacutepericoronitis.Themostcommonclinicalverticalsofttissueimpactedmandibularthirdmolarpericoronitis.

[clinicalpresentation]earlystageofinflammationonlyshoweddiscomfortofposteriormolarregion,slightpain,andnosystemicsymptoms.Wheninflammationisaggravating,localspontaneousthrobbingpain,radiationtotheearandeararea.Inflammationandmasticationofmusclearelimitedtovaryingdegreesofmouthopening,chewingandswallowingpainincreased,poororalcleaningandbadbreath.Thegeneralmalaise,fever,chills,headache,lossofappetite,constipationandothersymptoms.Routinebloodtestshowedaslightincreaseinthetotalnumberofleukocytes.

Theoralexaminationrevealedthatthemandibularthirdmolarwasincompleteorimpacted,andthesofttissuearoundthecrownwasinflamed,ulcerated,andtender.Withaprobe,thecrowncanbereachedbelowtheswollengumflap,oftenwithpurulentdischargeandsometimesacoronalabscess.Severecasescanbeseenswellingofthelingual,palatalarchandpharyngealsidewall,swellingandtendernessofthelowersubmandibularlymphnodes.

[]complicationsinsubperiostealabscessformationofretromolararea,theinfectioncanspreadtoofspace,therearethefollowingways:

diffusionofinfectiontothefront,alongtheexternalobliquevestibuleinthefirstmolarbuccalsulcusabscessformation,perforationandformationoffistula,easilymisdiagnosedasfirstmolarinfectionorperiodontaldisease;

infectionbetweenmassetermuscletheleadingandtrailingedgeoutwarddiffusionformedinfrontofbuccinatorbuccalabscess,ulcerationformedafterprolongedunhealedfistulaincheek;

infectiononmandibularlateralback,canformamasticatorspaceabscessorosteomyelitis;

infectionbackalongthemandibularbranchinside,canformthepterygomandibularspaceandparapharyngealspaceorperitonsillarabscess;

infectionofthejawbodyinnerdiffusion,canformthesubmandibularspaceabscessesandcellulitisoffloorofmouth.

[diagnosis]thecorrectdiagnosiscanbeobtainedaccordingtothemedicalhistory,theclinicalmanifestation,theoralexaminationandtheX-rayfilm.Attentionshouldbepaidtotheinfectionofthefirstmolar,thepainintheposteriormolarareaandtheabscessaroundthetonsils,andthelimitationofmouthopening.

[treatment]

Theacutestagewasmainlytreatedwithantiinflammation,analgesia,drainageandsymptomatictreatment.

Systemictreatment:

shouldpayattentiontorest,intotheflowjuicediet,garglefrequently,anduseantibioticstocontrolinfection.

Localtreatment:

3%hydrogenperoxideandsalinerespectivelyforflushingPericoronalblindbag,theninwetconditions,withaprobedippediniodinephenolor10%iodinemixtureburningblindbag,sprinklewithBingpengsanorpericoronitisfilm,alsohasanalgesic,anti-inflammatorytherapy,andimprovetheeffectofmouth.IftheformationofPericoronalabscess,abscessshouldbecutinstripsorplacedunderlocalanesthesia,iodoformgauzedrainage,infectionspreadtoneighboringgap,shouldalsomakecorrespondingclearanceincisionanddrainage.

Chronicphase:

themainreasonshouldberemoved,andtheblindbagortoothextractioncanbeeliminated.

Aftertheacuteinflammationsubsided,theblindextractionorextractionofthegingivalflapwasperformedaccordingtothespecificsituationofthethirdmolar.Generalverticalimpactedteeth,andadorableaftermasticationonhisteeth,crowncovercanberemovedtohelpouttheadorablenormalgingivalflap.Theremovaloftheblindpocketshouldberemovediftheexcisionofthegingivalflapisperformedandtheblindtoothshouldberemoved.Ifyouhaveafistulaofthecheek,youcanhealityourself.Ifyoudonotheal,youshouldeitherscratchthefistulaorperformaresectionofthefistula.

Ifthedegreeofimprovementisslow,becauseofthemaxillarythirdmolarelongation,oftenchewingtostimulatethemandibularPericoronalsofttissue,soitcanbeinthelocalanesthesiamaxillarythirdmolarextraction,eliminatethestimulusfactors,itcanrapidlyimprovethedegreeofmouthopening.

Thirdcasesofmaxillofacialspaceinfection

Maxillofacialspaceinfection（fascialspaceinfectionofmaxillofacialalsoknownasregion）isageneraltermofcellulitis,suppurativeinflammationandmaxillofacialoropharyngealregioninthepotentialgap.Diffusestagespaceinfectionknownascellulitis,purulentabscesscalledlimited.

Undernormalcircumstances,betweenvariousorganizationssuchasmaxillofacial,subcutaneoustissue,muscle,salivarygland,jaw,filledwithvaryingamountsoflooseconnectivetissueorfat,includingbloodvessels,nervesandlymphtissue,salivaryductwalking.

Thisstructurehasabufferfromthephysicalmotiongeneratedwhenthetensionandpressure,theanatomicalstructureisapotentialgap,andthegapbetweentheadjacentconnectionwitheachother.Whentheinfectioninvadesthesepotentialspaces,itcancau