THIRD MOLARSURGERY

Complications and Managements of

Presenter: 黃偉家

①Contemporary Oral and Maxillofacial Surgery, 6th, 2013②Management of Complications in Oral and Maxillofacial Surgery, 2012③Oral sugery, 2007 ④A Practical Guide to the Management of Impacted Teeth, 2010⑤Oral and Maxillofacial Surgery: An Objective-Based Textbook, 2nd, 2007

乾槽症Alveolar Osteitis

第3,4 天第12 小時

纖維蛋白溶解

Management

PreventionGood surgical technique Copious irrigationChlohexidine, Tetra

Gentle irrigation Mechanical debridement ?Obtundant dressings

Pain and Swelling腫 痛

第

12小時

不超過3 天

第3 天開始消退

第

1,2天

IV steroids ?Good surgical techniqueHome care instruction

Analgesics Ice pack ?Hot pack

Management

Prevention

Infection

感染

感染機率約3%

拔牙後2~3 週

近端感染

遠端感染

近端傷口感染

遠端轉移感染

代謝疾病器官移植血液疾病

免疫低下

心內膜炎

人工瓣膜特定 CHD曾經患病

Medical historyProphylactic antibiotics ?Infection control

Antibiotics I & DReferral

Management

Prevention

Hemorrhage

出血

區域因素

全身因素

Von Willebrand disease

Myocardial infarction

Vitamin K deficiency

Atrial fibrillation

Hemophilias

Leukemia

Cerebrovascular accidents Aaspirin

Liver disease

Warfarin

本人家人藥物

Medical historyHemostasis at surgeryHome care instruction

Tea bag3 questions燒・壓・縫・綁・塞

Management

Prevention

TMD顳顎關節

Bone Fracture下頷骨折

0.0049%

Preoperative evaluationHome care instruction

Fixitionor…

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of Teeth Displacement

松下問童子言師採藥去只在此山中雲深不知處

厚薄

舌側 頰側

Submandibular space

下頷舌骨肌Mylohyoid muscle

頷下間隙

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ComplicationNeurologic

舌神經

下齒槽神經

Lingual nerve

Inferior alveolar nerve

!

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Thanks for attention