Dental alveolitis ndizovuta zomwe zimachitika pambuyo pochotsa dzino. Pali mitundu itatu ya socket youma: socket youma, socket yowonjezera, yomwe imakhala ndi mafinya, ndi patchy osteic socket, yomwe imakhudza fupa ndi kuwonekera patatha sabata lachitatu mutachotsa. Zomwe zimayambitsa zimakhalabe zosamvetsetseka, koma zimagwirizanitsidwa ndi machiritso osauka, choncho ndi vuto lokhudzana ndi magazi omwe amayenera kupanga pamene dzino lachotsedwa. Chithandizo chilipo; Dry socket, yomwe imakhala yofala kwambiri, nthawi zambiri imapita patsogolo pang'onopang'ono kupita kuchira pakatha masiku khumi. Ma analgesics adzakhala ndi cholinga chochepetsa ululu, womwe ungakhale wovuta kwambiri. Nthawi zina maantibayotiki amagwiritsidwa ntchito.

Tanthauzo la socket youma

Dental alveolitis ndizovuta zomwe zimachitika pambuyo pa kuchotsedwa kwa dzino. Matendawa amakhudza zitsulo, zomwe ndi nsagwada zomwe zimayikidwa dzino.

Izi alveolitis zotsatirazi m'zigawo ndi chifukwa kutupa khoma la alveolus. Dry socket ndi yofala kwambiri pambuyo pochotsa mano anzeru, ndipo makamaka a mandible, ndiko kunena za nsagwada zapansi.

Zomwe zimayambitsa socket youma

Pali mitundu itatu ya alveolitis: socket youma, socket suppurative, ndi patchy osteitic alveolitis (yokhudzana ndi matenda a mafupa). Etiology yawo imakhalabe nkhani yofunsidwa mafunso, chifukwa maphunziro ochepa alipo. 

Alveolitis, komabe, imafotokozedwa ndi kusapanga bwino kwa magazi omwe, pamene dzino lachotsedwa, liyenera kulola kuchiritsa.

Dry socket, or dry socket, ndi mtundu wofala kwambiri wa alveolitis, chifukwa chake, zovuta za pambuyo pochotsa. Mapathogenesis ake sanafotokozedwe bwino, malingaliro atatu amayesa kufotokoza zomwe zimayambitsa:

• Zitha kukhala zokhudzana ndi kusakhalapo kwa mapangidwe a magazi, chifukwa cha magazi osakwanira ozungulira alveolus, makamaka pa mlingo wa mandible, fupa lomwe limapanga nsagwada zapansi. 
• Zitha kukhalanso chifukwa cha kuwonongeka kwa magazi oundana pambuyo povulala pambuyo pochotsa dzino.
• Zitha kuchitika chifukwa cha lysis ya magazi kuundana. Ichi ndi chiphunzitso chofala kwambiri. Izi, kapena fibrinolysis, zimachitika chifukwa cha michere (mapuloteni omwe amatha kupangitsa kuti zinthu zichitike), omwe amapezeka m'mphepete mwa mucosa wapakamwa, makamaka. Itha kuyambitsidwanso ndi fupa lomwe limapangidwa ndi kutulutsa, komanso ndi tizilombo tating'onoting'ono ta m'kamwa, monga. Treponema denticola. Komanso, mankhwala monga odana ndi kutupa mankhwala ndi kulera pakamwa, kapena fodya, yambitsa fibrinolysis. 

Suppurative alveolus amayamba chifukwa cha superinfection ya socket, kapena clot yomwe imapangidwa pambuyo pochotsa. Zimavomerezedwa ndi:

• kusowa kwa asepsis (chitetezo ndi njira zopewera matenda);
• kukhalapo kwa zinthu zakunja monga mafupa, mano, kapena zinyalala za tartar;
• matenda amene analipo kale pamaso m'zigawo, kapena anaonekera pambuyo m'zigawo;
• matenda ochokera ku mano oyandikana nawo;
• ukhondo wapakamwa wosauka.

Pomaliza, patchy osteic alveolite (kapena 21st day cellulitis) amayamba chifukwa cha superinfection ya granulation minofu (minofu yatsopano yomwe imapangidwa potsatira zipsera, ndipo imathiriridwa kwambiri ndi mitsempha yaying'ono yamagazi). Kutengera kwake? Zimachitika pafupifupi sabata lachitatu pambuyo pochotsa dzino. Itha kuphunzitsidwa ndi:

• kukhalapo kwa zinthu zakunja, monga zinyalala za chakudya.
• kugwiritsa ntchito mosayenera mankhwala oletsa kutupa (NSAIDs) pambuyo pa opaleshoni.

Matenda a soketi youma

Ndi dotolo wa mano amene angathe kupanga matenda a mano alveolitis, makamaka potsimikizira kusakhalapo kwa magazi muzitsulo za dzino lomwe linachotsedwa.

• Dry socket imapezeka maola angapo, kapena mpaka masiku asanu kuchokera pamene dzino lachotsedwa. Zizindikiro zoyamba zimatha kuyambitsa matenda, monga kutopa ndi zowawa.
• Suppurative alveolitis amapezeka pafupifupi masiku asanu pambuyo m'zigawo, ndipo matenda ake akhoza kupangidwa makamaka ngati malungo 38 mpaka 38,5 ° C limodzi ndi ululu, zochepa kwambiri kuposa nkhani ya socket youma.
• Kuzindikira kwa patchy osteic alveolitis kudzapangidwa pakachitika malungo, komanso kuyambira 38 mpaka 38,5 ° C, komanso kutsagana ndi ululu womwe wapitilira kwa masabata awiri.

Anthu okhudzidwa

Dry socket ndizovuta kwambiri zochotsa mano: zimakhudza 1 mpaka 3% ya odwala omwe achotsedwa mosavuta, ndi 5 mpaka 35% ya odwala omwe amatsatira opaleshoni.

Nkhani yomwe ili pachiwopsezo chachikulu chokhala ndi socket youma, socket youma, akuti ndi mayi wazaka zapakati pa 30 mpaka 50, wopsinjika, yemwe amamwa njira zakulera zapakamwa, komanso ukhondo wake wamkamwa ndi wosauka. Chiwopsezo chimamuchulukirachulukira ngati dzino loti achotsedwe ndi nsagwada ya m'munsi - kapena dzino lanzeru.

Kusakhala bwino kwa aseptic panthawi ya opareshoni ndiye chiwopsezo chachikulu cha socket youma, monganso ukhondo wamkamwa. Komanso, akazi sachedwa kutero, makamaka pamene kumwa mankhwala kulera m`kamwa.

Zizindikiro zazikulu za socket youma

Dry socket kumachitika patatha maola angapo, ndipo mpaka masiku asanu pambuyo pochotsa dzino. Chizindikiro chake chachikulu chimadziwika ndi ululu wosiyanasiyana. Izi nthawi zina zimakhala zowawa zazing'ono, zosapitirira, zomwe zimawonekera kukhutu kapena kumaso. Koma nthawi zambiri, zowawazi zimakhala zamphamvu komanso zosalekeza. Ndipo amakhala ocheperako pang'ono komanso osakhudzidwa kwambiri ndi ma analgesics a Level 1 kapena Level 2.

Zina mwa zizindikiro zake:

• kutentha pang'ono (kapena febrile), pakati pa 37,2 ndi 37,8 ° C;
• kutopa pang'ono;
• kusowa tulo komwe kumakhudzana ndi ululu waukulu;
• mpweya woipa (kapena halitosis);
• makoma otuwa-oyera a cell, okhudzidwa kwambiri ndi kukhudza;
• kutukusira kwa akalowa kuzungulira zitsulo;
• fungo loipa lochokera pa soketi pakuswa.

Nthawi zambiri, kuyesa kwa X-ray sikuwulula chilichonse.

Zizindikiro zazikulu za alveolitis suppurativa

Suppurative alveolitis nthawi zambiri imachitika patatha masiku asanu dzino litachotsedwa. Zowawa ndizochepa kwambiri kuposa za socket youma; iwo ndi ogontha, ndipo amawonekera ndi zilakolako.

Zizindikiro zake zina:

• kutentha kwapakati pa 38 ndi 38,5 ° C;
• kukula kwa ma lymph nodes (otchedwa satellite lymphadenopathy);
• kutupa kwa vestibule (gawo la bony labyrinth wa khutu lamkati), kaya kapena ayi kugwirizana ndi fistula mu mucous nembanemba kuzungulira zitsulo;
• zitsulozo zimadzazidwa ndi magazi, okhala ndi mtundu wa bulauni kapena wakuda. Soketiyo idatuluka magazi, kapena kusiya mafinya onyansa atuluke.
• makoma a selo ndi ovuta kwambiri;
• pansi pa socket, mafupa, mano kapena tartaric zinyalala zimapezeka kawirikawiri.
• Kukula sikungathetseretu, ndipo kungayambitse zovuta, monga patchy osteic alveolitis.

Zizindikiro zazikulu za patchy osteic alveolitis

Chiwembu cha osteic alveolitis chimayambitsa kupweteka kosalekeza mkati mwa masiku khumi ndi asanu pambuyo pochotsa. Ululuwu umatsagana ndi:

• kutentha kwa 38-38,5 ° C;
• nthawi zina kulephera kutsegula pakamwa pako (kapena trismus);
• asymmetry ya nkhope, chifukwa cha cellulitis kuzungulira nsagwada zapansi, ndiko kuti, matenda a mafuta a nkhope;
• kudzazidwa kwa vestibule;
• kukhalapo kapena ayi kwa khungu fistula.
• X-ray, kawirikawiri, imasonyeza kuchotsedwa kwa fupa (chidutswa cha fupa chomwe chimachotsedwa, ndipo chataya vascularization ndi kusungidwa kwake). Nthawi zinanso, x-ray iyi siwulula chilichonse.

Chisinthikocho chikhoza kuchitidwa pakuchotsa kwa sequestrant, popanda chithandizo. Zingayambitsenso matenda opatsirana kwambiri.

Chithandizo cha socket youma makamaka chimakhala ndi mpumulo wopweteka, by analgesics. Machiritso a thupi, kapena kusintha kwachidziwitso ku machiritso, kawirikawiri kumachitika pakadutsa masiku khumi. Nthawi yomwe ingafupikitsidwe ngati wodwalayo akulandira chithandizo.

Chitsulo chowuma ichi ndi chomwe chimapezeka kawirikawiri, ndipo chimakhala chodzidzimutsa kuchipatala cha mano: ndondomeko zayesedwa, kuti zichiritse. Mayesero awiri, mwachitsanzo, adachitidwa ndi gulu lochokera ku Abidjan consultation and odonto-stomatological treatment center ndipo ali ndi:

• Ikani mavalidwe mkati mwa socket, pogwiritsa ntchito bacitracin-neomycin pamodzi ndi eugenol.
• Ikani chovala cha ciprofloxacin (m'makutu ake) pazitsulo zowawa.

Chithandizocho cholinga chake ndikuchiritsa socket.

M'malo mwake, machiritso a socket youma amakhala pamwamba pa zonse zoteteza (kuphatikiza kuthetsa zomwe zingayambitse). Iwo amachiritsanso:

• Machiritso a suppurative ndi osteitic alveolitis amachokera ku mankhwala opha tizilombo, ma analgesics, ndi chisamaliro chapafupi, monga kuchapa ndi saline kapena antiseptic solution, komanso kuvala kwapakati pa alveolar.
• Pakuti suppurative alveolitis, ngati m`deralo chisamaliro ikuchitika mofulumira kwambiri, ndipo pakalibe malungo, mankhwala mankhwala si koyenera.
• Pazitsulo zowuma, maantibayotiki angapo, omwe amagwiritsidwa ntchito okha kapena ophatikizana ndi zinthu zina zosiyanasiyana, alipo, omwe amalimbikitsidwa kwambiri ndi tetracycline ndi clindamycin. Komabe, Afssaps samalimbikitsa kugwiritsa ntchito maantibayotiki, mwa anthu ambiri, kapena odwala omwe alibe chitetezo chokwanira, pochiza socket youma; Iye amalangiza izo kokha milandu mkulu chiopsezo cha matenda endocarditis, mpaka mucosal machiritso.

Kuonjezera apo, mafuta ofunikira a clove osungunuka mu mafuta a masamba, monga mafuta a azitona kapena mafuta a kokonati, ndi kuikidwa pa socket, malinga ndi odwala ena, amatha kupweteka, kapena kuchiritsa socket youma. Komabe, ndikofunikira kusamala kuti muchepetse mafuta a clove awa. Mafuta ofunikirawa, motero, ndi mankhwala achilengedwe, akatswiri azitsamba amakhulupirira. Komabe, sayenera kuperekedwa kwa amayi apakati ndi ana, kapena m'malo mankhwala ena amene dokotala wa mano.

Ukhondo wabwino wamkamwa musanayambe ndondomeko, komanso mikhalidwe yabwino ya aseptic panthawi yochotsa ndi zina mwazofunikira zodzitetezera ku socket youma.

Pofuna kupewa zitsulo zouma, zomwe zimakhala zowawa kwambiri, malangizo operekedwa ndi dokotala atatha kuchotsa dzino ayenera kutsatiridwa mosamalitsa, monga:

• sungani compress pazitsulo ndikusintha nthawi zonse, kwa maola awiri kapena atatu. Izi zidzalimbikitsa mapangidwe a magazi;
• osatsuka pakamwa pako kwambiri;
• osalavula;
• samalani potsuka mano, ndipo pewani kusisita pafupi kwambiri ndi tsinde la dzino lochotsedwa;
• musadutse lilime kumene kuchotsedwako kunachitika;
• kutafuna kutali ndi malo omwe adachotsedwapo dzino;
• potsiriza, kusuta kuyenera kupewedwa kwa masiku osachepera atatu.