今回は

知歯抜歯後に顔面領域へ波及した深部感染が

どれほど起きるかを調査しています。

7名の糖尿病患者を含む993名の患者に対して

局所麻酔下で抜歯を行い、抜歯後は3～4日の

抗菌薬を投与しています。

Nine hundred and ninety-three patients who underwent surgical removal of the mandibular third molars with oral antibiotic prophylaxis were examined to determine the incidence of postoperative deep fascial space infection and its background factors.

Postoperative deep fascial space infection was observed in 8 of the patients (0.8%; 4 males and 4 females), and submandibular spaces were involved in all infected patients. Only 1 of these 8 patients was an immune compromised host. Patients aged 30 years or more had a significantly higher incidence of deep fascial space infection than those aged under 30. Five patients had partial bony impactions and 3 had complete bony impactions. However, the incidence of infection according to the molar positions was not significantly different between partial bony impaction and complete bony impaction. The 8 patients had not had pericoronitis preoperatively. The clinical courses of all were favorable after antibiotics were administered intravenously.

In conclusion, the incidence of deep fascial space infection after removal of the mandibular third molars was low, at 0.8%. However, it may be desirable to remove the molars, if applicable, at a younger age because of the higher incidence of infection in patients aged over 30. The results of this study also offer information that will be useful as a basis for obtaining informed consent from patients whose mandibular third molars are to be removed.

結果、8名に感染が認められ

内、5人が半埋伏、3人が完全埋伏だったが

埋伏状態による有意差は認められなかった。

また、993人中7人に糖尿病患者が含まれていたが

いずれもコントロール良好であり

感染は認められなかった。

結論として、糖尿病患者でも糖尿病がコントロールされて

術後抗菌薬の投与を受けていれば

顔面領域へ波及した深部感染を起こすリスクはないということです。

引用文献

Yoshii T, Hamamoto Y, Muraoka S, Kohjitani A, Teranobu O, Furudoi S, Komori T.

Incidence of deep fascial space infection after surgical removal of the mandibular third molars.

J Infect Chemother. 2001 Mar;7(1):55-7.