Severe third molar complications including death-lesson from 100 cases requiring hospitalization
Severe third molar complications including death-lesson from 100 cases requiring hospitalization
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DOI：
10.1016/j.joms.2007.04.014
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发表时间：
2007-09-01
影响因子：
1.9
通讯作者：
Wagner, Wilfried
中科院分区：
文献类型：
--
作者：
Kunkel, Martin;Kleis, Wilfried;Wagner, Wilfried
目的：在这项研究中，我们调查了因第三磨牙（M3）并发症住院的患者。具体来说，我们分析了频率，年龄分布，和结果方面的M3临床status.Patients和方法：我们建立了一个前瞻性队列研究，包括100例受试者入院管理急性M3相关并发症。M3的临床状态定义为1）预防性M3切除，2）治疗性（非选择性）M3切除，或3）入院时存在M3。结果变量为临床感染标志物（C反应蛋白、白细胞计数）和经济参数（治疗费用、住院时间和残疾天数）。非参数检验用于比较亚群（手术与非手术，松弛相关与非松弛相关）。共有80例严重感染，11例下颌骨骨折，3例神经损伤，5例牙齿/牙根脱位，1例术后出血。27例并发症来自预防性手术，44例来自非选择性切除，29例来自冠周炎。术后，一名77岁的男性患者因非选择性切除术住院，持续发生致命性心肌梗死。治疗费用为260，086 C（平均2，608（原文如此）/例）;总残疾天数为1，534天。术后并发症表现出较高的C-反应蛋白值相比，冠周炎引起的complications.Conclusions：在集水区，我们的机构，大部分的并发症，需要住院治疗，导致患病的第三磨牙或其删除。观察性策略的副作用，如并发症向更高年龄的转移，值得未来关注。(C)2007年美国口腔颌面外科医师协会。
Purpose: In this study we investigated patients that were hospitalized due to third molar (M3) complications. Specifically we analyzed frequency, age distribution, and outcome with respect to the M3 clinical status.Patients and Methods: We set up a prospective cohort study and included 100 subjects admitted for management of acute M3-associated complications. The clinical status of the M3 was defined as 1) prophylactic M3 removal, 2) therapeutic (nonelective) M3 removal, or 3) M3 present at the time of admission. Outcome variables were clinical infection markers (C-reactive protein, leukocyte counts) and economic parameters (treatment costs, length of hospital stay, and days of disability). Nonparametric tests were used for comparison of subpopulations (surgical vs nonsurgical, prophylaxis-related vs nonprophylaxis-related).Results: One third of the 100 patients were age 40 or older. Overall 80 severe infections, 11 mandibular fractures, 3 nerve injuries, 5 tooth/root luxations, and 1 postoperative hemorrhage were noticed. Twenty-seven complications resulted from prophylactic surgery, 44 from nonelective removal, and 29 from pericoronitis. Postoperatively, a 77-year-old mate patient hospitalized with nonelective removal sustained fatal myocardial infarction. Treatment costs were 260,086 C (mean 2,608 (sic)/case); total days of disability were 1,534. The postsurgical complications showed higher C-reactive protein values compared with pericoronitis-induced complications.Conclusions: Within the catchment area of our institution, the majority of complications requiring hospitalization resulted from diseased third molars or their removal. Side effects of observational strategies such as the shifting of complications to higher ages deserve future attention. (C) 2007 American Association of Oral and Maxillofacial Surgeons.