航海人员洁治术对干槽症的影响及原因分析

目的　探讨干槽症发病的相关因素和预防航海人员干槽症发生的方法。方法　对 4 6 8例需要拔除双侧下颌阻生智齿的航海人员在无拔牙禁忌证的情况下分次进行拔牙手术 (相隔时间 2个月以上 )。第 1次拔牙前不进行特殊术前准备 ,第 2次术前进行全口龈上下洁治术 ,术后 3～ 5 d拔牙。 2次拔牙前均牙菌斑取样检测幽门螺杆菌 (Helicobacter pylori,H.Pylori)。结果　第 1次拔牙后 78颗发生干槽症 ,占 16 .6 7% ;第 2次拔牙后仅 9颗发生干槽症 ,占 1.92 % ,差异非常显著 (P<0 .0 1)。牙菌斑 H.py-lori检测结果 2次拔牙前阳性率分别为 5 4 .2 7% (2 5 4 / 4 6 8)和 14 .74 % (6 9/ 4 6 8) ,差异亦有显著性 (P<0 .0 5 ) ,且所有发生干槽症的手术拔牙前牙菌斑 H.Pylori检测均为阳性。结论　口腔幽门螺杆菌感染可能是航海人员干槽症发病率高的原因 ,术前口腔洁治可以有效预防拔牙术后干槽症的发生。

Influnce and analysis of oral prophylaxis to dry socket in seamen

Objective To investigate the pathogeny of dry socket and causes for a high incidence of dry socket in seamen.Methods A total of 468 seamen with 2 impacted third molar were studied.The 2 teeth were extracted separately in 2 mouths.The first time,the left impacted third molars were extracted with no oral prophylaxis;the second time,the right third molars were extracted after gingival curettage.The helicobacter pylori(H.Pylori) in dental plaque were detected by polymerase chain reaction (PCR) before extraction.Results 78(16.67%) of the 468 seamen suffered from dry socket after the first extraction,and 9(1.92%) suffered from dry socket after the second extraction,and highly significant difference was shown( P <0.01).The positive H.Pylori in their dental plaque were 54.27% and 14.74% for the two times,and there were significant difference( P <0.01).Conclusions H.Pylori perhaps is one of the pathogenic factors for the pathogenic process of dry socket.The bad oral hygienic condition and the high H.Pylori positive rate in seamen mouth may be one of the causes for the high incidence of dry socket in seamen.Oral prophylaxis before extraction can prevent dry socket effectively.