- 期刊
Facial Ecchymosis Developed after Periodontal and Implant Surgery: Report of Two Cases
牙周及植牙手術後產生顏面瘀斑：病例報告
摘要
瘀斑的形成一般是因外傷導致部分微血管破裂，血液溢出至組織中而形成。病人在接受牙科手術後，有時會在其手術區域附近的外顏部出現瘀斑，甚至延伸至眼眶下緣或頸部，尤其是某些需要將翻瓣往牙冠方向牽動來達到傷口完全密合的手術，例如引導組織再生術，引導骨再生術，植牙手術，牙塉增進術等。此篇病例報告的第一個病例是一位六十五歲的女性患者，並無牙科手術的禁忌症，同一天接受＃l3拔牙，骨引導再生術以及在＃l4，＃l6和＃l7等無牙塉處植入人工植體。手術隔天，瘀斑出現在他的右臉頰，並於接下來的幾天蔓延開來，甚至延伸至頸部，將近三週才完全消失。第二個病例是一位七十一歲的男性急者，有慢性肝炎，但肝功能和凝血功能皆正常，無牙科手術的禁忌症。＃l4因懷疑牙根斷裂，而進行探查性手術，翻開後確定牙根斷裂而予以拔除，並將翻瓣做了鬆弛性切開以達到拔牙傷口的完全密合。術後隔天，病患的右臉頰便開始產生瘀斑，並於接下來幾天瘀斑蔓延至眼眶下緣及頸部，同樣將近三週才完全消失。本病歷報告追蹤瘀斑自開始發生到消失的過程變化，探討瘀斑發生的病因，發生率，處理方式，以及可以採取的預防措施。
並列摘要
Ecchymosis is usually resulted from traumatic damage which causes blood to escape from the vascular tree and accumulate in the tissue. Ecchymosis sometimes occurs after dental surgery, such as guided bone regenerative surgery, implant surgery, or socket preservative surgery, etc. We present two cases, one of which is a 65-year-old female with no contraindication for surgery. She received extraction, GBR and dental implant surgery over upper-right quadrant on the same day. Ecchymosis first occurred on her right cheek the day after the operation and persisted for 2 to 3 weeks. The other case is a 71- year-old male with controlled hepatitis. He has normal liver and coagulative function. After he received extraction of the root fracture tooth #14 and flap advanced procedure for complete closure of the socket, ecchymosis developed on his right cheek at first, then, extending to the nasolabial fold, infraorbital area, and neck. We had monitored the appearance of the ecchymosis for 3 weeks since the lesion developed initially, till it disappeared finally. We present the changes of the ecchymosis during the healing process, and discuss its etiology, prevalence, contributing factors, as well as the way how to prevent.