牙周手術造成口竇瘻管之病例報告

The Oroantral Fistula in Periodontal Surgery

張儷卿(Li-Ching Chang) ； 歐陽玲(Ling Auyeung) ； 許啟森(Chi-Sen Hsu)

《中華民國牙周病醫學會雜誌》 6卷1期 (2001/03) Pp. 39-45

摘要

“口竇瘻管”常發生於上顎後牙區的拔牙、外傷及手術；但是有關牙周手術與口竇瘻管的文獻卻很少。尤其沒有牙周手術造成口竇瘻管及續發性鼻竇炎的病例追蹤報告，所以特別提出此臨床病例報告。病患為43歲男性，因左上顎臼齒區持續發炎且牙周探測深度大於7mm，所以接受牙周手術。術後一週病人抱怨有膿液從口腔流入鼻腔，而且發現左上顎第一與第二臼齒之間有滲出液，經臨床及X光檢查得知結果為“口竇瘻管”，並引發鼻竇炎；另外也採樣做細菌培養。在服用抗生素後，症狀便消失。兩年八個月後回診，囊袋深度降至3mm，X光片亦顯示缺損處有骨壁形成。由此例可知：只要去除感染源，口竇瘻管與鼻竇炎並不影響牙周手術的結果與預後，至於長期結果則需追蹤觀察。

關鍵字

口竇瘻管 ； 牙周手術 ； 牙周手術併發症

並列摘要

The oroantral fistula is a rare complication in periodontal surgery. The 43 years old male patient received conventional periodontal surgery of left maxillary premolar and molar area due to persist bleeding on probing. One week after surgery, he complained that there are discharge of pus and escape of fluid into nose. An oroantral fistula is found between the left maxillary first and second molars by ways of the clinical and X-ray finding. The results of bacterial culture are Kleb Pnenmoniae, E. coli and Viridans streptococcus. His symptom and sign disappeared by antibiotic therapy. After 32 months, the probing depth decreased to 3mm and there is bone repair in the bony defect of sinus wall. Therefore, we get a conclusion that if infections are eliminated, the result of periodontal surgery wound not be influenced by the complications of oroantral fistula and sinusitis.

並列關鍵字

oroantral communication ； periocontal surgery ； periocontal surgery complication