Clinical Observation And Prevention Of Reactive Pain And Swelling After Mandibular Impacted Tooth Extraction

Objective:Through the analysis of clinical data,the occurrence of reactive pain and swelling after the extraction of mandibular impacted wisdom teeth was studied.The clinical effect of reducing postoperative reactive pain was observed by adding arti caine locally immediately after surgery,and the clinical effect of reducing postoperative reactive swelling was observed by adding dexamethasone locally immediately after surgery.Methods:① Choose from September 2018 to May 2019,the first affiliated hospital of zhengzhou university stomatological hospital of henan province,oral and maxillofacial surgery clinic diagnosis definitely need maxillary wisdom tooth in mandible nearly pulling patients,conform to the standard of the research object,a total of 200 cases,all affected teeth with 2%lidocaine line after the alveolar nerve block anesthesia by using double disc out and minimally invasive method,The extraction was performed by the same doctor,the extraction wound was rinsed and sutured after routine treatment,and the reactive pain was recorded 1d,2d and 3d after surgery,and the reactive swelling was recorded 1d,2d and 3d after surgery.②Choose from June 2019 to February 2020 the first affiliated hospital of henan province zhengzhou university stomatological hospital,oral and maxillofacial surgery clinic diagnosis definitely need mandible impacted wisdom tooth pull out patients,are nearly in the maxillary,conform to the standard of the research object,A total of 158 cases,the patients in accordance with the order number,using the stochastic indicator method is divided into A,B two groups,each group of 79 people,All affected teeth were treated with 2%lidocaine for inferior alveolar nerve block anesthesia,followed by flap flap and minimally invasive extraction,which were removed by the same doctor.After suturing,group A,control group:routine postoperative treatment;The experimental group B was immediately injected with 1.0ml articaine locally after surgery.Another doctor(who did not know the patient’s experimental situation)was followed up at the specified time,and the pain of the patients was recorded at 2h,4h,6h,8h,and 10h after surgery.③ Choice in March 2020 to November 2020 the first affiliated hospital of henan province zhengzhou university stomatological hospital,oral and maxillofacial surgery clinic diagnosis definitely need mandible impacted wisdom tooth pull out patients,are nearly in the maxillary,conform to the standard of the research object,a total of 172 cases,the patients in accordance with the order number,divided into two groups,C,D by random indicator method,each group of 86 people,All affected teeth were treated with 2%lidocaine for inferior alveolar nerve block anesthesia,followed by flap flap and minimally invasive extraction,which were removed by the same doctor.After suturing,group C and control group were treated with routine postoperative treatment.Group D:additional injection of dexamethasone 5mg immediately after operation.The swelling of the patients was followed up at 1d,2d,3d,4d,and 5d after surgery by another doctor(who did not know the patient’s experimental situation)at the specified time.Results:① there were 180 cases of postoperative reactive pain,accounting for 90%;There were 20 cases(10%)who did not have reactive pain,and the most reactive pain occurred on the first postoperative day,and the most reactive pain occurred at 2h after the first postoperative day.Postoperative reactive swelling occurred in 182 cases(91%).There were 18 cases(9%)without reactive swelling,and the most severe swelling occurred on the second day after surgery.②1.The pain rate of group B was 63.29%,lower than that of group A(91.14%),and the difference between the two groups was statistically significant(P<0.05).2.Postoperative pain in 2hB group was significantly lighter than that in group A,and the difference was statistically significant(P<0.05);With the increase of time,reactive pain decreased in both groups,but there was no significant difference in pain scores between the two groups at 4h,6h,8h and 10h after surgery(P>0.05).③ 1.The swelling rate of experimental group D was 55.81%,lower than that of control group C(93.02%),and the difference was statistically significant(P<0.05).2.The degree of swelling in both groups reached the peak on the second day,and then showed a trend of gradual decrease.On the 2nd postoperative day,the degree of swelling in group D was significantly lighter than that in group C,and the difference was statistically significant(P<0.05).There was no significant difference in swelling score between the two groups on day 1,3,4 and 5 after surgery(P>0.05).Conclusion:① There is a high incidence of reactive pain and swelling after mandibular mesial impacted third molars extraction.It is necessary to take some measures to reduce the occurrence of postoperative reaction.② Local addition of articaine immediately after extraction of mandibular meso-middle impacted wisdom teeth can effectively reduce postoperative reactive pain.③ Local immediate addition of dexamethasone after extraction of mandibular mesial impacted wisdom teeth can effectively reduce postoperative reactive swelling.