발치 후 합병증, 드라이 소켓 예방!

발치 후 합병증, 드라이 소켓!

 

드라이소켓(dry Socket)이라고 하니까 별거 아닌 것 같지만 다른 말로 하면 ‘치조골염(Alveolar Osteitis)’입니다. 치아를 뽑은 자리에 염증이 생겨 붓고 아픈 발치 후의 합병증을 말합니다.

 

드라이 소켓 발생빈도

 

연구 논문에 따르면 가장 흔한 발치 후 합병증은 치조골염(드라이 소켓)으로 일반적인 발치는 1.7%~3% 정도, 매복치(사랑니) 발치의 경우 15~37%까지 발생하며, 주로 하악 구치부(아래턱 어금니 쪽)에 많이 발생합니다.

 

드라이 소켓의 증상

 

∙발치 후 이틀 후에도 통증이 끊이지 않고 오히려 증가함
∙진통제에도 통증이 경감되지 않음
∙빈 발치와(혈전이 없고 골이 노출되어 있음)
∙액화 된 혈전
∙악취
∙역겨운 맛
∙귀쪽(뼈)으로 통증이 전이되는 경우도 있음

드라이소켓의 원인

 

∙흡연
∙혈액 공급의 감소
∙발치 후 환자의 과도한 헹굼
∙단순발치보다 수술 발치시 발생 빈도가 높음
∙세균에 의한 감염(플라그, 치석, 불량한 구강 위생 상태 등)
∙음식물찌꺼기
∙장시간의 환부에 압박을 가한 발치
∙경구 피임약 복용기간
∙발치 후 구토

 

발치 후 드라이소켓 예방에 베나셀 지혈거즈!

혈액과 접촉시 끈적한 젤라틴 스카폴드화 하여 즉시 혈병을 형성하고 상처를 보호합니다. 수분과 만나 끈적해 지므로 흘러내리거나 빠지지 않아 상처부위를 지속적으로 보호 합니다.

베나셀은 아스피린®등의 혈액희석제를 복용하는 환자의 지혈에도 매우 효과적입니다.

Gen Dent. 2015 May-Jun;63(3):17-21.

A retrospective study on the use of a dental dressing to reduce dry socket incidence in smokers.

Murph JT Jr, Jaques SH, Knoell AN, Archibald GD, Yang S.

Abstract

This study assessed the effectiveness of using an oxidized cellulose dental dressing in order to reduce the rate of alveolar osteitis after posterior tooth extraction in smokers. Dry socket incidences of heavy smokers from 4 independent dental clinics, which routinely used oxidized cellulose dental dressings to mitigate dry socket formation between March 2011 and December 2012, were compiled and evaluated. All extraction sites healed uneventfully except for those cases that developed dry sockets. Overall, 1.7% of male patients and 2.2% of female patients developed dry sockets. No conclusive relationship was found between the number of cigarettes smoked and dry socket formation among patients in this study. The results of this study were consistent with the view that gender, age, postextraction regimen, and multiple extractions affect dry socket formation. The results indicate that an oxidized cellulose dental dressing postextraction is a safe and effective method for mitigating dry socket formation among smokers.

BenaCel® dental dressing is made of biocompatible oxidized cellulose and contains no chemical additives. BenaCel® dental dressing adheres to moist oral mucosa and forms a temporary barrier protecting the wound from further irritation and pain. When placed in the extraction socket, BenaCel® dental dressing forms a gelatinous scaffold in the blood extrude, facilitating the development of a stable blood clot to prevent dry socket formation.

BenaCel® dental dressing is designed for use in the extraction site and the management of bleeding and alveolar osteitis (dry socket). It may also be used as a wound dressing for the temporary management of oral surgical wounds, such as operative, postoperative, donor sites and traumatic injuries.

Benacel-Retrospective-StudyRGB.pdf

 

Q & A WITH AN EXPERIENCED BENACEL® USER

Dr. Tommy Murph, author of "Extraction Guide for the Exodontist", Hands on Extraction Course Director, Inventor the "Dr. Murph Crane Pick"
Conway, South Carolina

1. How long have you been an exodontist?
   • 25 years
2. How long have you used BenaCel® Dental dressing? What do you use BenaCel® mostly for?
   • Over 7 years
   • Prevention of Dry Sockets
3. Prior to BenaCel® Dental Dressing, what products did you use and why did you decide to switch to BenaCel® Dental Dressing?
   • Gel-Foam mostly. Benacel is so much easier to use and costs less.
4. There are several configurations of BenaCel®. How do you decide which configuration is preferred for each case?
   • Very Simple...Size one is for small conical sockets, Size 2 is for lower molars and buccal roots of upper molars, Size 3 is for Large conical roots and sinus perforations
5. Is BenaCel® easy to use and what is the best way to use it?
   • Very Easy too use. Many new BenaCel® users don't put it in deep enough. You have to pack it down into the socket so it doesn't come out
6. How long does it takes for BenaCel® to resorb?
   • It varies from 1 to 2 weeks, or more, depending on the amount of BenaCel® used and bleeding conditions.
7. After placing BenaCel® in the socket, do you retain the material with sutures? If so, what sutures do you use and how do you place the sutures to retain BenaCel®?
   • Only if there is a sinus perforation to prevent the material from dislodging into the sinus space. Chromic Gut is my suture of choice and I run the suture through the hole in the size 1 and 3 BenaCel® before closing a sinus perforation.
8. Have you used BenaCel® on patients who take blood thinner, such as Aspirin® or Coumadin®?
   • BenaCel® is mandatory for any patient on a blood thinner. Just common sense that you want to do everything possible to get a clot and maintain a clot in this patient group.
9. Have you used BenaCel® for any another purpose, other than bleeding and dry socket management?
   • I use it mainly for dry socket prevention, but you can use it to TREAT a dry socket that presents to your office by cleaning the socket, packing with BenaCel® and then suturing the socket closed.
10. Have your patients encountered any allergic reactions or complaints due to BenaCel®?
    • Never, on the contrary we have had some patients report to us that they had STOPPED smoking and wondered if the material had any chemical composition that would make them not want to smoke. As far as I know it doesn't, but we tell them Congratulations, glad we could help you stop smoking.

Benacel-Retrospective-StudyRGB.pdf

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