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Alveolit

ALVEOLIT

Poremecaj zarastanja koji je u literaturi poznat kao “dry socket”(“suva ALVEOLA”).

Ucestalost ove komlikacije se krece od 1,2-2,0 %.Najcesce nastaje posle vadjenja gangrenoznih i pulpiticnih zuba.Cesce u donjoj vilici u odnosu na gornju,cesce kod muskaraca nego kod zena,u prolece nego u ostalim godisnjim dobima.

Klinicka slika

Dva osnovna simptoma su odsustvo zdravog,vitalnog koaguluma i intenzivan bol.Alveola je ispunjena raspadnutim i rastresitim koagulumom,koji je prljavo sive boje,neprijatnog mirisa i koji se vrlo lako kida pincetom(alveolitis exudativa),mada alveola moze da bude i potpuno prazna(alveolitis sicca).Bol se javlja neposredno posle prestanka dejstva anestezije ili treceg i cetvrtog dana ,mada se moze javiti i nesto kasnije.

Prevencija alveolita

Pozeljno je da se zub ekstrahira sa sto manje traume,adekvatno izvrsi debridman rane.Savetuje se i preoperativno ispiranje usta blagim dezificijentnim sredstvom.Neophodno je da stomatolog ,posle vadjenja zuba,saceka da se alveola ispuni krvlju ,a ne pljuvackom.Ako je aveola suva neophodno je isprovocirati krvarenje.

Terapija alveolita:

Cilj terapije alveolita je formiranje vitalnog,elasticnog i kompaktnog koaguluma koji treba u potpunosti da ispunjava ranu i smanji neprijatan bol pacijentu.To se postize uklanjanjem delova raspadnutog koaguluma iz alveole kiretom,u lokalnoj anesteziji jer je intervencija veoma bolna.Zatim se rana ispira mlakim fizioloskim rastvorom i kiretom se isprovocira krvarenje sa citave kostane povrsine alveole,a u alveolu aplikuje neko medikamentno sredstvo koje ce smanjiti ili suzbiti bol-obicno je to neki medikament koji se resorbuje( na primer Alvogyl) ili, klasicno,jodoform-traka nakvasena rastvorom Chlumskog(koji deluje anelgeticno).

Bez obzira na aplikovani medikament,predeo alveole treba da se ekstraoralno zraci infracrvenim zracima,dva puta dnevno po 20 minuta,cime se postize vazodilatacija i bolja prokrvljenost alveole.

alveolit

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