The contraindications of wisdom tooth extraction.

1. Heart disease

Patients with heart disease are good in heart function. They are level I or II, and can tolerate tooth extraction and other small oral surgery. However, it is necessary to ensure that the analgesic is complete, and the patient is quiet, not excited, fear or nervous. The hemp medicine is not appropriate for 2%Lida because of the 2%Lida, but it is not appropriate to apply it if there is a transmission blocker above the II level.

1. Rheumatic heart disease

For the most common heart disease in China, heart valve is often damaged. During tooth extraction, an excessive bacteria can cause severe endometritis complications and must be prevented with antibiotics.

2. Coronary heart disease

Patients can cause serious complications such as acute myocardial infarction, atrial fibrillation, and ventricular fibrillation due to tooth extraction. Orally oral nitrate sorge glycol or nitroglycerin -containing glycerin is expanding coronary arteries.

3. Heart rate disorders

Frequent ventricular premature fighting persons are prone to increase during anesthesia and surgery. There is a possibility of ventricular fast arrhythmia. Those who should control Ⅲ degree rooms in a timely manner (ECG performance: PP intermediary period and RR interval period. The respective rhythm of each, P wave frequency is not related to each other; the P wave frequency is greater than the QRS wave frequency) should not be extracted. A complete left -bouquetal block often occurs with severe heart disease. It should be noted that bilateral blockers are more dangerous and cannot be extracted. Chronic atrial fibrillation is likely to occur in embolism, and should be extracted after controlling its condition.

4. Hypertensive heart disease

Coronary heart disease can be concurrent, accompanied by angina pectoris or myocardial infarction. The prevention measures during teeth are the same as hypertension and coronary heart disease.

5. Lung Heart disease

In the late stage, there are neck vein anger, large liver, ascites, and edema of the lower limbs. Cardiopulmonary failure should be prevented during tooth extraction. Antibiotics can be used to prevent lung infection. Give oxygen inhalation if necessary.

6. Congenital heart disease

Pay attention to prevent the occurrence of bacterial heart enditis during extraction.

7. Myocarditis

Most of them are viral. Pay attention to the prevention of heart -related accidents when extraction.

2. Hypertension

According to the recent definition of the blood pressure of WHO, <120/85mmHg is normal blood pressure;> 140/90mmHg is abnormal blood pressure; it is critical blood pressure between the two. If it is an abnormal blood pressure, it is best to surge in the surgery of downloping. When the systolic blood pressure is higher than 160 ~ 180mmHg, or the diastolic pressure is higher than 100 ~ 110mmHg, hypertension should be treated first, and the blood pressure should be reduced to 180/100mmHg before dental removal.

Patients with hypertension are prone to symptoms such as bleeding after extraction. Therefore, preparation should be made before extraction. After surgery, the antihypertensive drug should be taken routinely to control the blood pressure within the appropriate range. Pain should be guaranteed during surgery. The hemp medicine should be used to use Lida because it is appropriate. After surgery, the wound should be sutured and the hemostasis should be compressed to prevent the bleeding of the wound.

Third, hematopoietic system disease

1. anemia

The hemoglobin standard diagnosed with anemia is: adult men are less than 130g/L (13g/d1), adult women are less than 120g/L (12g/d1), and pregnant women are lower than 110g/L (11g/d1). Hemorrin is more than 80g/L (8g/d1), and red blood cell ratio is more than 30%, which can generally be extracted. Chronic anemia has good adaptability and compensation function because of the body, even if hemoglobin is low, it can tolerate general surgery.

(1) Regenerative disorder anemia:

White blood cells, platelets, hemoglobin and red blood cells are reduced during blood testing, and the coagulation time is prolonged. If the treatment has been relieved and hemoglobin is more than 80g/L (8g/dl), you can get tooth extraction.

(2) Giant cellular anemia:

If anemia is not serious, it is tolerant of tooth extraction.

(3) Iron deficiency anemia:

Anemia is not severe to tolerate tooth extraction.

(4) Hemolytic anemia:

There is a possibility of hemolysis or adrenal cortex crisis during the operation or after surgery.

2. White blood cell reduction and granulocyte deficiency

If neutral granulocytes are less than 1 × 10 (9)/L, it is easy to cause severe infection and affect wound healing, and to avoid tooth extraction and surgery. If the neutral granulocyte is above (2 ~ 2.5) × 10 (9)/L, or the total number of white blood cells above 4 × 10 (9)/L, patients can tolerate tooth extraction.

3. Alphentic disease

For the vicious diseases of the hematopoietic tissue, it accounts for about 5%of the cancerous composition ratio.

(1) Acute leukemia:

The onset of onset is the main symptoms with general pain, high fever, bleeding, and sexual anemia. The total number of white blood cells shows the number of white blood cells, and a large number of primitive white blood cells appear. Taboo for tooth extraction.

(2) Chronic leukemia:

Chronic cellular leukemia is more common. Most patients with slow granus are in a stable period after treatment. If they must be extracted, they should cooperate with specialist physicians to prevent infection and bleeding.

4. Bleeding disease

(1) Primitive platelet reduction purpura:

This disease is characterized by shortening platelet life. There is no significant swelling of the spleen, and bone marrow giant cells increase. Acute types are common in children. Sudden extensive and severe skin and mucous membrane bleeding, tooth extraction is not available at this time. Chronic types are more common, slow onset, and there may be persistent bleeding or recurrence. Tooth extraction should be selected at 50 × 10 (9)/L or more, pay attention to prevent bleeding, and stop bleeding during surgery.

(2) Hematomy disease:

It is characterized by active coagulation activation enzymes to generate disorders. The coagulation time is prolonged. Bloody friends should avoid tooth extraction. Before surgery, you should be treated with a doctor in the Department of Medicine. Enter a small amount of fresh blood or plasma daily. You can also enter anti -hemophilia galinoprotein. After the coagulation time is basically normal, remove it. During the operation, the trauma should be minimal, narrowing the wound, and the factors that were lacked closely after the operation and replenishing the lack until the wound healed. For patients with more than bleeding after tooth extraction, in addition to blood transfusion or coagulation factors, local bleeding should use absorbent pause sponges, iodine imitation gauze, or various hemostatic powder to compress the hemostasis.

Fourth, diabetes

It is a common metabolic endocrine disease with type I and II types. It is characterized by decreased blood sugar, urine sugar, and glucose tolerance. The most serious complications are cardiovascular lesions, including arteriosclerosis and microvascular lesions, which can cause hypertension, coronary heart disease, retinal arteriosclerosis, coronary arteriosclerotic heart disease, cerebral vascular accidents, etc.

When extraction, the empty blood glucose should be controlled below 8.88mmol/L (160 mg/d1). Unprecedented and severe diabetes should be temporarily extracted. Patients with diabetes are subject to insulin therapy, and tooth extraction is best to be carried out 1 to 2 hours after breakfast, so the drug effect is the best at this time. These patients often have low resistance, infection, and postoperative wounds. Therefore, trauma should be reduced. Postoperative sutures should be sutured to avoid the wound exposure in the oral cavity. Antibiotic treatment is given after surgery to prevent postoperative infection.

Fifth, hyperthyroidism

This disease is a high -functional state, which is characterized by thyroid enlargement, increased basic metabolic rate, and abnormality of autonomous nervous system. Tooth extraction may cause thyroid crisis to patients' mental stimulation or surgical infection, which may endanger life. Therefore, the tooth extraction should be considered after the control of the disease. The static pulse is less than 100 times/min, and the basic metabolic rate can be performed below+20%. Patients should be reduced during surgery to ensure good anesthesia, and a sufficient amount of antibiotics should be given before and after surgery. The adrenaline cannot be added to the anesthetic of surgery.

Six, kidney disease

Patients with acute nephropathy should temporarily extract teeth. Various chronic nephropathy should determine the degree of damage to the kidney. If it is in the compensation period of the renal function, the endogenous creatinine clearance is> 50%, and the serum creatinine <133umol/L (1.5mg/d1), the clinical asymptomatic, there is no problem with tooth extraction. However, in order to avoid deterioration of kidney function, we should pay attention to use antibiotics to prevent infection after surgery.

Patients with long -term adrenal corticosteroids can cause adrenal cortex atrophy. The stress response and resistance of this patient's body are reduced. If the tooth extraction must be given to the corticosteroids before surgery, a sufficient amount of antibiotics will be given after surgery. If infection, trauma, surgery and other stress can cause crisis, it must be rescued. About 20 hours after surgery is the most dangerous period of crisis.

Seven, hepatitis

Slow -tooth extraction should be temporarily extracted. For patients with chronic hepatitis and liver function, patients are susceptible to bleeding after extraction due to synthetic obstacles of coordinase and coagulation factors. The original time of the coagulation should be checked before surgery. If the coagalase is abnormal, it should be given a sufficient amount of vitamin K and vitamin C before surgery, and hepatotes can be preserved. Local hemostatic drugs should also be added during the operation.

If patients with liver cirrhosis are in a period of liver function compensation, liver function examination is normal or only mild abnormalities, tooth extraction is non -contraindication, but it should be noted that there may be bleeding after surgery. The remaining patients with cirrhosis are taboos of tooth extraction.

Eight, pregnancy

For patients with great pain and removal of patients during pregnancy, it is advisable to choose 4 to 6 months of pregnancy. Due to abortion 3 months before pregnancy, pregnant women have nausea, vomiting and other reactions to perform surgical operations difficult; in the next 3 months, pregnant women are prone to premature birth. Obstetrics and gynecologists should be requested before surgery to take preventive measures, such as injection of progesterone to increase safety. Avoid mental stimulation when extraction, no adrenaline is added to the anesthetic.

Nine, menstrual period

Tooth extraction during menstruation may cause compensation bleeding, and generally tooth extraction should be selected.

10. Acute inflammation period

Whether the acute inflammation can be extracted should be determined according to the nature of inflammation, the stage of progress, the system, and the difficulty of surgery. There is acute inflammation in acute crown inflammation. Tooth extraction is likely to cause trauma, which may cause infection to spread, resulting in severe systemic complications or even sepsis. If the intellectual tooth extraction of the acute crown Zhou Yan is simpler, tooth extraction will not spread the infection, and tooth extraction will help pus drainage and anti -inflammatory, and can also shorten the course of disease.

When the acute crowning inflammation is removed, it should be performed under the control of antibiotics. It should be observed closely after surgery, and antibacterial and anti -inflammatory treatment should be continued to prevent aggravation or diffusion of infection.

Eleven, malignant tumors

The teeth of the neighboring teeth around the malignant tumor or around the tumor may cause the tumor to diffuse and the wounds for a long time. It should generally be removed with the tumor during surgery. Patients who need radiation therapy should be removed from the emotional area of the radiation area 7 to 10 days before the radiotherapy. After radiation therapy, the radiation areas should be cautious when the teeth are removed, and tooth extraction should not be extracted within 3 to 5 years after radiotherapy, otherwise it may cause radioactive bone necrosis.

12. Long -term anticoagulant drug treatment

Patients who take anticoagulant drugs for a long time should be removed after the drug is closed and the original time of coagulation is removed to normal. However, if there are patients with severe or fatal embolism after stopping the drug, the drug is not advocated; at this time, the surgery should be carefully stopped, and the bleeding should be controlled by suture the wound, local hemostatic agent and local cold compress.

Thirteen, nerve mental illness

Patients with tremor paralysis and cerebral palsy often cannot cooperate, and tooth extraction cannot be implemented in a tingling state. Patients with epilepsy must be given antiepileptic drugs before the tooth extraction, and it is best to use an opening in the operation. In the case of the big hair, you should take the export inner equipment as soon as possible, flatten the surgical chair, and keep the head low, keep the respiratory tract open, and release the neckline. Give oxygen absorption and injection anti -spasm.

The contraindications of wisdom tooth extraction.

1. After the Zhizhi Crown is close to the formation or has been formed, the tilt angle of the wisdom tooth crowns on the X -ray film is not large. Zhiya can also sprout normally, and the two can establish a normal jaw relationship. Such wisdom teeth should not be removed.

2. The wisdom tooth crown and roots are close to form, and they are the intellectual tooth, but those in front of Zhiya have large caries that cannot be retained or lacking. The method of traction replace the possibility of first and second molars. Such wisdom teeth should not be removed.

3. The ambush position of Zhiya has a deep position, and there is no major damage to the surroundings. There is no obvious symptoms in the patient. Once removed, the surrounding damage is greater than the damage to ambush in the jaw bone.

4. The ambush position of Zhiya is deeper. The Zhiya is located in the upper maxlonin or its edge, in the lower alveolar nerve tube, or most of the wisdom tooth is mostly pressed on the lower alveolar nerve tube. Those who do not consider tooth extraction.

5. Smart teeth ambush is located below the neck of the second teeth or below the root of the neck, and even below the root. If Zhizhi tooth is removed, the second molar is difficult to retain. Just retain Zhiya.