牙根先脱位法拔除下颌低位水平阻生第三磨牙的微创化意义

中国口腔医学继续教育杂志 ›› 2021, Vol. 24 ›› Issue (6): 359-366.

牙根先脱位法拔除下颌低位水平阻生第三磨牙的微创化意义

王兵, 孙睿, 赵吉宏

湖北省口腔基础医学重点实验室–省部共建国家重点实验室培育基地,口腔生物医学教育部重点实验室（武汉大学）武汉大学口腔医（学）院口腔外科湖北省武汉市珞喻路237号430079

出版日期:2021-11-30 发布日期:2022-03-01
通讯作者: 赵吉宏,联系方式 13607122535,电子邮箱 jhzhao988@whu.edu.cn

Online:2021-11-30 Published:2022-03-01

摘要/Abstract

摘要： 目的评价牙根先脱位法拔除下颌低位水平阻生第三磨牙的临床效果。方法选取126例拟拔除下颌低位水平阻生第三磨牙的患者,术前曲面体层片及CBCT均显示第三磨牙为下颌低位水平阻生,随机分为试验组和对照组,其中试验组采用牙根先脱位法,对照组采用传统牙冠先脱位法,并记录相关临床资料。结果试验组与对照组在拔牙时间、术后疼痛VAS评分以及术后不良反应发生率无统计差异（P>0.05);术后30天的试验组邻近第二磨牙松动度低于对照组;术后3个月的试验组邻近第二磨牙远中及颊侧牙周探诊深度、牙根外露发生率均小于对照组,差异有统计学意义（P<0.05）。结论牙根先脱位法拔除下颌低位水平阻生第三磨牙有助于保护邻近第二磨牙牙槽嵴顶骨质,对维持其术后牙周健康具有重要的临床意义。

关键词: 下颌低位水平阻生第三磨牙, “牙根先脱位”法, 下颌第二磨牙, 牙槽骨, 牙周

王兵, 孙睿, 赵吉宏. 牙根先脱位法拔除下颌低位水平阻生第三磨牙的微创化意义[J]. 中国口腔医学继续教育杂志, 2021, 24(6): 359-366.

参考文献

[1] 胡开进. 牙及牙槽外科学 [M]. 北京: 人民卫生出版社, 2016.
[2] SYNAN W, STEIN K.Management of Impacted Third Molars[J]. Oral and maxillofacial surgery clinics of North America, 2020, 32(4): 519-59. https://doi.org/10.1016/j.coms. 2020.07.002
[3] BOULOUX G F, STEED M B, PERCIACCANTE V J.Complications of third molar surgery[J]. Oral and maxillofacial surgery clinics of North America, 2007, 19(1): 117-28, vii. https://doi.org/10.1016/j.coms.2006.11.013
[4] KUGELBERG C F, AHLSTRöM U, ERICSON S, et al. Periodontal healing after impacted lower third molar surgery. A retrospective study [J]. International journal of oral surgery, 1985, 14(1): 29-40. https://doi.org/10.1016/s0300-9785(85)80007-7
[5] CANDOTTO V, OBERTI L, GABRIONE F, et al. Complication in third molar extractions [J]. Journal of biological regulators and homeostatic agents, 2019, 33(3 Suppl. 1): 169-72. Dental supplement
[6] 赵吉宏. 现代牙槽外科新技术 [M]. 北京: 人民卫生出版社, 2017.
[7] MARCIANI R D.Complications of third molar surgery and their management[J]. Atlas of the oral and maxillofacial surgery clinics of North America, 2012, 20(2): 233-51. https://doi.org/10.1016/j.cxom.2012.06.003
[8] QI W, LEI J, LIU Y N, et al.Evaluating the risk of post-extraction inferior alveolar nerve injury through the relative position of the lower third molar root and inferior alveolar canal[J]. International journal of oral and maxillofacial surgery, 2019, 48(12): 1577-83. https://doi.org/10.1016/j.ijom.2019.07.008
[9] HILLERUP S. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases [J]. Clinical oral investigations, 2007, 11(2): 133-42. https://doi.org/10.1007/s00784-006-0089-5
[10] KIRLI TOPCU S I, PALANCIOGLU A, YALTIRIK M, et al. Piezoelectric Surgery Versus Conventional Osteotomy in Impacted Lower Third Molar Extraction: Evaluation of Perioperative Anxiety, Pain, and Paresthesia[J]. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2019, 77(3): 471-7. https://doi.org/10.1016/j.joms.2018.11.015
[11] JIANG Q, QIU Y, YANG C, et al. Piezoelectric Versus Conventional Rotary Techniques for Impacted Third Molar Extraction: A Meta-analysis of Randomized Controlled Trials [J]. Medicine, 2015, 94(41): e1685. https://doi.org/10.1097/md.0000000000001685
[12] GE J, YANG C, ZHENG J, et al. Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal: A Retrospective Study [J]. Medicine, 2016, 95(12): e3192. https://doi.org/10.1097/md.0000000000003192
[13] STATHOPOULOS P, MEZITIS M, KAPPATOS C, et al.Cysts and tumors associated with impacted third molars: is prophylactic removal justified?[J]. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 2011, 69(2): 405-8. https://doi.org/10.1016/j.joms.2010.05.025
[14] TABERNER-VALLVERDú M, NAZIR M, SáNCHEZ-GARCéS M, et al. Efficacy of different methods used for dry socket management: A systematic review [J]. Medicina oral, patologia oral y cirugia bucal, 2015, 20(5): e633-9. https://doi.org/10.4317/medoral.20589
[15] RODELLA L F, FAVERO G, BONINSEGNA R, et al. Growth factors, CD34 positive cells,fibrin network analysis in concentrated growth factors fraction [J]. Microscopy research and technique, 2011, 74(8): 772-7. https://doi.org/10.1002/jemt.20968
[16] SOHN D S, HEO J U, KWAK D H, et al. Bone regeneration in the maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone [J]. Implant dentistry, 2011, 20(5): 389-95. https://doi.org/10.1097/ID.0b013e31822f7a70
[17] ZHANG L, AI H. Concentrated growth factor promotes proliferation, osteogenic differentiation,angiogenic potential of rabbit periosteum-derived cells in vitro [J]. Journal of orthopaedic surgery and research, 2019, 14(1): 146. https://doi.org/10.1186/s13018-019-1164-3
[18] VEZEAU P J.Topical Hemostatic Agents: What the Oral and Maxillofacial Surgeon Needs to Know[J]. Oral and maxillofacial surgery clinics of North America, 2016, 28(4): 523-32. https://doi.org/10.1016/j.coms.2016.06.007