中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (3): 173-178.DOI: 10.12337/zgkqjxjyzz.2025.03.009

• 病例报告 • 上一篇    下一篇

颊舌向埋伏阻生下颌第一磨牙拔除1例

张宏羽, 肖玉洁, 吴杨*   

  1. 口颌系统重建与再生全国重点实验室,口腔生物医学教育部重点实验室,口腔医学湖北省重点实验室,武汉大学口腔医(学)院口腔颌面外科
  • 出版日期:2025-05-31 发布日期:2025-05-31
  • 通讯作者: *吴杨,联系方式:027-87686110,电子邮箱:wuyang83@whu.edu.cn,通讯地址:湖北省武汉市洪山区珞喻路237号,430079

A Case of Extraction of a Buccolingually Embedded Obstructed Mandibular First Molar

Hongyu Zhang, Yujie Xiao, Yang Wu*   

  1. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Department of Oral & Maxillofacial, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei Province, P. R. China
  • Online:2025-05-31 Published:2025-05-31
  • Contact: Yang Wu. Tel: 027-87686110. Email: wuayng83@whu.edu.cn. Address: No. 237, Luoyu Road, Hongshan District, Wuhan 430079, Hubei Province, P. R. China.

摘要: 目的:报道1例颊舌向埋伏阻生下颌第一磨牙的手术拔除病例,分析术中关键操作及其对术后恢复的影响。诊治经过:术前通过锥形束计算机断层扫描评估阻生牙位置及与邻近解剖结构的关系,制定个性化手术方案。设计舌侧主开窗结合颊侧辅助开窗,逐步去骨分牙后拔除。术后密切随访,观察拔牙窝愈合情况。结果:术后即刻X线片检查未见牙体组织残留。术后3个月复查,患者拔牙区骨质呈改建状态,表明手术取得良好效果。结论:合理选择手术切口及去骨方式是提高颊舌向埋伏阻生下颌第一磨牙拔除手术成功率、减少创伤、保护邻近结构的关键所在。

关键词: 阻生牙, 下颌第一磨牙, 微创拔除, 电动手机, 拔牙术

Abstract: Objective: This article discusses a case of surgical extraction of a buccolingually embedded obstructed mandibular first molar and analyzes the key intraoperative operations and their impact on postoperative recovery. Diagnosis and treatment: Preoperative cone-beam computed tomography (CBCT) was used to assess the location of the obstructed tooth and its relationship with adjacent anatomical structures, and a personalized surgical plan was formulated. During the operation, the main lingual window was opened, combined with buccal auxiliary opening window technique, to gradually debride and split and remove the tooth. Postoperative close follow-up was performed to observe the healing of the extraction socket. Results: No residual dental tissue was seen in the immediate postoperative X-ray examination. On review 3 months after surgery, the patient’s bone in the extraction area was in a remodeled state, indicating that the surgery had achieved a good result. Conclusions: Proper selection of the surgical incision and bone removal technique is crucial for improving the success rate of impacted mandibular first molar extraction in the buccolingual direction, minimizing trauma, and protecting adjacent structures.

Key words: obstructed tooth, mandibular first molar, minimally invasive extraction, electric handpiece, tooth extraction