超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙临床效果的Meta分析

doi:10.12337/zgkqjxjyzz.2025.03.003

中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (3): 133-141.DOI: 10.12337/zgkqjxjyzz.2025.03.003

超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙临床效果的Meta分析

李凯^1,2, 罗宁洁^1,2, 白希婧^1,2,*

¹天津市口腔医院口腔颌面外科,南开大学医学院;
²天津市口腔功能重建重点实验室

出版日期:2025-05-31 发布日期:2025-05-31
通讯作者: ^*白希婧,联系方式：022-59080561,电子邮箱：baixijing2009@163.com,通讯地址：天津市和平区大沽北路75号,300041
基金资助:
天津市临床医学重点学科（口腔医学-口腔颌面外科学专项基金）（项目编号：HWZX016）

Combined Application of Piezosurgery and Rotary Instrument for Impacted Mandibular Third Molar Extraction: a Meta-analysis

Kai Li^1,2, Ningjie Luo^1,2, Xijing Bai^1,2,*

¹Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, P.R. China;
²Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, P.R. China

Online:2025-05-31 Published:2025-05-31
Contact: Xijing Bai. Tel: 022-59080561. Email: baixijing2009@163.com. Address: No.75 North Dagu Road, Heping District, Tianjin 300041, P.R. China.
Supported by:
Tianjin Key Clinical Discipline (Special Fund for Stomatology with Oral and Maxillofacial Surgery) (No.HWZX016)

摘要/Abstract

摘要： 目的：采用Meta分析评价超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙的临床效果。方法：计算机检索中国知网、万方数据知识服务平台、中文科技期刊数据库、SinoMed、PubMed和Web of Science数据库,搜集超声骨刀联合高速外科手机（试验组）与单纯应用高速外科手机（对照组）拔除下颌中低位阻生第三磨牙临床效果的随机对照试验（randomized controlled trial,RCT）,检索时限均从建库至2024年12月24日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件和Stata 11.0软件进行Meta分析。结果：共纳入11个RCT,包括试验组454例,对照组454例。中文RCT研究Meta分析显示试验组手术时间较对照组缩短1.92min,但差异无统计学意义;英文RCT研究Meta分析显示试验组手术时间较对照组延长5.79min,差异有统计学意义。术后疼痛采用视觉模拟量表（visual analogue scale,VAS）进行评分,术后前2 天试验组疼痛VAS评分显著低于对照组,术后前3天试验组张口度大小优于对照组,术后第5天和第7天两组疼痛VAS评分和张口度大小无显著性差异。术后1周内试验组张口受限发生率、面部肿胀发生率均低于对照组,术后3天内试验组面部肿胀程度与对照组无显著性差异。结论：目前证据显示超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙可减轻术后疼痛反应和张口受限程度。

关键词: 超声骨刀, 高速外科手机, 下颌阻生第三磨牙, 临床效果, Meta分析

Abstract: Objective: To systematically review the efficacy and complications of impacted mandibular third molar extraction with combined application of piezosurgery and rotary instrument. Methods: CNKI, WanFang Data, VIP, SinoMed, PubMed and Web of Science databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and complications of combined application of piezosurgery and rotary instrument (experimental group) versus rotary instrument alone (control group) in extracting impacted mandibular third molar from inception to December 24th, 2024. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Then, a meta-analysis was performed by using Revman 5.3 software and Stata 11.0 software. Results: A total of 11 RCTs involving 454 cases in experimental group and 454 cases in control group were included. The results of meta-analysis showed that the operation duration was shorter in experimental group based on Chinese RCTs and longer based on English RCTs, the pain Visual Analog Scale (VAS) was lower in post-operative 1st and 2nd day and the MIO (maximal interincisal opening) was larger in experimental group in post-operative 1st and 3rd day. Within 1 week, the incidences of trismus and facial swelling were lower in experimental group, but there were no significant differences between two groups in facial swelling degree in post-operative 1st, 3rd day. Conclusions: Current evidence shows that combined application of piezosurgery and rotary instrument may not consistently shorten the operation duration and reduce postoperative facial swelling, but it can reduce the degree of postoperative pain reaction and restriction of mouth opening.

Key words: piezosurgery, rotary instrument, impacted mandibular third molar, treatment outcome, meta-analysis

李凯, 罗宁洁, 白希婧. 超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙临床效果的Meta分析[J]. 中国口腔医学继续教育杂志, 2025, 28(3): 133-141.

Kai Li, Ningjie Luo, Xijing Bai. Combined Application of Piezosurgery and Rotary Instrument for Impacted Mandibular Third Molar Extraction: a Meta-analysis[J]. Chinese Journal of Stomatological Continuing Education, 2025, 28(3): 133-141.

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超声骨刀联合高速外科手机拔除下颌中低位阻生第三磨牙临床效果的Meta分析

Combined Application of Piezosurgery and Rotary Instrument for Impacted Mandibular Third Molar Extraction: a Meta-analysis

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