不同分牙方式拔除低位阻生下颌第三磨牙的临床效果分析  

Outcomes of impacted mandibular third molar extraction with different tooth separation techniques

作　　者：董建辉[1] 朱亚琴[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔综合科上海市口腔医学重点实验室,上海200011

出　　处：《上海交通大学学报（医学版）》2011年第2期191-193,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科委基金(08DZ2271100)~~

摘　　要：目的观察和比较以不同分牙方式拔除低位阻生下颌第三磨牙的临床效果。方法选取第三磨牙低位水平、近中阻生或完全骨埋伏阻生的150例患者作为研究对象,分别采用传统锤凿去骨劈牙法(传统锤凿分牙组,n=50)、锤凿去骨联合T形分牙法(锤凿T形分牙组,n=50)和涡轮机去骨联合T形分牙法(涡轮机T形分牙组,n=50)实施低位阻生下颌第三磨牙拔除手术。观察三组患者的术后反应(局部肿胀和疼痛)及并发症的发生情况。结果涡轮机T形分牙组术后局部重度肿胀的发生率显著低于传统锤凿分牙组(16%vs34%,P<0.05);传统锤凿分牙组、锤凿T形分牙组和涡轮机T形分牙组术后Ⅲ度疼痛的发生率分别为36%、20%和4%,组间比较差异均有统计学意义(P<0.05)。锤凿T形分牙组和涡轮机T形分牙组术后下唇麻木、舌侧骨板同牙根一同取出和发热等并发症的发生率显著低于传统锤凿分牙组(P<0.05)。结论与传统锤凿分牙法相比,涡轮机去骨联合T形分牙拔除低位阻生下颌第三磨牙具有术后反应轻微、并发症发生率低的优点,值得在临床上推广应用。Objective To observe and compare the outcomes of impacted mandibular third molar extraction with different tooth separation techniques. Methods One hundred and fifty low and medial impacted mandibular third molars in 150 patients were selected,and were extracted with traditional hammer and chisel technique(n=50),hammer and chisel+'T' typed tooth separation technique(n=50) and turbine+'T' typed tooth separation technique(n=50),respectively.The incidences of postoperative reactions(regional swelling and pain) and complications were compared among groups. ResultsThe incidence of severe postoperative regional swelling in patients treated with turbine+'T' typed tooth separation technique was significantly lower than that in those treated with traditional hammer and chisel technique(16% vs 34%,P<0.05).The incidences of postoperative Ⅲ degree pain in patients with traditional hammer and chisel technique,hammer and chisel+'T' typed tooth separation technique and turbine+'T' typed tooth separation technique were 36%,20% and 4%,respectively,and there were significant differences among patients treated with different techniques(P<0.05).The incidences of postoperative complications such as numbness of lower lip,extraction of lorum together with dental root and fever in patients treated with hammer and chisel+'T' typed tooth separation technique and turbine+'T' typed tooth separation technique were significantly lower than those in patients treated with traditional hammer and chisel technique(P<0.05). Conclusion Compared with traditional hammer and chisel technique,turbine+'T' typed tooth separation technique works better in extraction of impacted mandibular third molars with less postoperative reactions and complications.

关 键 词：T形分牙法 传统锤凿法 低位阻生 下颌第三磨牙 

分 类 号：R783.5[医药卫生—口腔医学]