超声骨刀在上颌死髓劈裂磨牙拔除中的应用  

Applicational evaluation of split tooth extractions of upper molars using piezosurgery

作　　者：李丹[1] 郭传瑸[2] 刘宇[2] 王恩博[2] 

机构地区：[1]北京大学口腔医学院·口腔医院第二门诊部,北京100081 [2]北京大学口腔医学院·口腔医院口腔颌面外科,口腔数字化医疗技术和材料国家工程试验室,口腔数字医疗北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2016年第4期709-713,共5页Journal of Peking University:Health Sciences

摘　　要：目的:评价超声骨刀(piezosurgery)在上颌死髓劈裂磨牙拔除术中的应用效果。方法:临床选取需拔除无保留价值的死髓、劈裂的上颌磨牙患者40例,分为试验组和对照组,每组各20例,试验组使用超声骨刀拔牙工作尖切削去骨、扩大牙周间隙后拔除,对照组采用常规峨眉凿去骨、增隙后拔除。比较两组在手术时间、颊侧牙槽嵴顶高度及牙槽窝宽度的改变量、患者术中感觉评价、患者对手术的畏惧率等指标上的差异。结果:试验组手术时间为(629.5±171.0)s,对照组(456.0±337.2)s;试验组颊侧牙槽骨降低(1.07±0.64)mm,对照组降低(1.49±0.61)mm,两者差异均有统计学意义(P<0.05);牙槽窝宽度的改变两组差异无统计学意义(P>0.05);患者术中畏惧率、术中手术不适感VAS评分、术后24 h的VAS评分两组差异亦无统计学意义(P>0.05)。结论:上颌死髓、劈裂牙拔除术中应用超声骨刀去骨、扩隙与应用凿去骨增隙相比在原理上类似,但可更好地保存牙槽骨骨量,降低骨创伤,同时降低了患者对手术的畏惧率,体现出微创拔牙的特点,具有推广的价值。Objective：To evaluate the efficacy of Piezosurgery in split teeth extractions. Methods：A single-center, randomized, split-mouth study was performed using a consecutive serious of unrelated healthy patients attending the departing of oral and maxillofacial surgery, Peking University School and Hospital of Stomatology. 40 patients were selected for extraction of maxillary molars without reservation value, splitting or nonvital teeth. They were divided into control （20 patients） and test groups （20 patients） randomly. Surgical treatments for both groups were under local anesthesia. Molar teeth of control group were extracted by common equipments like dental elevators, chisels, forceps, etc. While molar teeth of experimental group were extracted by Piezosurgery, aided with the use of common equipments if needed. Then we compared the duration of surgery, frequency of the usage of chisels, expansion of post- operative bony socket surgical discomfort and postoperative pain between two groups. Results： The average of operation time was （629.5 ± 171.0） s in control group and （456.0± 337.2） s in test group. The buccal alveolar bone reduced （1.07 ±0.64） mm in control group and （1.49 ±0.61 ）mm in test group. There was a significant difference between the two groups （P 〈 0.05 ）. The duration of surgery for experi- mental group was significantly longer than that of the control group, but the change of buccal alveolar bone was lower than the control group. For visual analogue scale （VAS） value of surgical discomfort, ex- pansion of postoperative bony socket and the operative fear rate, there were no significant difference between the two groups （ P 〉 0.05 ）. Conclusion： Piezosugery can be better to preserve alveolar bone, reduce trauma and patient＇ s fear. Application of the piezosugery reflect the characteristics of minimally invasive extraction, which has the value of promotion. The Piezosurgery technique have the advantage of re- ducing change of buccal alveolar bone duri

关 键 词：超声骨刀 磨牙 拔牙 

分 类 号：R782.1[医药卫生—口腔医学]