微创拔除压迫下牙槽神经的第三磨牙方法分析  

Minimally invasive extraction of impacted mandibular third molar compressing the inferior alveolar nerve: a comparison of three techniques

作　　者：汪湧[1] 徐颖[2] 杨驰[1] 戈旌[1] 池政兵[3] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,上海市口腔医学重点实验室,上海市口腔医学研究所,国家口腔疾病临床研究中心,上海200011 [2]上海交通大学医学院附属瑞金医院口腔科,上海200025 [3]上海交通大学医学院附属第九人民医院·口腔医学院儿童口腔科,上海200011

出　　处：《中国口腔颌面外科杂志》2018年第1期48-51,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市浦东新区卫生和计划生育委员会资助项目(PW2014D-6);上海市卫生和计划生育委员会资助项目(201440401)

摘　　要：目的 :应用牵引拔牙、截冠和超声骨刀微创拔牙技术拔除压迫下牙槽神经的第三磨牙,观察术后产生下唇麻木等并发症的发生情况。方法:选择60例全景片和锥形束CT(CBCT)显示下颌第三磨牙牙根压迫下牙槽神经的患者,分别采用3种方法拔牙各20例,术后检查下唇麻木情况。结果:应用牵引拔牙技术和截冠方法拔除压迫下牙槽神经的第三磨牙,术后无人发生下唇麻木,而应用超声骨刀微创拔牙的患者中有1例出现轻微的下唇麻木症状,经用药1个月后好转。结论:牵引拔牙技术、截冠和超声骨刀3种方法均可有效避免智牙拔除后下唇麻木的并发症。PURPOSE： Extraction of impacted mandibular third molar compressing inferior alveolar nerve（IAN） is highly related to inferior alveolar nerve injury. The aim of this study was to compare the incidences of IAN injury in orthodontic traction, coronectomy and piezosurgery for the impacted mandibular third molar removal. METHODS： After examination of panoramic radiography and cone-beam computed tomography（CBCT）, sixty patients with impacted mandibular third molar compressing the IAN were enrolled in this study. Orthodontic traction, coronectomy and piezosurgery were carried out in 20 patients, respectively. Signs of postoperative neurosensory impairment were recorded. RESULTS： No sign of neurosensory impairment was observed in patients undergoing orthodontic traction or coronectomy. One patient （5%） undergone piezosurgery had postoperative lower lip numbness, and recovered within 1 month after drug treatment. CONCLUSIONS： Orthodontic traction, coronectomy and piezosurgery can reduce the incidence of nerve injury during removal of impacted mandibular third molar compressing IAN.

关 键 词：牵引拔牙 截冠 压迫下牙槽神经 埋伏阻生牙 

分 类 号：R782.1[医药卫生—口腔医学]