干槽症与拔牙方式的关联性:一种医源性、急性、震荡压缩性骨挫伤  

The correlation between dry socket and manner of tooth extraction:an iatrogenic,acute,concussive and compressive bone contusion

作　　者：许竞 XU Jing(Stomatological Hospital,Southern Medical University(Guangdong Provincial Stomatological Hospital),Guangzhou 510280,China)

机构地区：[1]南方医科大学口腔医院(广东省口腔医院),广州510280

出　　处：《实用医学杂志》2018年第15期2522-2526,共5页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2013B021800166)

摘　　要：目的探讨干槽症发病与拔牙方式的可能关联性及其确切发病机制。方法收集自2004年1月至2016年12月下颌阻生第三磨牙拔除病例共6 012例,分为锤击拔牙组2 793例及涡轮机拔牙组3 219例,分别实施锤击骨凿的方式拔牙或涡轮手机切割的方式拔牙,观察两组干槽症发病率的不同。统计学分析干槽症发病与年龄、性别、阻生程度、阻生类性、手术时间以及局部骨质炎症性病理改变等之间可能存在的规律。结果涡轮机组没有发现符合干槽症的病例。锤击组共出现有119例符合术后干槽症定义的病例,干槽症发病率为4.26%。干槽症发病随阻生程度加重而增高,并且在26～35岁的年龄段发病率最高,达到7.77%,差异有统计学意义。干槽症与手术时间存在线性正相关关系,相关系数r=0.989 5。在局部骨质存在局限性骨髓炎等炎症性病理改变时,发病率反而降低,差异有统计学意义。干槽症发病与性别、阻生类型、冠周炎、龋蚀以及吸烟的关联性不大,差异没有统计学意义。结论干槽症与锤击拔牙方式有关,可能是一种医源性、急性、震荡压缩性骨挫伤。Objective This study aims to explore the correlation between dry socket and manner of tooth extraction,as well as the etiology of dry socket.Methods 6012 cases of the third impacted mandibular molar extraction were collected from Jan.2004 to Dec.2016.The cases were divided into two groups:the hammer group of 2793 cases and the turbine group of 3219 cases.For the cases of the hammer group,teeth extractions were performed with hammer and chisel;for those of the turbine group,extractions were performed with turbine hand-piece and burr.The incidence of dry socket was observed in each group.Results No dry socket was found in the turbine group.In contrast,119 cases of dry socket were found in the hammer group,and the total incidence is 4.26%.The incidence of dry socket increased as the impaction level increased,and reached the highest rate of 7.77%when patients were 26~35 years old.This result was statistically significant.Between the incidence of dry socket and operational duration,a positive linear correlation was found,with coefficient r=0.9895.The incidence of dry socket declined after teeth extraction in the case of local bone inflammation or other pathological changes.This result was statistically significant.No correlation was found between the incidence of dry socket and factors including gender,impaction type,pericoronitis,caries,and smoking.This result was not statistical significant.Conclusion The dry socket is associated with the extraction by using hammer and chisel,and could be an iatro-genic,acute,concussive and compressive bone contusion.

关 键 词：干槽症 骨挫伤 骨压缩 骨坏死 拔牙 下颌第三磨牙 

分 类 号：R782.11[医药卫生—口腔医学]