下颌埋伏阻生牙拔除后创口关闭与否对创口愈合的影响  

Influence of wound healing with or without wound suture after extraction of mandibular impacted teeth

作　　者：丁作友 朱光来[1] 修力军 DING Zuo-you;ZHU Guang-lai;XIU Li-jun(Department of Stomatology,Traditional Chinese Medicine Hospital of Lu'an.Lu'an 237000,Anhui Province,China)

机构地区：[1]六安市中医院口腔科,安徽六安237000

出　　处：《中国口腔颌面外科杂志》2021年第1期18-21,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：安徽省自然科学基金(1708085MH194)。

摘　　要：目的:探讨改良角形瓣切口不同愈合方式对下颌埋伏阻生牙拔除患者恢复及安全性的影响。方法:选择193例单侧下颌埋伏阻生智牙,随机分为创口封闭组(n=96)、创口未封闭组(n=97),所有患者均采用改良角形瓣切口拔除阻生牙。创口封闭组患者拔牙后采用一期缝合,完全关闭创口(TF-P);创口未封闭组患者拔牙后在第二磨牙远中留三角形牙龈缺损,行二期愈合(MTF-S)。比较2组患者术后第1、3、7天疼痛评分、肿胀程度、开口受限程度、愈合时间、术后并发症,第二磨牙远中探诊深度(PD)、附着丧失(CAL)。采用SPSS 20.0软件包对数据进行统计学分析。结果:术后第1天和第3天,创口未封闭组VAS评分显著低于创口封闭组(P<0.05);术后第1、3、7天,创口未封闭组肿胀程度显著轻于创口封闭组(P<0.05),开口受限程度显著低于创口封闭组(P<0.05);创口未封闭组切口愈合时间显著长于创口封闭组(P<0.05);创口未封闭组开口受限、肿胀发生率显著低于创口封闭组(P<0.05),干槽症、疼痛、切口感染发生率略低于创口封闭组,差异无统计学意义(P>0.05)。结论:二期愈合能显著改善下颌埋伏阻生牙患者拔除术后疼痛、肿胀、开口受限等并发症,值得临床推广。PURPOSE: To investigate the effect of different healing modes of modified angle flap on recovery and safety of impacted teeth extraction. METHODS: One hundred and ninety-three patients with unilaterally impacted mandibular molar extraction were enrolled, and randomly divided into two groups: wound suture group and non-suture group. All teeth were extracted with the same methods. After extraction, the wound of suture group underwent triangular flap-primary healing(TF-P), while modified triangular flap-secondary healing(MTF-S) was achieved on a triangular region of mucosa posterior to the lower second molar in the non-suture group. The pain(VAS) score, swelling degree, trismus, healing time,postoperative complications, probing depth(PD) and clinical attachment loss(CAL) of the second molar were compared between the two groups. SPSS 20.0 software package was used for data analysis. RESULTS: VAS score of non-suture group was significantly lower than that of suture group at 1 d and 3 d postoperatively(P <0.05). Swelling degree and trismus of non-suture group were significantly milder than those of suture group at 1, 3 and 7 d postoperatively(P<0.05).The incision healing time of non-suture group was significantly longer than that of the suture group(P <0.05). The incidence of trismus and swelling in non-suture group was significantly lower than that in the suture group(P<0.05). The incidence of dry socket, pain and incision infection in non-suture group was slightly lower than that in the suture group,but with no significant difference(P>0.05). CONCLUSIONS: Modified triangular flap-secondary healing for patients with unilaterally impacted mandibular molar extraction can effectively ameliorate the pain degree, swelling, and trismus, which is worthy of clinical promotion.

关 键 词：改良角形瓣切口 埋伏阻生牙 创口愈合 安全性 

分 类 号：R782.1[医药卫生—口腔医学]