CBCT辅助下应用超声骨刀行儿童上颌埋伏多生牙拔除术临床研究  

Clinical Study on the Extraction of Children's Maxilla Embedded Multiple Teeth with Ultrasound Bone Knife Assisted by CBCT

作　　者：刘鹏[1] 李宏伟 张同韩[1] 陈觉尧[1] 苏葵[3] 何奋军[1] LIU Peng;LI Hong-wei;ZHANG Tong-han;CHEN Jue-yao;SU Kui;HE Fen-jun(Department of Oral and Maxillofacial Surgery,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,China;Department of Hematology,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,China;Department of Pediatric Stomatology,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,China)

机构地区：[1]中山市人民医院口腔颌面外科,广东中山528400 [2]中山市人民医院血液内科,广东中山528400 [3]中山市人民医院儿童口腔科,广东中山528400

出　　处：《中国美容医学》2021年第8期146-149,共4页Chinese Journal of Aesthetic Medicine

基　　金：中山市医学科研项目(编号:2020J039)。

摘　　要：目的:研究锥形束电子计算机断层扫描(CBCT)辅助下应用超声骨刀行儿童上颌埋伏多生牙拔除术的临床价值。方法:选取2019年10月-2020年6月笔者医院收治的90例上颌埋伏多生牙患儿为研究对象,按照抽签方式将其随机分为超声骨刀组和微动力组,每组45例(埋伏牙均为76颗),微动力组采取电动式颌面外科微动力手术治疗,超声骨刀组采取超声骨刀手术治疗;比较两组手术时间、出血量、离院时间、麻醉药用量及手术成功率,比较两组治疗后1、3、7d疼痛视觉模拟评分(VAS)、张口度,比较两组治疗后上腭黏膜麻木和牙齿松动发生情况,比较两组手术并发症发生情况。结果:超声骨刀组出血量、离院时间显著低于微动力组,差异有统计学意义(P<0.05),两组手术成功率比较无统计学意义(P>0.05)。超声骨刀组术后各时间段VAS评分组间比较,显著低于微动力组,张口度比较显著高于微动力组,差异有统计学意义(P<0.05);两组术后VAS评分组内比较,术后1d>术后3d>术后7d,张口度组内比较,术后1d<术后3d<术后7d,差异有统计学意义(P<0.05)。超声骨刀组术后未发生黏膜麻木及牙齿松动患者比例显著高于微动力组,差异有统计学意义(P<0.05)。超声骨刀组并发症总发生率为8.89%,与微动力组17.78%比较,差异无统计学意义(P>0.05)。结论:CBCT引导下利用超声骨刀拔除上颌埋伏多生牙有较好的临床疗效,能更好的减少手术创伤,加快患者恢复,安全性良好,临床价值较高。Objective To investigate the clinical value of cone beam computed tomography(CBCT)assisted ultrasound osteotome in the extraction of children's maxillary impacted supernumerary teeth.Methods 90 cases of children with impacted supernumerary teeth in our hospital from October 2019 to June 2020 were selected as the research objects,and they were randomly divided into ultrasonic osteotome group and micro dynamic group according to the drawing method,with 45 cases in each group(76 embedded teeth),The micro power group was treated with electric micro power operation in maxillofacial surgery,while the ultrasonic osteotome group was treated with ultrasonic osteotome.The operation time,blood loss,hospital leaving time,anesthetic dosage and operation success rate were compared between the two groups.The pain visual analogue scale(VAS)score and mouth opening degree at 1,3 and 7 days after treatment were compared between the two groups.The occurrence of palatal mucosa numbness and tooth loosening after treatment in the two groups was compared,and the incidence of surgical complications in the two groups was compared.Results The bleeding volume and time of leaving hospital in ultrasound osteotome group were significantly lower than those in micro power group(P<0.05).The VAS score of ultrasound osteotome group was significantly lower than that of micro power group,and the mouth opening degree between groups was significantly higher than that of micro power group,the difference was statistically significant(P<0.05),the VAS score of the two groups was statistically significant(P<0.05).The proportion of patients without mucosal numbness and tooth loosening in ultrasonic osteotome group was significantly higher than that in micro dynamic group(P<0.05).The total incidence of complications in the ultrasound osteotome group was 8.89%,which was not significantly different from that in the micro power group(17.78%)(P>0.05).Conclusion CBCT guided ultrasound osteotome extraction of maxillary embedded supernumerary teeth has good clinical

关 键 词：超声骨刀 锥形束电子计算机断层扫描 上颌埋伏多生牙 电动式颌面外科微动力手术 微创拔牙 

分 类 号：R783.9[医药卫生—口腔医学]