年轻人拔除无症状阻生下颌第三磨牙术后下颌第二磨牙远端的牙周变化  

Mandibular second molar periodontal healing after impacted third molar extraction in young adults

作　　者：李娟[1] 张栋 刘玉东 牛帅[1] 米欢 谷建琦[1] LI Juan;ZHANG Dong;LIU Yudong;NIU Shuai;MI Huan;GU Jianqi(Department of Oral and Maxillofacial Surgery,Hebei General Hospital,Shijiazhuang 050000)

机构地区：[1]河北省人民医院口腔科,石家庄050000

出　　处：《现代口腔医学杂志》2021年第5期320-323,共4页Journal of Modern Stomatology

基　　金：河北省卫生和计划生育委员会科研基金项目(20190226)。

摘　　要：目的评估年轻人无症状的完全埋伏阻生下颌第三磨牙(M3)采用微创拔除12个月内下颌第二磨牙(M2)远端牙周状况的变化。方法本研究在69名健康年轻患者(24.42±2.20岁)中抽取69个完全阻生未暴露于口腔的M3。在术前和术后3、6、9和12个月随访。记录口内M2远端5个位点的菌斑指数、牙龈指数、探诊深度(PD)和附着水平。结果初始PD为(5.82±3.53)mm,最深的平均PD在远中中点。12个月时,PD平均值为(3.69±2.91)mm,平均恢复高度为(2.13±2.57)mm(P<0.05),3个月时较高为(1.70±2.61)mm(P<0.05)。并且从术前到术后12个月M2远端的5个位点PD的改善均具有统计学意义(P<0.05)。术前M25个位点附着丧失比率为80.2%,术后12个月64.0%附着丧失等级降低,29.3%未改变,6.7%程度加重。术后12个月M2的菌斑指数和牙龈指数均改善。结论邻近M2的无症状完全阻生M3导致牙周缺损,在远中中点最深,拔除后12个月5个位点均不同程度恢复。前3个月被认为是牙周愈合的重要时期。年轻人的完全埋伏阻生M3导致的邻牙牙周组织缺损在M3拔除后恢复良好。Objective To evaluate the change in the periodontal status of mandibular second molars(M2)after minimally invasive surgical extraction of asymptomatic adjacent impacted lower third molars(M3).Methods This prospective clinical study was conducted in 69 healthy young patients(24.42±2.20 years old)with 69 extractions of higher-risk periodontal impacted M3.Plaque and gingival indexes,bleeding on probing,probing depth(PD),and attachment level were recorded before surgery and at 3,6,9,and 12 months after surgery at 5 sites on the distal aspect of the M2.Results The initial mean PD was(5.82±3.53)mm,with the deepest mean PD at the the middle of the distal surface.At 12 months,a mean PD average of(3.69±2.91)mm was recorded,with a total average recovery of(2.13±2.57)mm(P<0.05),that was higher at 3 months(1.70±2.61)mm(P<0.05).The PD improvements were statistically significant(P<0.05)from baseline to 12-month follow-up and from the buccal to the lingual side of the distal aspect of the M2.Before extraction of the impacted M3,80.0%of cases had attachment loss at the distal aspect of the M2.At 12 months,64.0%exhibited a decrease in the grade of attachment loss,29.3%were unchanged,and 6.7%exhibited an increased grade of attachment loss.The plaque index and gingival index of M2 at 12 months after surgery were improved compared with those before surgery.Conclusion Impacted M3 adjacent to M2 lead to periodontal defects that are deepest at the lingual side and almost recover at 12 months after extraction.The first 3 months is considered the cutoff for periodontal healing.Young adults with high-risk periodontal M3 impactions may benefit from early extraction.In young people the periodontal tissue defect of M2 caused by completely impacted M3 recovered well after M3 extraction.

关 键 词：阻生下颌第三磨牙 下颌第二磨牙 牙周缺损 微创拔牙 

分 类 号：R782.1[医药卫生—口腔医学]