微创拔除阻生下颌第三磨牙时高速涡轮手机车针断裂30例临床分析  

Clinical study of 30 cases of the fracture of high-speed handpiece bur during minimally invasive extraction of impacted mandibular third molar

作　　者：李泽溪 郑恺 尉超 李媛 翁芷杰 肖灿[1] LI Ze-xi;ZHENG Kai;WEI Chao;LI Yuan;WENG Zhi-jie;XIAO Can(Department of Stomatology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China;不详)

机构地区：[1]苏州大学附属第一医院口腔科,江苏苏州215000 [2]苏州工业园区星海医院口腔科,江苏苏州215000

出　　处：《中国实用口腔科杂志》2022年第3期341-344,共4页Chinese Journal of Practical Stomatology

摘　　要：目的探讨拔除阻生下颌第三磨牙时高速涡轮手机车针断裂的原因及处理对策。方法收集苏州大学附属第一医院口腔科从2010年2月至2019年10月拔除阻生下颌第三磨牙时高速涡轮手机车针断裂的30例患者病例资料,对断针留存的部位及取出方法进行总结分析。结果所有断针全部取出,20例患者无明显术后反应,10例患者术后第2天复诊局部有明显肿胀及张口受限。2例患者术后第2天出现下唇及舌尖麻木。1周后复诊,创口均一期愈合,无感染和张口受限。1个月后复诊,2例唇舌麻木的患者完全恢复。结论在使用高速涡轮手机拔牙时应及时更换车针,避免车针使用次数过多;在操作中切勿使用暴力,尽量保护舌侧骨板的完整性;在车针断针后,行相关影像学检查辅助定位,切莫盲目手术;采用多学科交叉的方法有利于断针的取出。Objective To analyze the causes and management of the fracture of high-speed handpiece bur during impacted mandibular third molar extraction.Methods A total of 30 cases of the fracture of high-speed handpiece bur during impacted mandibular third molar extraction were collected in the First Affiliated Hospital of Soochow University from Feb.2010 to Oct.2019.The site of the fractured bur and the method of removal were summarized and analyzed.Results All 30 fragments were successfully removed.There were no obvious postoperative reactions in 20 patients.Ten patients had significant postoperative swelling and limited mouth opening.Two patients had sense of numbness in the lower lip and tip of the tongue.A week later,all wound healed well and there was no infection or limited mouth opening.After one mouth,the two patient who had numbness completely recovered.Conclusion When using high-speed handpiece,the bur should be replaced in time to avoid excessive using.The instrument should be used gently during the operation,and try to keep the lingual lamina intact.When there is bur fracture,imaging examination should be performed to assist positioning and blinded operation should be avoided.The multidisciplinary method is beneficial to the operation.

关 键 词：阻生下颌第三磨牙 高速涡轮手机 并发症 微创拔牙 车针 

分 类 号：R782.11[医药卫生—口腔医学]