列线图分析下颌阻生智牙拔除术后下牙槽神经血管束损伤的风险模型  

Nomogram risk model of inferior alveolar neurovascular bundle injury after extraction of impactedwisdomteeth

作　　者：祁海龙[1] 马蓉 付建军[1] Qi Hailong;Ma Rong;Fu Jianjun(Department of Stomatology,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000)

机构地区：[1]宝鸡市中医医院口腔科,宝鸡721000

出　　处：《中国医师杂志》2024年第10期1504-1508,共5页Journal of Chinese Physician

基　　金：陕西省重点研发计划项目(2020SF-182)。

摘　　要：目的列线图分析下颌阻生智牙拔除术后下牙槽神经血管束损伤的风险模型。方法回顾性分析2022年2月至2023年11月在宝鸡市中医医院接受下颌阻生智牙拔除术患者193例的临床资料,术后3个月,根据患者是否发生下牙槽神经血管束损伤分为发生组与未发生组。对比两组临床资料,分析下颌阻生智牙拔除术后发生下牙槽神经血管束损伤的影响因素,构建并验证下颌阻生智牙拔除术后发生下牙槽神经血管束损伤的风险模型。结果术后3个月,193例患者下牙槽神经血管束损伤发生率为12.95%(25/193)。发生组(n=25)年龄≥25岁、性别为女性、阻生深度为低位阻生、关系分类为ClassⅢ类、下牙槽管(IAC)偏移、阻生牙与IAC的方向关系为Ⅱ~Ⅲ类、阻生牙与IAC的接触关系为Ⅱ~Ⅲ级占比高于未发生组(n=168)(均P<0.05)。年龄(OR=5.280,95%CI:1.856~15.025)、阻生深度(OR=5.766,95%CI:2.026~16.407)、阻生牙与IAC的方向关系(OR=4.504,95%CI:1.583~12.816)、阻生牙与IAC的接触关系(OR=3.991,95%CI:1.403~11.356)为下颌阻生智牙拔除术后发生下牙槽神经血管束损伤的影响因素(均P<0.05)。列线图模型预测下颌阻生智牙拔除术后发生下牙槽神经血管束损伤的灵敏度为88.00%,特异度为91.07%,曲线下面积为0.906(95%CI:0.748~0.959)。结论基于年龄、阻生深度、阻生牙与IAC的方向关系、阻生牙与IAC的接触关系构建下颌阻生智牙拔除术后下牙槽神经血管束损伤风险模型,有助于早期评估下牙槽神经血管束损伤风险。Objective To analyze the nomogram risk model of lower alveolar neurovascular bundle injury after mandibular impacted wisdom tooth extraction.Methods The clinical data of 193 patients who received mandibular impacted wisdom tooth extraction in Baoji Hospital of Traditional Chinese Medicine from February 2022 to November 2023 were retrospectively analyzed.3 months after surgery,the patients were divided into the occurrence group and the non-occurrence group according to whether the inferior alveolar neurovascular bundle injury occurred.By comparing the clinical data of the two groups,the influencing factors of lower alveolar neurovascular bundle injury after mandibular impacted wisdom tooth extraction were analyzed,and the risk model of lower alveolar neurovascular bundle injury after mandibular impacted wisdom tooth extraction was constructed and verified.Results 3 months after operation,the incidence of lower alveolar neurovascular bundle injury in 193 patients was 12.95%(25/193).In the occurrence group(n=25),the age was≥25 years old,the gender was female,the depth of impacted was low impacted,the relationship was classified as Class II,the lower alveolar canal(IAC)was offset,the orientation relationship between impacted teeth and IAC was class II-II,and the contact relationship between impacted teeth and IAC was class II-II,the proportion of cases in the occurrence group was higher than that in the non-occurrence group(n=168)(all P<0.05).Age(0R=5.280,95%Cl:1.856-15.025),depth of impacted teeth (OR =5.766, 95% CI: 2.026-16. 407), direction relationship between impacted teeth andIAC (OR =4. 504, 95% Cl: 1.583-12.816), and the contact relationship between impacted teeth andIAC (OR=3.991, 95% CI: 1. 403-11. 356) were the influencing factors of lower alveolar neurovascularbundle injury after mandibular impacted wisdom tooth extraction ( all P<0. 05). The sensitivity, specificityand area under the curve were 88. 00% , 91.07% , and 0. 906(95% Cl: 0.748-0.959) for the predictionof inferior alveolar neurovascular bundl

关 键 词：拔牙 下颌阻生智牙 下牙槽神经血管束损伤 风险模型 

分 类 号：R782.11[医药卫生—口腔医学]