刚体力学在下颌阻生第三磨牙拔除术中的理论和应用探索  

Geostatics in impacted mandibular third molar surgury

作　　者：王兴 Wang Xing(Department of Oral and Maxillofacial Surgery,Shanxi Medical University School and Hospital of Stomatology,Taiyuan 030001,China)

机构地区：[1]山西医科大学口腔医学院·口腔医院口腔颌面外科,太原030001

出　　处：《中华口腔医学杂志》2025年第2期109-115,共7页Chinese Journal of Stomatology

摘　　要：如何微创拔除下颌阻生第三磨牙,实现"创伤小、时间短、恢复快"的治疗目标,仍是口腔医师热切关注的焦点。目前,下颌阻生第三磨牙拔除术多使用仰角气动手机、超声骨刀、骨凿或其他动力系统,通过去骨、分牙方法解除牙冠和牙根阻力后分块拔除。然而在不同省市和基层医院,如何在复杂下颌阻生第三磨牙拔除术中避免过量去骨,如何优选分牙的具体位置和角度,存在牙根阻力时如何寻找支点和设计最佳脱位道,仍主要依赖经验的传授,缺乏原理层次上的解析归纳。本文将刚体力学原理引入下颌阻生第三磨牙拔除术,分析如何应用刚体力学原理巧妙地设计牙齿切割,提高分牙效率;研究如何优化牙根脱位的力学设计,分析牙根脱位道;重点关注如何在拔牙过程中减少对阻生牙周围牙槽骨组织的损伤,降低术中、术后的并发症风险,为广大口腔医师微创拔牙的手术设计和技巧提供解读和参考。Exploring the application of minimally invasive techniques in the extraction of impacted mandibular third molar(IMTM),to achieve the treatment goal of"less trauma,short time,fast recovery",remains the focus of dentists.For now,the IMTM are mostly extracted in pieces after removing the crown and root resistance by bone removal and tooth segmentation,using 45°reverse-angle high speed turbine,piezosurgery,chisel or other dynamic system.However,There is a lack of principle-level parsing in different provinces and primary hospitals,while experience is still the main factor in avoiding excessive bone removal in complex IMTM extraction,as well as optimizing the specific position and angle of the parting teeth,finding the fulcrum and designing the best dislocation path when there is root resistance.In this review,the principle of geostatics was introduced into the extraction of IMTM.According to this principle,we analyzed how to design a clever tooth cutting line cleverly to enhance the efficiency of tooth segmentation,and how to optimize the mechanical design of root dislocation and the root dislocation path.Meanwhile,we will also focus on how to minimize trauma to alveolar bone during tooth extraction,so as to reduce the risk of intraoperative and postoperative complications,and provide interpretation and reference for dentists in surgical design and techniques of minimally invasive tooth extraction.

关 键 词：拔牙 下颌阻生第三磨牙 牙 阻生 磨牙 第三 微创拔牙 刚体力学 

分 类 号：R782.11[医药卫生—口腔医学]