超声骨刀拔除下颌第三磨牙断根效果评价
|
摘要
目的:通过采用超声骨刀和凿骨法拔除下颌第三磨牙断根比较两者临床效果。方法:选取2017年1月～2018年1月期间在我院口腔外科拔除下颌第三磨牙发生断根患者200例,随机分传统组99例和实验组101例,两组断根前均采用微创拔牙理念技术,断根后传统组常规凿骨法取出断根,实验组采用超声骨刀取出断根,对两组手术时间、并发症进行统计分析。结果:传统组时间(13.11±2.14) min,实验组时间(19.57±3.11) min。实验组取出断根时间长于传统组(P<0.05),两组术后均完整取出断根。实验组无血管神经损伤,传统组有4例神经损伤。传统组有8例出现舌侧骨板断裂,其中有3例断根进入舌下、下颌下及咽旁间隙。实验组术后并发症低于传统组(P<0.05)。结论:采用超声骨刀取出下颌第三磨牙断根,明显降低术中及术后并发症,优于传统骨凿法。应用微创理念,配合超声骨刀,给予患者舒适化、无痛化的操作,具有较好的临床意义。
Objective: To compare the clinical effects of ultrasonic bone knife and chisel in extraction the broken root of mandibular third molars. Methods: A total of 200 patients with root fractures of mandibular third molar were enrolled from 2017,1 to 2018,1. The patients were randomly divided into the traditional group(99 cases) and the experimental group(101 cases). Both groups were treated with minimally invasive extraction before root fracture. Conceptual technology, the traditional group of conventional bone-cutting method was used to remove the root after root-cutting. The experimental group used the super-bone knife to remove the root, and statistical analysis was performed on the operation time and complications of two groups. Results: The time of the traditional group was(13.11±2.14) min, and the experimental group was(19.57±3.11) min. The root withdrawal time of the experimental group was longer than that of the traditional group(P<0.05), and the roots were completely removed after operation. There was no vascular nerve injury in the experimental group, and there were 24 cases of nerve injury in the traditional group. In the traditional group, 8 cases had lingual bone plate fracture, and 3 cases were broken into the sublingual, submandibular, and parapharyngeal spaces. The postoperative complications in the experimental group were lower than those in the traditional group(P<0.05). Conclusion: Ultrasonic osteotome, when removing the root of the mandibular third molar, significantly reduces the intraoperative and postoperative complications. The piezoelectric bone knife has good clinical significance.
Objective: To compare the clinical effects of ultrasonic bone knife and chisel in extraction the broken root of mandibular third molars. Methods: A total of 200 patients with root fractures of mandibular third molar were enrolled from 2017,1 to 2018,1. The patients were randomly divided into the traditional group(99 cases) and the experimental group(101 cases). Both groups were treated with minimally invasive extraction before root fracture. Conceptual technology, the traditional group of conventional bone-cutting method was used to remove the root after root-cutting. The experimental group used the super-bone knife to remove the root, and statistical analysis was performed on the operation time and complications of two groups. Results: The time of the traditional group was(13.11±2.14) min, and the experimental group was(19.57±3.11) min. The root withdrawal time of the experimental group was longer than that of the traditional group(P<0.05), and the roots were completely removed after operation. There was no vascular nerve injury in the experimental group, and there were 24 cases of nerve injury in the traditional group. In the traditional group, 8 cases had lingual bone plate fracture, and 3 cases were broken into the sublingual, submandibular, and parapharyngeal spaces. The postoperative complications in the experimental group were lower than those in the traditional group(P<0.05). Conclusion: Ultrasonic osteotome, when removing the root of the mandibular third molar, significantly reduces the intraoperative and postoperative complications. The piezoelectric bone knife has good clinical significance.
引文
[1] 张志愿,俞光岩.口腔颌面外科学[M].第7版.人民卫生出版社, 2012:112-113.
[2] Tay AB, Go WS. Effect of exposed inferior alveolar neurovascular bundle during surgical removal of impacted lower third molars [J]. Oral Maxillofac Surg, 2004, 62(5): 592-600.
[3] MarniI M, Rohhrig A, ReiIch RH, et al. Comparison between piezosurgery and conve ntional osteotomy in cranioplasty with fronto-orbital advancement [J]. J Craniomaxillofac Surg, 2017, 45(3): 395-400.
[4] Simons WF, Desmit M, Duyck J, et al. The proportion of cancellous bone as predictive factor for early marginal bone loss around implants in the posterior part of the mandible [J]. Clin Oral Implants Res, 2015, 26(9): 1051-1059.
[5] Wasiak J, Shen AY, Tan HB, et al. Methodological quality assessment of paper-based systematic reviews published in oral health [J]. Clin Oral Implants Res, 2016, 20(3): 399-431.
[6] 孟凡文,胡开进,胡坤.无痛微创拔牙技术在齿槽外科的应用[J].口腔医学研究,2007,23(4):431-433.
[7] 李丹,郭传瑸,刘宇,等.超声骨刀在上颌死髓劈裂磨牙拔除中的应用[J].北京大学学报,2016,48(4):709-713.
[8] 高永波,蒋瑷,李伯友,等,超声骨刀与凿骨劈冠法拔除下颌阻生齿的比较[J].华西口腔医学杂志,2011,29(4):372-374.
[9] Weeraya T, Kiyoshi O, Yoshikuni F, et al. A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular conal and impacted third molars [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2007,103(2):253-259.
[10] 桑泽玲.王鲲鹏,陈萌彬,等.超声骨刀和高速涡轮机分根去骨拔除上颌磨牙的比较[J].中华医学杂志,2017,97(24):1899-1901.
[11] Ge J, Yang C, Zheng JW, et al. Four osteotomy methods with piezosurgery to remove complicated mandibular third molars: a retrospective study [J]. J Oral Maxillofac Surg, 2014, 72(11):2126-2133.
[12] Preti G, Martinasso G, Peirone B, et al. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique:a pilot study in minipigs [J]. J Periodontol, 2007, 78(4):716-722.
[13] 程波,东耀峻.下颌升支矢状劈开截骨术对下牙槽神经功能的影响[J].口腔颌面外科杂志,2003,13(3):229-231.
[14] 郭裴,叶丽娟,康非吾,等.锥形束CT中下颌第三磨牙与下颌管的关系及其与阻生类型的相关性分析[J].口腔颌面外科杂志,2013,23(3):186-191.
[15] 张卓,卢华,张小冬,等.超声骨刀法拔除下颌阻生智齿的临床效果的Meta分析[J].临床口腔医学杂志,2017,33(10):102-103.
[2] Tay AB, Go WS. Effect of exposed inferior alveolar neurovascular bundle during surgical removal of impacted lower third molars [J]. Oral Maxillofac Surg, 2004, 62(5): 592-600.
[3] MarniI M, Rohhrig A, ReiIch RH, et al. Comparison between piezosurgery and conve ntional osteotomy in cranioplasty with fronto-orbital advancement [J]. J Craniomaxillofac Surg, 2017, 45(3): 395-400.
[4] Simons WF, Desmit M, Duyck J, et al. The proportion of cancellous bone as predictive factor for early marginal bone loss around implants in the posterior part of the mandible [J]. Clin Oral Implants Res, 2015, 26(9): 1051-1059.
[5] Wasiak J, Shen AY, Tan HB, et al. Methodological quality assessment of paper-based systematic reviews published in oral health [J]. Clin Oral Implants Res, 2016, 20(3): 399-431.
[6] 孟凡文,胡开进,胡坤.无痛微创拔牙技术在齿槽外科的应用[J].口腔医学研究,2007,23(4):431-433.
[7] 李丹,郭传瑸,刘宇,等.超声骨刀在上颌死髓劈裂磨牙拔除中的应用[J].北京大学学报,2016,48(4):709-713.
[8] 高永波,蒋瑷,李伯友,等,超声骨刀与凿骨劈冠法拔除下颌阻生齿的比较[J].华西口腔医学杂志,2011,29(4):372-374.
[9] Weeraya T, Kiyoshi O, Yoshikuni F, et al. A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular conal and impacted third molars [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2007,103(2):253-259.
[10] 桑泽玲.王鲲鹏,陈萌彬,等.超声骨刀和高速涡轮机分根去骨拔除上颌磨牙的比较[J].中华医学杂志,2017,97(24):1899-1901.
[11] Ge J, Yang C, Zheng JW, et al. Four osteotomy methods with piezosurgery to remove complicated mandibular third molars: a retrospective study [J]. J Oral Maxillofac Surg, 2014, 72(11):2126-2133.
[12] Preti G, Martinasso G, Peirone B, et al. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique:a pilot study in minipigs [J]. J Periodontol, 2007, 78(4):716-722.
[13] 程波,东耀峻.下颌升支矢状劈开截骨术对下牙槽神经功能的影响[J].口腔颌面外科杂志,2003,13(3):229-231.
[14] 郭裴,叶丽娟,康非吾,等.锥形束CT中下颌第三磨牙与下颌管的关系及其与阻生类型的相关性分析[J].口腔颌面外科杂志,2013,23(3):186-191.
[15] 张卓,卢华,张小冬,等.超声骨刀法拔除下颌阻生智齿的临床效果的Meta分析[J].临床口腔医学杂志,2017,33(10):102-103.