微创拔牙在下颌低位阻生智齿拔除术中的应用分析

张蓉

[摘要]目的：探讨微创拔牙术应用于下颌阻生智齿拔除的临床效果。方法：选取2015年3月-2017年7月在笔者科室就诊，需拔除下颌低位阻生智齿的112例患者为研究对象，按手术方式不同分为实验组和对照组，每组56例。实验组行微创拔牙术，对照组行传统拔牙术，分析比较两组的手术效果、并发症、患者畏惧率和满意度情况。结果：实验组和对照组的手术时间分别为（19.0±7.2）min和（40.0±10.5）min，存在显著性差异（P<0.05）。实验组术后疼痛、肿胀和张口受限程度显著轻于对照组（P<0.05），术中及术后并发症、畏惧率明显低于对照组，且实验组患者满意度高，两组间差异有统计学意义（P<0.05）。结论：微创拔牙术应用于下颌低位阻生智齿临床效果显著，并发症少，对患者心理影响小。

[关键词]微创拔牙术；传统拔牙术；拔牙；阻生牙；下颌第三磨牙

[中图分类号]R783.5 [文献标志码]A [文章编号]1008-6455（2018）04-0091-03

Application of Minimally Invasive Extraction in the Removal of Impacted Mandibular Third Molars

ZHANG Rong

（Department of Oral and Maxillofacial Surgery，General Hospital of Xinjiang Military Command，Urumqi 830000，Xinjiang，China）

Abstract： Objective To explore the clinical application of minimally invasive extraction in the removal of impacted mandibular third molars. Methods 112 patients with impacted mandibular third molars were equally divided into two groups. Patients in the experimental group were treated with minimally invasive extraction， while patients in the control group were treated with traditional method. The operation time， the incidence rate of intraoperative and postoperative complications， and dental fear rate were compared between the two groups. Results The operation time was （19.0±7.2） min in the experimental group， significantly shorter than that in the control group， which was （40.0±10.5） min （P<0.05）.Not only the incidence of moderate or severe pain，the degree of mouth opening after surgery was significantly lower in the experimental group than that of the control group， but also the intraoperative complications， postoperative complications and dental fear rate in the experimental group were lower than the control （P<0.05）. Conclusion The results demonstrated that minimally invasive extraction in the removal of impacted mandibular third molars could give better results than conventional osteotomy method.

Key words： minimally invasive extraction； traditional extraction； tooth extraction； impacted teeth； mandibular third molar

下頜智齿阻生常常导致冠周炎、龋齿、牙源性囊肿以及邻牙病变等，因此，临床上一致主张早期拔除下颌阻生智齿[1]。传统的锤凿劈冠拔除方法，由于创伤大会使患者产生畏惧心理，带来剧烈疼痛，并引起面部肿胀等反应[2]。尤其是拔除下颌低位完全骨埋伏阻生牙时，由于操作空间狭小局限，手术难度大，易出现严重并发症。随着科技的快速发展，微创拔牙技术被逐渐应用于临床。微创拔牙采用45°仰角冲击式气动手机及外科专用切割钻，先分开牙体，去除硬组织阻力，再利用微创拔牙刀切断牙周膜，挤压牙槽骨拔除牙体，从而减少了周围硬软组织损伤，减轻了患者的恐惧和疼痛不适。本研究通过回顾性资料分析，评估微创拔牙术应用于112例驻疆部队战士下颌阻生智齿拔除的临床效果，现分析报道如下。

1 临床资料和方法

1.1 一般资料：选取2015年3月-2017年7月在笔者科室就诊，需拔除下颌低位阻生齿的116例战士作为研究对象，均为男性，均无拔牙禁忌证，将其随机分为两组。……