高频电刀联合高速涡轮牙钻治疗下颌低位埋伏阻生智齿疗效观察

陈宇 闫妍 刘长亮

[摘要]目的：對比高频电刀联合高速涡轮牙钻治疗下颌低位埋伏阻生智齿的疗效。方法：选择2017年1月-2018年10月笔者医院就诊的86例下颌低位埋伏阻生智齿患者为研究对象，以随机数表法分为观察组和对照组。对照组：40例，给予传统锤骨劈冠法实施手术;观察组：46例，给予高频电刀联合高速涡轮牙钻实施手术。比较两组手术时间、龈沟液炎症因子、应激因子、视觉模拟评分法（VAS）的变化及并发症。结果：观察组手术时间明显短于对照组（P<0.05），两组龈沟液肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、丙二醛（MDA）、活性氧（ROS）、超氧化物歧化酶（SOD）、VAS评分之间均具有交互作用（P<0.05），观察组邻牙松动、严重张口受限、严重面颊肿胀、感染及干槽症的总发生率明显低于对照组（P<0.05）。结论：和传统锤骨劈冠法相比，高频电刀联合高速涡轮牙钻在下颌低位埋伏阻生智齿拔牙术中效果显著，术后炎症、应激反应小，具有恢复快、痛苦小、并发症少等优点，值得临床推广应用。

[关键词]传统锤骨劈冠法;高频电刀;高速涡轮牙钻;下颌低位埋伏阻生智齿;炎症因子;应激因子

[中图分类号]R783    [文献标志码]A    [文章编号]1008-6455（2021）03-0124-03

Curative Effect Observation of the High-frequency Electrosurgical Knife Combined with High-speed Turbodrill in the Treatment of Impacted Wisdom Teeth in Lower Mandible

CHEN Yu，YAN Yan，LIU Chang-liang

（Department of Stomatology， Langfang People's Hospital， Langfang 065000， Hebei，China）

Abstract：Objective  To study the therapeutic effect of the high-frequency electrosurgical knife combined with high-speed turbodrill in the treatment of impacted wisdom teeth in lower mandible. Methods  86 patients of impacted wisdom teeth in lower mandible who received therapy from January 2017 to October 2018 in our hospital were divided into the 46 cases in the observation group and the 40 cases in the control group by the random number table， the control group was treated with traditional malleolus crown splitting method， while the observation group was treated with high frequency electric knife combined high-speed turbodrill. The operation time， the changes of gingival crevicular fluid inflammatory factors， stress factors， visual analogue scale （VAS） and complications were compared between the two groups. Results  The operation time in the observation group was significantly shorter than that of  the control group （P<0.05），the tumor necrosis factor-α （TNF-α）， interleukin-6（IL-6）， malondialdehyde（MDA） and active oxygen（ROS）， superoxide dismutase （SOD） in gingival crevicular fluid and VAS scores between groups had interaction（P<0.05）.The total incidence of loosening of adjacent teeth， severe mouth opening restriction， severe cheek swelling， infection and dry socket in the observation group was significantly lower than that of the control group（P<0.05）. Conclusion  Compared with traditional malleolus crown splitting method， high-frequency electric knife combined with high-speed turbodrill has remarkable effect in extraction of impacted wisdom teeth in lower mandible， it has less inflammation and stress reaction， quick recovery， less pain and fewer complications， it's worth popularizing.

Key words： traditional malleolus crown splitting method; high frequency electrosurgical knife; high-speed turbodrill; impacted wisdom teeth in lower mandible; inflammatory factors; stress factors

下颌低位埋伏阻生智齿是一种较为常见的智齿类型，由于阻生智齿生长位置不当，难以萌出到正常的咬合位置，不仅对日常咀嚼功能产生影响，还极易增加牙周炎的发生率，影响生活质量。及时的通过手术拔除智齿是多数选择的首选方案，在传统的阻生智齿拔牙术中，通常使用锤骨劈冠法进行，虽然具有操作简单、拔牙效果确切的优势，但该术式对局部组织的损伤较大，术后牙周组织会出现过度的炎症、应激反应，不仅不利于术后恢复，还容易增加一系列并发症。高速涡轮牙钻在拔除阻生牙中具有转速快、切割效率高等优点，近年来已逐渐开展于临床，高频电刀在口腔修复等领域中的应用范围也不断拓广，具有迅速止血、清晰术野的效果[1-2]。因此，本研究旨在探讨高频电刀结合高速涡轮牙钻在下颌低位埋伏阻生智齿的应用效果。……