高速涡轮钻法与增隙后推旋法用于下颌阻生智齿拔除中的效果比较

扶晟　　蒋立辉　　李欢　　陈刚

[關键词] 高速涡轮钻法;增隙后推旋法;下颌阻生智齿拔除;效果

[中图分类号] R782.31          [文献标识码] B          [文章编号] 1673-9701（2021）15-0069-04

Comparison of the efficacy of high-speed turbine drilling method and gap-increasing backward rotation method in the extraction of impacted mandibular wisdom teeth

FU Sheng   JIANG Lihui   LI Huan   CHEN Gang

Department of Stomatology， Xiaolan People′s Hospital of Zhongshan City in Guangdong Province， Zhongshan   528415，China

[Abstract] Objective To investigate the efficacies of high-speed turbine drilling method and gap-increasing backward rotation method in the extraction of impacted mandibular wisdom teeth. Methods A total of 172 patients with impacted mandibular wisdom teeth admitted to our hospital from January 2018 to October 2019 were randomly divided into group A and group B， with 86 cases in each group. Group A was treated with high-speed turbine drilling method， while group B was treated with gap-increasing backward rotation method. The tooth extraction efficacy， inflammatory factor level and incidence of complications of the two groups were compared. Results The extraction time in group A was shorter than that of group B. Meanwhile， the degree of mouth opening limitation，pain degree and maxillofacial swelling degree were all lower than those in group B， with statistically significant differences between two groups（P<0.05）. There were no significant differences in the levels of IL-6， TNF-α， and CRP in both groups before treatment（P>0.05）. After treatment， IL-6， TNF-α and CRP in group A were significantly lower than those in group B， with statistically significant differences between two groups（P<0.05）. The total incidence of postoperative complications was 3.49% in group A， which was lower than that of 11.63% in group B， with statistically significant difference（P<0.05）. Conclusion High-speed turbine drilling method causes less trauma and shorter operation duration， which can effectively reduce postoperative inflammatory reaction， and the incidence of postoperative complications is low. However，gap-increasing backward rotation method causes more trauma， and is helpful to preserve the normal alveolar fossa. The method of tooth extraction can be selected according to the actual situation in clinic.

[Key words] High-speed turbine drilling method; Gap-increasing backward rotation method; Extraction of impacted mandibular wisdom teeth; Efficacy

下颌阻生智齿拔除是口腔科常见手术，特别是拔除低位且埋伏阻生智齿时，由于手术时间较长、创伤大、出血多，极易导致术后出现局部疼痛、肿胀、张口受限制等情况发生[1]。有研究显示，传统拔牙设备通常需要利用锤子实施辅助敲击，在拔牙过程中起到增隙效果，但此操作具有较强震动感，极易带给患者恐惧、紧张感，不仅容易导致其下颌关节脱位、组织性损伤等严重并发症，也不利于术后恢复[2]。因此本研究为进一步探讨采取不同拔除术对其下颌阻生智齿拔除后效果进行对比，现将高速涡轮钻法与增隙后推旋法用于下颌阻生智齿拔除，特对我院收治的172例下颌阻生智齿患者进行分析，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年1月至2019年10月我院收治的下颌阻生智齿患者172例作为研究对象，随机将其分为A组与B组，每组各86例。其中A组男45例，女41例，平均年龄（31.91±2.44）岁;B组男37例，女49例，平均年龄（33.01±2.51）岁;两组基础资料比较，差异无统计学（P>0.05），具有可比性。

纳入标准：①符合下颌阻生智齿诊断标准[3]者;②阻生牙导致神经疼痛者;③阻生牙导致颌骨囊肿或引发其他病灶牙者;④因食物嵌塞或邻牙龋坏，导致牙根吸收或邻牙牙槽骨吸收者;⑤对本研究知情且积极配合者;⑥经医院医学伦理委员会审批者。排除标准：①有精神疾病者;②妊娠、哺乳期女性;③表达功能障碍者;④心血管疾病者;⑤凝血功能或免疫系统障碍者。