摘要
目的:探讨微创手术拔除下颌近中水平完全埋伏阻生牙时保留颊侧骨板的效果.方法:选取近中低位水平埋伏阻生牙86颗,随机分为2组,试验组以球钻开窗,暴露牙冠远中面,保留颊侧骨板,使用仰角手机配合加长车针行多次T形截冠,去除牙冠,微创拔除.对照组采用球钻去除远中及颊侧骨板,暴露远中及颊部牙冠,T形截冠,其余操作均一致.观察2组患者术后肿胀程度、开口受限程度以及疼痛视觉模拟量表(VAS)评分,检测C反应蛋白水平以及抗溶血链球水平;1个月后检查邻近第二磨牙牙周探诊深度(probing depth,PD)、出血指数(bleeding index,BI)及临床附着丧失(clinical attachment loss,CAL)水平.采用SPSS 25.0软件包对数据进行统计学分析.结果:试验组术后肿胀程度显著轻于对照组(P＜0.05),开口受限与疼痛程度无显著差异(P＞0.05).试验组C反应蛋白水平显著高于对照组(P＜0.05),抗溶血链球菌水平2组之间比较无显著差异(P＞0.05).术后1个月,对照组PD和CAL均显著高于试验组(P＜0.05),2组BI比较无显著差异(P＞0.05).结论:保留颊侧骨板微创拔除下颌近中水平完全埋伏阻生牙患者术后反应更轻,创口愈合更好.
Abstract
PURPOSE:To explore the effect of extracting the completely impacted teeth by minimally invasive surgery with preserving the buccal bone plate.METHODS:Eighty-six cases were selected and randomly divided into 2 groups.In the experimental group,a fenestration was made with a ball drill to expose the buccal and lingual margin of crown,and the buccal bone plate was preserved.T-shaped crown cuttings were performed,minimally invasive extraction was con-ducted.In the control group,the distal and buccal bone plates were removed with a ball drill,the distal and buccal crowns were exposed,and T-shaped crown was cut.The other procedures were the same.The degree of swelling,restricted mouth opening and VAS pain score after operation were observed,the levels of C-reactive protein and anti-hemolytic strep-toglobulin were detected by laboratory tests,and the periodontal probing depth(PD),bleeding index(BI),and clinical at-tachment loss(CAL)of the adjacent second molar were examined 1 month after surgery.SPSS 25.0 software package was used for data analysis.RESULTS:The swelling degree of the two groups was significantly relieved in the experimental group than in the control group(P＜0.05),and there was no significant difference in the degree of mouth opening limitation and pain(P＞0.05).The level of C-reactive protein in the control group was significantly higher than that in the observation group(P＜0.05).There was no significantly difference in the level of anti-hemolytic streptococcus between the 2 groups(P＞0.05).One month after operation,the PD and CAL in the control group were significantly higher than those in the experi-mental group(P＜0.05).There was no significant difference between the 2 groups in BI(P＞0.05).CONCLUSIONS:The patients who preserve the buccal bone plate by minimally invasive extraction of impacted mandibular teeth have less reac-tion and better wound healing.
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