经舌侧骨板切除术拔除下颌低位阻生第三磨牙29例报道

Extracting the impacted mandibular third molar via resection of lingual bone plate: Report of 29 cases

目的:探讨经舌侧骨板切除术拔除下颌低位阻生第三磨牙的可行性及其优势。方法:47例下颌低位阻生第三磨牙患者,半随机分为2组进行手术拔牙。其中29例为实验组,采取经舌侧骨板切除术式拔牙;18例为对照组,采取传统的颊侧去骨术式拔牙。同期标准对照,比较2组手术的时间、伤口愈合及术后组织反应如疼痛、肿胀、开口受限等的差异,对有关数据进行F检验、t检验及χ2检验。结果:全部病例均获一期愈合,无后遗症。2组手术时间、疼痛及开口受限无显著差异。实验组切口小、去骨及拔牙相对容易,但清创及缝合占用的时间相对较多。在颊侧组织肿胀方面,第2天对照组中度以上肿胀比例达61%,远高于实验组的3%,χ2=19.7653,P<0.005,差异有显著性;第7天2组肿胀消退接近正常,且无差异。2组舌侧组织肿胀均不显著,且无差异。结论:以舌侧骨板切除术拔除下颌低位阻生第三磨牙切口小,能轻松消除骨阻力及拔除牙,术后组织反应程度较轻,无不良后遗症。

PURPOSE: The purpose of this study was to investigate the feasibility and advantage of extracting the impacted mandibular third molar via resection of lingual bone plate. METHODS: 47 cases with lower impacted mandibular third molar were semi-randomly divided into two groups, one was the experimental group with 29 cases, another was the control group with 18 cases. The impacted teeth were removed with resection of lingual bone plate in the experimental group and of buccal bone plate in the control group respectively. The operating time, wound healing and tissue reaction (pain, swelling, restriction of mouth opening) were compared between the two groups at the same time. Statistical methods including F test, student's t test, χ2 test were used for analysis. RESULTS: All cases healed at 7th day postoperatively. No sequelae were found. No significant differences of operating time, pain and restriction of mouth opening existed in the two groups. In the experimental group, the incision was smaller and the extraction was more easily, but debridment and suture took more time. At the 2nd day postoperatively, the proportion of moderate buccal swelling was 61% in the control group, and 3% in the experimental group. χ2 test showed the difference of buccal swelling was significant between the two groups (χ2=19.7653, P<0.005). At the 7th day postoperatively, buccal swelling subsided approximately to normal and no difference existed in the two groups. Lingual swelling was not significant and no difference was found in the two groups. CONCLUSION: The results indicated that extraction of the impacted mandibular third molar via resection of lingual bone plate is easier, and needs smaller incision, which results in less severe tissue reaction.