拔牙术后面部肿胀的几种相关因素的分析

Analysis study of some relative factors on postoperative buccal swelling

目的探讨拔牙术中人为因素对面部肿胀的影响。方法选择门诊要求拔除双侧下颌中、低位阻生第三磨牙的患者100例,随机分为两组,分别由年资不同的两位医生分别施行拔牙手术,术后3 d复诊,观察患者面部肿胀情况。结果低年资医生(工作时间<3年)平均手术时间多于高年资医生(工作时间>5年),有可比性,但肿胀发生率没有显著差异。面部肿胀发生与切开、翻瓣范围,特别是远中龈瓣切开剥离的程度明显相关。结论下颌阻生智齿拔除过程中,过度切开、分离牙龈组织是导致面部肿胀的主要原因;缝合过紧,拔牙窝内填塞物过多也易致术后肿胀。

Aim To investigate the relativity of some mannual factors in the process of extracting teeth and buccal swelling. Methods 100 cases, which required to extract impacted lower mandibular wisdom teeth on both sides ,were selected strictly and randomly divided into two groups. The first group was extracted by a senior dentist, and the second group was extracted by a younger dentist respectively. After three days, patients were required to see the dentist again to evaluate the buccal swelling. Results The younger dentist spent longer operative time than the senior dentist. There were significant differences between the operative time,but we couldn＇t draw a conclusion from the study that buccal swellings had relativity with operative time between the two groups. However, buccal swelling was strongly relative to range of incising and detaching degree of distal soft tissue of lower mandibular impacted wisdom teeth. Conclusions In the process of extracting lower mandibular impacted wisdom,it was the main reason to cause buccal swelling that incising and detaching distal soft tissues excessive, while suturing tightly and filling in socket with too much gelfoam were other reasons that led to the buccal swelling.