分根法与去近中阻力法拔除下颌阻生牙的比较

A comparative study of split-root and medial resistance removal in extraction of medially impacted tooth

目的:比较分根拔除法与去近中阻力拔除法在下颌近中中位小角度阻生第三磨牙拔除术中手术时间、术中断根情况、术后并发症方面的差异,探讨分根法在近中阻生牙拔除术中的优点。方法:随机选取40例双侧基本对称的下颌近中中位小角度阻生第三磨牙、全景片显示为多根的男性患者,一侧阻生牙用分根拔除法拔除(分根组),对侧用去近中阻力法拔除(去阻力组),记录2组的手术时间,术中断根情况,术后疼痛程度、肿胀程度及开口受限程度,采用SPSS11.5软件包对数据进行配对t检验。结果:分根组手术时间、断根次数小于去阻力组,有统计学差异(P<0.05)。术后24h,分根组疼痛、肿胀、开口受限程度均小于去阻力组,有统计学差异(P<0.05)。术后72h,分根组仅开口受限程度小于去阻力组,有统计学差异(P<0.05)。术后120h,2组各种术后并发症无统计学差异。结论:对于多根的下颌中位近中小角度阻生牙,分根拔除术较去近中拔除术手术时间短,断根几率小,术后并发症轻。

PURPOSE： To compare the operating time, root fracture and postoperative complications between split-root extraction and medial resistance removal in extraction of mandibular small-angle impacted third molars, to evaluate the advantages of split-root extraction in medially impacted tooth extraction. METHODS： Forty male patients with bilaterally mandibular medial small-angle impacted third molars, having multiple roots in panoramic films, were selected. The impacted teeth on one side were extracted by using split-root method, while the similar impacted teeth on the other side were extracted by using medial resistance removal method. The operating time, root fracture, postoperative pain, facial edema, and mouth opening were recorded. SPSS11.5 software package was used and paired t test was performed to analyze the data. RESULTS： There were significant differences in operating time and root fracture between the two methods （P〈 0.05）. In the split-root group, the operating time was shorter and root fracture were less. After 24 hours, facial edema, limited mouth opening, and pain of the split-root group was less severe than that of the medial resistance removal group, differences were significant （P〈0.05）. After 72 hours, limited mouth opening of the split-root group was milder than that of the resistance removal group, the difference was significant （/~〈0.05）. After 120 hours, there was no significant difference of any complications between the two groups. CONCLUSIONS： In extraction of mandibular medial small-angle impacted third molars with multiple roots, the operating time of split-root extraction is shorter. The root fracture possibility of splitroot extraction is smaller, and postoperative complications are less common.