下颌阻生第三磨牙拔除后邻牙牙周治疗的临床疗效

Effects of extraction of impacted mandibular third molar followed by periodontal treatment of adjacent tooth

目的:观察下颌阻生第三磨牙拔除后邻牙远中面不同牙周处理方法的疗效。方法:采用自身双侧对照法,选择双侧下颌第三磨牙前倾或水平阻生的患者53名106个牙,一侧(对照组)53个阻生齿拔除后常规骚刮拔牙窝,简单根面平整,间断缝合,压迫止血;对侧(实验组)阻生齿(53个)拔除后第二磨牙远中面做龈下基础刮治和根面平整术及楔形牙周手术,锚式缝合,压迫止血。术后跟踪观察1年,检查记录第二磨牙远中面菌斑指数(PLI),出血指数(BI),探诊敏感(DH),牙周探诊深度(PD),牙槽骨的变化等并进行统计学分析。结果:术后1年,PLI、BI,PD、DH等各项指标实验组分别为0.82±0.57、0.90±0.82、(1.37±0.31)mm和5.66%,对照组分别为1.65±0.60、1.21±0.71、(1.93±0.45)mm和62%;牙槽骨骨质增加者实验组为39.47%,对照组为3.77%,各项指标差异均有统计学意义(P<0.05)。结论:下颌第三磨牙阻生齿拔除后邻牙远中面精细的牙周治疗加楔形手术可减少术后并发症。

AIM ： To evaluate th effects of extraction of impacted mandibular third molar followed by periodontal treatment of adjacent tooth. METHODS ： Bilateral 106 native forward or horizontaly impacted mandibular third molars in 53 patients were included. 53 teeth on one side were extracted by conventional surgery as the controls, 53 teeth on the other side were extracted by conventional surgery followed by periodontal treatment of adjacent second molars as the experimental group, including root scaling, planing and wedge-shaped teeth week operation. One year follow-up was conducted, plaque index（ PLI）, bleeding index （BI） , periodontal probing depth （PD）, probing sensitivity （DH） and alveolar bone changes of the second molar were measured, data were statisticaly analysed. RESULTS ： One year after treatment PLI, BI, PD and DH in experimental group were 0.82 ± 0.57, 0.90 ± 0.82, （ 1.37 ± 0.31 ） mm and 5.66%, those in the control group were 1.65 ± 0.60, 1.21 ± 0.71, （ 1.93 ± 0.45） mm and 39.62% , respectively （P 〈 0.05 ）. Alveolar bone increase was observed in 39.47% of the experimental cases and 3.77% of the controls （ P 〈 0.05 ）. CONCLUSION ： Periodontal treatment with wedge valve operation may reduce the postoperative compli- cations of the adjacent mandibular second molars after extraction of the impacted third molars.