涡轮机磨断牙冠法拔除下颌近中或水平阻生智齿的临床研究

Clinical research on mandible wisdom teeth extraction in low mesioangular impaction or horizontal impaction by high-speed air turbine drill

目的探讨涡轮机磨断牙冠法(冠磨断法)拔除下颌近中或水平阻生智齿的效果。方法 2000—2013年因近中或水平阻生而被拔除的下颌第三磨牙共290例(290颗)。遵循不同患者意愿,采用传统的劈冠法或冠磨断法,拔除下颌近中或水平阻生智齿,并将两组每牙拔除平均耗时、术后反应进行比较分析。结果采用劈冠法拔除128颗,拔除每牙平均耗时(53.0±11.3)min,术后重度反应发生率为54.7%(70/128),中、轻度反应发生率为45.3%(58/128);冠磨断法拔除162颗,拔除每牙平均耗时(36.0±9.4)min,术后重度反应发生率为27.8%(45/162),中、轻度反应发生率为72.2%(117/162)。两组拔牙平均耗时、术后重度反应比较,差异有统计学意义(P<0.01)。结论冠磨断法拔除下颌近中或水平阻生智齿,比劈冠法手术时间短、术后重度反应轻、患者对拔牙恐惧心理小、对操作者的心理压力小,是一种科学、可行的拔牙方法。

Objective To explore the efficacy of high-speed turbine drill on wisdom teeth extraction in low mesioangu- lar impaction or horizontal impaction. Methods A total of 290 cases of third molar （290 teeth ） in low mesioangular impaction or horizontal impaction extracted from 2000 to 2013 were selected. Followed the patients＇ willingness ,the traditional corona-splitting and corona-grinding with turbine were adopted to extract mandible wisdom teeth in low mesioangular impaction and horizontal impaction. The average time-consuming of extraction for each tooth and postoeprative reactions by the two methods were analyzed comparatively. Results 128 teeth were extracted by corona-splitting, the average time-consuming of extraction for each tooth was （53.0-＋ 11.3 ）minutes with the incidence rate of postoperative servere reaction of 54.7% （70/128） and incidence rate of moderate and light reaction of 45.3% （58/128）. 162 teeth were extracted by corona-grinding with turbine, the average time-consuming of ex- traction for each tooth was （36.0-＋9.4）minutes with the incidence rate of postoperative servere reaction of 27.8% （45/162） and inci- dence rate of moderate and light reaction of 72.2% （117/162）. The comparason of the mean time-consuming for extraction and postoperative reactions between the two groups was statistically significant （P〈0.O1）. Conclusion Compared to the traditional method of corona-splitting, corona-grinding with turbine is with shorter operative time,less postoperative reaction,less psychological afraid of patients to extraction,less psychological pressure of operator to extract mandible wisdom teeth in low mesioangular im- paction and horizontal impaction, therefore, it is an scientific and feasible method of tooth extraction.