不同方式分冠法拔除下颌阻生第三磨牙的临床观察

A Comparison between Different Coronetomy Techniques in Impacted Third Molar Extraction

目的:比较不同分冠法的两种高速涡轮机拔牙方法的临床应用效果,并与传统劈冠法进行比较。方法 :对210颗下颌阻生第三磨牙(186例),进行随机分组,每组70颗牙。A组:"T+V"型涡轮机分牙冠加C型颈部增隙法;B组:T型涡轮机分牙冠法;C组:传统劈冠分牙增隙法。观察拔牙时间、拔牙术中并发症、术后反应。结果 :3组中,A组拔牙时间平均(26.14±0.78)min,B组拔牙时间平均(34.53±0.52)min,C组拔牙时间平均(41.57±0.62)min。3组间比较(P<0.05),差异有统计意义。A组术后疼痛和术后肿胀均较B组、C组低(P<0.05),但术后张口受限以及术后感染在3组间无差异(P>0.05)。A组术中断根、舌侧骨板U折断发生率较B组、C组低(P<0.05)。3组间,术中明显出血、下齿槽神经损伤的发生率,差异无统计意义(P>0.05)。结论:高速涡轮机配专用长裂钻或球钻进行阻生牙拔除术,采用"T+V"型分冠结合C型颈部去骨法,拔牙时间较短,术中断根率、舌侧骨板折断率较低,术后疼痛、肿胀较少。

Objective： To compare the clinical effects of 3 different techniques in the practice of impacted mandibular third molar surgery. Methods： 210 impacted mandibular third molars（186 patients provided informed consent） were divided into 3 groups. Group A used ＂T＋V＂ shape of cutting crown by high speed turbine handpiece, combining with ＂C＂type of cervical increasing gap to extract the impacted mandibular third molars. Group B used ＂T＂shape of dividing crown.Group C used dental chisel to split the impacted molar for coronectomy. The operative time length, intraoperative and postoperative complications were recorded and compared. Results： The operation time length in group A was statistically shorter than those in group B and group C（P0.05）. Furthermore, postoperative pain, swelling, broken roots and fracture of lingual plate of group A, were also lower（P0.05）. But the clinical complications such as trismus, hemorrhage, infection,and damage of alveolar nerve showed no differences between three groups. Conclusion： Extractions of impacted mandibular wisdom teeth, with the method of ＂T＋V＂ shape coronetomy combining with cervical ＂C＂ increasing gaps, may be more benefits.