龈瓣缝合类型对下颌阻生智齿拔除术后生活质量的影响

Effects of types of gingival flap suture on postoperative quality of life after removal of impacted mandibular wisdom teeth

目的评价下颌阻生智齿拔除术后不同牙龈瓣关闭缝合方式对患者术后生活质量的影响。方法采用随机、自身对照的临床试验设计,选取就诊于天津医科大学口腔医院外科门诊要求拔除双侧对称阻生下颌第三磨牙患者62例,龈瓣缝合时一侧采用封闭式缝合(一期缝合),另一侧采用开放引流式缝合(二期缝合)。应用下颌第三磨牙拔除术后症状严重度量表(Po SSe量表)对患者进行术后生活质量的评价。分别于术后第7天完成评价并分析比较2组得分。结果共57例患者资料进入结果分析,一期缝合组手术用时(17.7±4.6)min,二期缝合组为(16.3±5.1)min,差异无统计学意义(t=1.539,P>0.05)。一期缝合组与二期缝合组的Po SSe量表分值分别为26.348±12.414和21.633±11.382。前者高于后者(P<0.05)。结论开放引流式缝合通过缓解疼痛、肿胀在一定程度上减缓拔牙对患者生活质量的影响,适于临床推广应用。

Objective To evaluate effects of different types of gingival flap suture on the quality of life in patients after removal of mandibular third molar. Methods A randomized, controlled clinical trial design was adopted. Sixty-two patients in oral surgery department, Stomatology Hospital of Tianjin Medical University were selected. Patients were required removal of bilateral symmetry impacted mandibular third molars, and enclosed suture （primary suture） was used in one side, open drainage suture （secondary suture） was used in the other side. The postoperative symptom severity scale （PoSSe scale） was used to evaluate the quality of life in patients after removal of mandibular third molar. The evaluation was completed 7 days after surgery, and the scale was compared between two groups. Results A total of 57 cases of clinical data were enrolled in the final analysis. The operative time for primary suture group was （17.7±4.6） min, and the operative time for secondary suture group was （16.3 ± 5.1） min, the difference was not statistically significant （t=1.539, P〉0.05）. The PoSSe score was significantly higher in primary suture group （26.348 ± 12.414） than that of secondary suture group （21.633 ± 11.382, P〈0.05）. Conclusion Secondary suture reduces the influence of teeth removal on quality of life in patients through relieving pain and swelling, and which is suitable for clinical application.