高速涡轮机法与增隙经舌侧法在下颌阻生齿拔除术中的效果对比

The comparative effect of the extraction of impacted mandibular third molar by High-speed turbine and the gap increas through lingual

目的对比研究高速涡轮机法与增隙经舌侧法在下颌阻生齿拔除术中的临床效果。方法收集2013年3月至2014年3月我科收治的354例下颌近中阻生齿患者,随机分为高速涡轮机组(176例)与增隙经舌侧组(178例),比较两组患者手术时间、术后张口受限、颞下颌关节区疼痛、局部肿胀等并发症发生情况,以及拔牙患者对两种术式手术操作后的感受情况,是否对拔牙产生恐惧感,并对结果进行统计学分析。结果两组患者的手术时间及术后张口受限、颞下颌关节区疼痛、局中部肿胀在近中中、高位阻生智齿患者中差异均无统计学意义(X^2分别为2.18、0.27、0.67、0.46,P>0.05);在近中低位、水平阻生智齿患者中拔牙时间、张口受限、颞下颌关节区疼痛、局中部肿胀差异有统计学意义(X^2分别为32.88、4.53、5.26、4.55,P<0.05)。增隙经舌侧组有90人产生了恐惧感,高速涡轮机法组有68人产生了恐惧感,差异有统计学意义(X^2=5.09,P<0.05)。结论在近中中、高位阻生智齿拔出术中,两种手术方式都能取得较好效果。在近中低位、水平阻生智齿拔除术中,高速涡轮机组的临床效果要优于传统术式。在临床应用中,相对患者的心理感受来讲,高速涡轮机法更能让患者接受,能够降低患者对拔牙的恐惧感。

Objective To investigate the clinical effect of High-speed turbine and increases the gap through lingual in the extraction of impacted mandibular third molar. Methods 354 impacted mandibular third molars were randomly di- vided into High--speed turbine group（176 cases） and the increases the gap through lingual group （178 cases ）. The operation time, the complications of limited mouth opening, temporomandibular joint pain, local swelling, and all patients with the overall feeling of tooth extraction were observed. Results There was no statistically significant difference of operation time and postoperative complications in patients with middle and high impacted （operation time X2= 2. 18, the complications of limited mouth opening x2 = 0.27; temporomandibular joint pain X2 = 0.67 and local swelling x2 = 0.46; P〉0.05） between the two groups. The difference of the two groups had statistically significant in the mesio-low, horizontal impacted wisdom teeth （operation time X2 = 32.88, the complications of limitedmouthopening X2 = 4.53, temporomandibularjointpain X2 = 5.26 ;localswelling X2 = 4.55;P〈0.05）. The two groups of patients had were generated the feelings of fear of two kinds of operative methods （90 cases were generated the feelings of fear in increases the gap through lingual, 68 cases were generated the feelings of fear in high-speed turbine X2= 5.09; P〈0.05）. Conclusion Both methods of high-speed turbine and increases the gap by lingual can obtain good effect in patients of the middle and high impacted mandibular wisdom teeth. The clinical effect of high-speed turbine is superior to that of conventional surgery in patients of the mesio-low horizontal impacted wisdom teeth. In clinical application, the operative method of high-speed turbine was more accepted than the method of increases the gap by lingual by the patient＇s psychological feelings, that can reduce patients fear of tooth extraction.