两种缝合方式对下颌低位阻生智齿拔除术后并发症的影响

The effects of two suture techniques on the postoperative complications after mandibular lower impacted third molar extraction

目的观察两种不同的缝合方式对下颌低位阻生智齿拔除术后并发症的影响。方法选择100例需翻瓣去骨拔除的下颌低位阻生智齿,随机分为观察组和对照组各50例。术中均采用传统角形切口(近中颊侧切口+远中切口),对照组拔牙术后切口采取完全缝合(远中切口缝合+颊侧切口缝合),观察组拔牙术后切口采取部分缝合(远中切口缝合+龈瓣转折处缝合,颊侧切口不缝合),两组术后均常规预防性抗感染治疗。比较两组术后48 h及7 d拔牙后出血、面颊部肿胀、疼痛及张口受限情况,并作统计学分析。结果两组术后在48 h及7 d拔牙后出血、疼痛、张口受限及面部肿胀程度均无显著性差异(P>0.05)。结论两种缝合方式对于下颌低位阻生智齿拔除术后出血、疼痛、张口受限及局部肿胀程度等并发症并无明显差异,但部分缝合术可以减少手术操作时间,简化手术过程,减少患者的创伤。

Objective To evaluate the effects of two different suture techniques of the triangular flap on the postoperative complications after the removal of impacted lower third molar. Method A prospective,randomized clinical trial was conducted among 100 patients who underwent surgical extraction of impacted lower third molar at the Department of Oral Surgery in Stomatological Hospital of Jiangsu Province. Patients were randomly divided into 2 groups（ each group of 50 people）. Two different techniques（ complete closure and partial closure of the wound） were performed respectively with conventional anti-infection therapy postoperatively. The control group adopted the complete closure while the observation group the partial closure after operation. Postoperative complications were evaluated prior to the surgical procedure and also at 48 hours and 7 days postoperatively. Result No statistically significant differences were observed for bleeding（ P〉0. 05）,swelling（ P〉0. 05）,pain（ P〉0. 05） and trismus（ P〉0. 05） between the observation group and the control group. Conclusion Partial closure of the flap without suturing the relieving incision after surgical extraction of lower third molar reduces operating time and it does not increase the postoperative complications compared with complete closure of the wound.