无痛口腔麻醉仪联合超声骨刀在埋伏上前牙正畸牵引治疗的临床应用

Clinical application of painless oral anesthesia instrument combined with piezosurgery in the orthodontic traction of impacted maxillary anterior teeth

目的探讨对需要正畸牵引的埋伏上前牙进行开窗手术时,应用无痛口腔麻醉仪联合超声骨刀对比卡式注射器联合涡轮快机的临床效果。方法选取因埋伏上前牙需要正畸牵引,实行开窗术的病例128例,随机分为无痛口腔麻醉仪联合超声骨刀组(麻醉仪联合超声骨刀组)和卡式注射器联合涡轮快机组(常规组),每组64例;对比2组患者开窗术中的配合情况以及术后的肿胀和疼痛情况。结果开窗术术中的配合程度比较,麻醉仪联合超声骨刀组0级和Ⅰ级占比分别为45.3%和31.3%,常规组0级和Ⅰ级分别为32.8%和20.3%,麻醉仪联合超声骨刀组术中配合优于常规组,差异有统计学意义(Z=-2.676,P<0.05)。术后24 h疼痛和术后48 h肿胀程度比较,麻醉仪联合超声骨刀组疼痛Ⅰ级为81.2%,常规组疼痛Ⅰ级为59.4%,麻醉仪联合超声骨刀组术后疼痛轻于常规组,差异有统计学意义(Z=-2.777,P<0.05);麻醉仪联合超声骨刀组术后肿胀Ⅰ级为81.2%,常规组肿胀Ⅰ级为71.9%,麻醉仪联合超声骨刀组术后肿胀轻于常规组,差异有统计学意义(Z=-2.097,P<0.05)。结论在埋伏上前牙需要正畸牵引作开窗术时,使用无痛口腔麻醉仪联合超声骨刀,患者更加容易配合且术后反应较小。

Objective To investigate the clinical efficacy of painless oral anesthesia combined with piezosurgerycompared with ordinary cassette syringe combined with high speed turbine handpiece in the Fenestration operation oforthodontic traction of impacted maxillary anterior teeth.Methods A total of128cases of impacted maxillary anteriorteeth were treated with Fenestration operation and orthodontic traction,and the patients were randomly divided into twogroups.Group A(64patients)received painless oral anesthesia combined with piezosurgery.Group B(64patients)received ordinary cassette syringe combined with high speed turbine handpiece.The cooperation of fenestration and theswelling and pain after operation were compared between the2groups.Results The proportion of0andⅠin the anesthesia group was45.3%and31.3%respectively,and the conventional group0and I accounted for32.8%and20.3%respectively.The difference between the two groups was statistically significant(Z=-2.676,P<0.05).The pateints??cooperative degree in group A was better than that in group B(P<0.05).The ratio of pain and swelling in the anesthesiainstrument combined with Piezosurgery group was81.2%,the conventional group had a grade I ratio of59.4%,and theanesthesia instrument combined with Piezosurgery group was lighter than the conventional group,The difference was statistically significant(Z=-2.777,P<0.05);anesthesia combined with Piezosurgery group after surgery accounted for81.2%of the swelling,the conventional group of pain accounted for71.9%,There was significant difference between thetwo groups(Z=-2.097,P<0.05).Symptoms and signs as swelling and pain degree in group A were relatively minorthan those in group B(P<0.05).Conclusion It is worthy clinical promotion to use Painless oral anesthesia combined with piezosurgery in the fenestration and orthodontic traction of impacted maxillary anterior teeth,for its better cooperation and minor post-surgery reaction.