数字化定位导板在埋伏多生牙拔除中的应用

Application of digital positioning guide plate in extraction of impacted supernumerary teeth

目的探讨数字化定位导板在埋伏多生牙拔除中的应用,并评价其应用效果。方法选取2019年3月~2019年8月于南方医科大学口腔医院颌面外科病房就诊的上颌前牙区唇侧埋伏多生牙患者30例,实验组15例通过数字化定位导板拔除埋伏多生牙,定位导板根据患者的CBCT数据和牙列模型,避开重要解剖结构,以牙-骨面作为支持,设计出软组织切口线和骨组织暴露范围。对照组15例不使用导板进行手术。记录术前设计时间、找牙时间、手术时间、术中并发症出现情况。结果实验组定位导板在术中均贴附良好,可快速定位并协助暴露多生牙,同时避免邻近重要解剖结构损伤。实验组术前设计时间为50±5 min,对照组该时间为0 min。实验组平均找牙时间为5±2 min,对照组为10±3 min,实验组显著小于对照组(t=15.40,P<0.01);实验组平均手术时间为25±4 min,对照组为45±6 min,实验组显著小于对照组(t=35.50,P<0.01);实验组未出现术中并发症,对照组出现一例定位稍偏差。结论应用数字化定位导板拔除埋伏多生牙,明显缩短了找牙时间,减少手术难度,提高手术质量,值得临床推广。

Objective To explore the application of digital positioning guide plate in extraction of impacted supernumerary teeth and evaluate its clinical efficacy.Methods From March to August,2019,30 patients with labial impacted supernumerary teeth treated in the Department of Oral and Maxillofacial Surgery,Stomatological Hospital,Southern Medical University were enrolled in this study.Fifteen of the patients were treated with digital positioning guide plate to remove the impacted supernumerary teeth(test group).According to the CBCT data and the dentition model of the patients,the positioning guide plate was positioned by avoiding the important anatomical structure with the tooth-bone surface as the support to design the soft tissue incision line and bone tissue exposure range.The other 15 patients who were treated without the use of the guide plate for operation served as the control group.The design time,tooth searching time,operation time and complications were compared between the two groups.Results The positioning guide plate was well attached during the operation and allowed quick location of the supernumerary teeth while helping to expose the supernumerary teeth and avoid the damage of the adjacent important anatomical structures.The pre-operative design time was 50±5 min in the test group and 0 min in the control group.The average time of tooth finding in the test group was 5±2 min,as compared with 10±3 min in the control group(t=15.40,P<0.01);the average time of operation was significantly shorter in the test group than in the control group(25±4 min vs 45±6 min;t=35.50,P<0.01).No intraoperative complications occurred in the test group,and slight deviation occurred in one case in the control group.Conclusion The application of digital positioning guide plate in extraction of embedded supernumerary teeth can significantly shorten the time of tooth finding,reduce the difficulty of operation,and improve the quality of operation.