下颌智齿拔除对第二磨牙牙周恢复情况的影响

Effect of mandibular wisdom tooth extraction on the gingival recovery of the second molars

目的探讨下颌智齿拔除对第二磨牙牙周患者牙周探诊深度、牙龈恢复情况的影响。方法选取2016年2月~2020年2月北京市第六医院收治的接受下颌智齿拔除治疗的患者98例,所有患者均接受过涡轮钻-微创法手术治疗。随机分为实验组和对照组(n=49),对照组:手术期间不切开、不缝合,术后不填塞明胶海绵;实验组:术中采用颊侧切开的角形切口,切开拉拢缝合,并填充明胶海绵。观察分析两组治疗后牙菌班指数及牙龈指数,第二磨牙远中牙周深度变化情况以及牙槽嵴附着丧失高度情况。结果治疗前两组患者牙菌斑指数、牙龈指数比较均不存在显著差异性(P>0.05)。治疗后1周,实验组及对照组牙菌斑指数以及牙龈指数改善程度均明显优于治疗前(P<0.05);拔牙前,两组患者第二磨牙远中牙周深度不存在显著意义(P>0.05),实验组、对照组患者拔牙后1个月第二磨牙远中牙周深度改善程度均明显优于治疗前(P<0.05);拔牙后3个月、6个月,两组第二磨牙远中的牙槽嵴附着丧失高度比较不存在显著差异性(P>0.05);实验组牙探诊出血阳性率低于对照组(P<0.05)。结论下颌阻生智齿拔除治疗能有效促进患者第二磨牙远中牙周情况的改善,降低牙菌斑的附着,减轻远中牙槽骨附着丧失的情况,对维护口腔健康有重要意义。

Objective To investigate the effect of mandibular wisdom tooth extraction on the periodontal probing depth and middle gingival recovery of the second molars. Methods A total of 98 patients admitted to Beijing No.6 Hospital from February 2016 to February 2020 who had received mandibular wisdom tooth extraction were selected. All the patients had received turbine-minimally invasive surgery. There were 49 cases in the experimental group and the control group, respectively. In the control group, no incision, no suture, and no padding of gelatin sponges were performed during the operation. In the experimental group, an angular incision with buccal incision was used during the operation, and gelatin sponges were cut, stitched and filled. Observe and analyze the plaque index and gingival index before and after the treatment, changes of distal periodantal depth of the second molar and the loss of alveolar ridge attachment. Results Before treatment, there was no significant difference in plaque index and gingival index between the two groups(P>0.05). One week after treatment, the improvement of plaque index and gingival index in the experimental group and the control group were significantly better than those before treatment(P<0.05). Before tooth extraction, there was no significant difference in the distal periodontal depth of the second molar between the two groups(P>0.05). The improvement of the distal periodontal depth of the second molar in the experimental group and the control group 1 month after tooth extraction was significantly better than that before treatment(P<0.05);At 3 and 6 months after tooth extraction, there was no significant difference in the height of attachment loss between the two groups(P>0.05);The positive rate of bleeding in the experimental group was lower than that in the control group(P<0.05). Conclusion Treatment of mandibular impacted wisdom tooth extraction can effectively promote the improvement of distal periodontal condition of the second molar, reduce the attachment of dental plaque, and reduce the loss of distal alveolar bone attachment, which is of great significance for the maintenance of oral health.