Er:YAG激光去骨法在下颌低位垂直阻生齿拔除术中的疗效评价

Efficacy evaluation of Erbium Yttrium-Aluminum-Garnet laser osteotomy in the extraction of low vertically impacted mandibular third molars

目的比较高速涡轮牙钻和Er:YAG激光去骨法在拔除下颌低位垂直阻生齿中的疗效,为临床选择合适的治疗方法提供指导。方法收集下颌低位垂直阻生齿并接受拔除治疗的患者60例,根据去骨方式分为传统高速涡轮牙钻去骨组(传统去骨组)和Er:YAG激光去骨组(激光去骨组)各30例,比较术后第1、3、7天2组疼痛程度视觉模拟评分(visual analogue scale,VAS),术后第3、7天面部肿胀及张口受限程度。结果2组患者术后疼痛程度VAS评分随着时间的延长有所降低,激光去骨组术后疼痛程度VAS评分低于传统去骨组,组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。术后第3天,激光去骨组面部肿胀、张口受限程度均低于传统去骨组(P<0.05);术后第7天,2组患者面部肿胀、张口受限程度差异无统计学意义(P>0.05)。结论在下颌低位垂直阻生齿拔除术中,Er:YAG激光去骨法与传统高速涡轮牙钻去骨法比较,能明显减少患者术后的疼痛、肿胀及张口受限程度,是一种值得在临床推广的拔牙方法。

Objective To compare the efficacy of traditional bur and Erbium Yttrium-Aluminum-Garnet(Er:YAG)laser osteotomy in the extraction of low vertically impacted mandibular third molars,so as to provide guidance for clinical treatments.Methods A total of 60 patients admitted with low vertically impacted mandibular third molars who received dental extraction were selected and randomly divided into two groups,traditional high-speed bur group(traditional bur group,n=30)and Er:YAG laser osteotomy group(laser group,n=30)according to different osteotomy methods.The visual analogue scale(VAS)score of postoperative pain at 1,3 and 7 d after surgery,facial swelling and mouth opening limitation at 3 and 7 d after surgery were compared between two groups.Results The VAS score of postoperative pain in the two groups decreased with the prolongation of time,which was lower in the laser group than in the traditional bur group;The differences of interaction between groups,time points and time points between groups were statistically significant(P<0.05).On the 3rd day after surgery,the degree of facial swelling and mouth opening limitation in the laser group were significantly lower than those in the traditional bur group(P<0.05),while on the 7th day,there was no difference between two groups(P>0.05).Conclusion Compared with traditional high-speed bur,Er:YAG laser osteotomy can better reduce the postoperative pain,facial swelling and mouth opening limitation after the extraction of low vertically impacted mandibular third molars,which is worthy of popularization and application in clinical practice.