CBCT介导下微创法拔除上颌第一前磨牙多根牙的临床研究

Clinical Effects of CBCT Mediated Minimally Invasive Extraction of Maxillary First Premolar With Multiple Roots

目的:探讨CBCT辅助下采用微创拔牙法拔除上颌第一前磨牙多根牙的临床应用效果。方法:选择需要拔除上颌第一前磨牙患者84例,分为对照组和观察组各42例。对照组行CBCT检查后采用传统方法拔牙,观察组行CBCT检查后采用微创法拔牙,比较两组患者手术前后对拔牙的恐惧程度,患者术中配合程度,手术时间和术后并发症。结果:观察组患者术前恐惧程度较对照组差异无统计学意义(P=0.611),患者术后恐惧程度比较观察组低于对照组,差异有统计学意义(P=0.002)。术中配合程度比较观察组优于对照组,差异有统计学意义(P=0.046)。观察组手术时间8~10min,平均(9.38±1.19)min;对照组手术时间8~14min,平均(10.60±1.99)min,观察组手术时间短于对照组,差异有统计学意义(t=5.740,P=0.000)。观察组术中牙龈裂伤、术后出血、干槽症及邻牙不适发生率低于对照组,差异均有统计学意义(χ^(2)=9.414,P=0.002;χ^(2)=6.802,P=0.009;χ^(2)=4.480,P=0.034;χ^(2)=6.943,P=0.008)。结论:CBCT辅助下采用微创拔牙法拔除上颌第一前磨牙多根牙,患者恐惧程度降低,手术时间缩短,患者术中配合度提高,拔牙并发症减少,是舒适、微创的拔牙术。

Objective:To evaluate the clinical effect of minimally invasive extraction of maxillary first premolars with multiple roots assisted by CBCT.Methods:84 patients with maxillary first premolars with multiple roots needed to be extracted were divided into control group and observation group with 42 cases each.Traditional extraction was performed in the control group and micro-invasive extraction was performed in the observation group.The fear of tooth extraction,cooperation,operation time and complications were compared between the two groups.Results:There was no significant difference in preoperative fear degree between the observation group and the control group(P=0.611).The postoperative fear degree of the observation group was significantly lower than that of the control group(P=0.002).The intraoperative cooperation degree of the observation group was better than the control group,the difference was statistically significant(P=0.046).The operation time in the observation group was 8-10min,with an average of(9.38±1.19)min;The operation time in the control group was 8-14min,with an average of(10.60±1.99)min.The operation time in the observation group was shorter than that in the control group,with a statistically significant difference(t=5.740,P=0.000).The incidence of gingival laceration,postoperative bleeding,dry socket and adjacent tooth discomfort in the observation group were significantly lower than those in the control group(χ^(2)=9.414,P=0.002;χ^(2)=6.802,P=0.009;χ^(2)=4.480,P=0.034;χ^(2)=6.943,P=0.008).Conclusion:Minimally invasive extraction of maxillary first premolars with multiple roots assisted by CBCT is a comfortable and minimally invasive procedure with less fear,shorter operation time,better cooperation and fewer complications.