45°反角高速涡轮牙钻法对下颌低位水平埋伏阻生牙患者炎症应激反应及疼痛介质水平的影响

Effects of 45°Counter Angle High Speed Turbine Drill on Inflammatory Stress Response and Pain Mediator Level in Patients with Impacted Mandibular Lower Teeth

目的:探讨45°反角高速涡轮牙钻法对下颌低位水平埋伏阻生牙患者炎症应激反应及疼痛介质水平的影响。方法:回顾性分析2020年1月-2022年3月期间在马鞍山市人民医院治疗的100例下颌低位水平埋伏阻生牙患者的临床资料。根据手术方案的不同将患者分为A组(n=48,传统锤凿劈冠法治疗)和B组(n=52,45°反角高速涡轮牙钻法治疗),对比两组围术期指标、炎症应激反应指标、疼痛介质和并发症发生情况。结果:B组的手术时间短于A组,张口受限度小于A组,术中出血量少于A组,牙窝完整率高于A组,术后视觉模拟量表(VAS)评分低于A组(P<0.05)。B组的并发症发生率低于A组(P<0.05)。两组术后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、细胞间粘附分子1(ICAM-1)、丙二醛(MDA)升高,但B组低于A组(P<0.05),两组术后超氧化物歧化酶(SOD)下降,但B组高于A组(P<0.05)。两组术后P物质(SP)、5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)、前列腺素E2(PGE2)升高,但B组低于A组(P<0.05)。结论:下颌低位水平埋伏阻生牙患者经45°反角高速涡轮牙钻法治疗,可减轻术后创伤,降低疼痛介质水平,缓解炎症应激反应,缩短手术时间。

Objective:To investigate the effect of 45°counter angle high speed turbine drill on inflammatory stress response and pain mediator level in patients with impacted mandibular lower teeth.Methods:The clinical data of 100 patients with impacted mandibular lower teeth who were treated in Maanshan People's Hospital from January 2020 to March 2022 were analyzed retrospectively.The patients were divided into group A(n=48,treated with traditional hammer chisel and chop crown method)and group B(n=52,treated with 45°counter angle high speed turbine drill method)according to the different operation schemes.The perioperative indicators,inflammatory stress response indicators,pain mediators and complications in the two groups were compared.Results:The operation time in the group B was shorter than that in the group A,the mouth opening limit was less than that in the group A,the intraoperative blood loss was less than that in the group A,the rate of dental integrity was higher than that in the group A,and the score of postoperative visual analog scale(VAS)was lower than that in the group A(P<0.05).The complication rate in the group B was lower than that in the group A(P<0.05).Interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),intercellular adhesion molecule-1(ICAM-1)and malondialdehyde(MDA)were increased in the two groups after operation,but the group B was lower than the group A(P<0.05).Superoxide dismutase(SOD)was decreased in the two groups after operation,but the group B was higher than the group A(P<0.05).Substance P(SP),5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP)and prostaglandin E2(PGE2)were increased in the two groups after operation,but the group B was lower than the group A(P<0.05).Conclusion:The treatment of patients with impacted mandibular lower teeth by 45°counter angle high speed turbine drill can reduce postoperative trauma,reduce the level of pain media,alleviate inflammatory stress reaction,and shorten the operation time.