超声骨刀在下颌复杂阻生牙拔除中的应用效果及对预后的影响

Application Effect of Ultrasonic Osteotome in the Extraction of Complex Impacted Mandibular Teeth and its Influence on Prognosis

目的研究超声骨刀在下颌复杂阻生牙拔除中的应用效果及对预后的影响。方法以2022年1月-12月北京华信医院口腔科收治的下颌复杂阻生牙患者为研究对象,按照随机数字表法分为对照组和试验组,各25例。对照组采用高速涡轮手机拔牙,试验组采用超声骨刀拔牙,比较两组手术时间、术中出血量、颊周径增长量、术后疼痛程度、术后张口受限程度、炎症介质水平[白细胞(WBC)]及术后不良反应。结果试验组手术时间长于对照组,但术中出血量、颊周径增长量少于对照组(P<0.05);试验组疼痛程度低于对照组(P<0.05);两组术后张口受限程度比较,差异无统计学意义(P>0.05);两组术后第3天WBC水平高于术前,但试验组低于对照组(P<0.05);两组术后1周不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声骨刀在下颌复杂阻生牙拔除中具有确切作用,其手术时间稍长,但术中出血量少,可减轻拔牙引起的面颊肿胀、术后疼痛情况,并减轻术后炎症反应,对预后康复具有积极作用。

Objective To study the effect of ultrasonic osteotome in the extraction of complex impacted mandibular teeth and its influence on prognosis.Methods Patients with complex impacted mandibular teeth admitted to the Department of Stomatology,Beijing Huaxin Hospital from January to December 2022 were selected as the research objects.According to the random number table method,they were divided into control group and experimental group,with 25 patients in each group.The control group was treated with high-speed dental instruments tooth extraction,and the experimental group was treated with ultrasonic osteotome tooth extraction.The operation time,intraoperative blood loss,buccal circumference growth,postoperative pain,postoperative mouth opening limitation,inflammatory mediator level[white blood cell(WBC)]and postoperative adverse reactions were compared between the two groups.Results The operation time of the experimental group was longer than that of the control group,but the intraoperative blood loss and the increase of cheek circumference were less than those of the control group(P<0.05).The degree of pain in the experimental group was lower than that in the control group(P<0.05).There was no significant difference in the degree of limitation of mouth opening between the two groups(P>0.05).The WBC level of the two groups on the third day after operation was higher than that before operation,but that of the experimental group was lower than that of the control group(P<0.05).There was no significant difference in the incidence of one-week postoperative adverse reactions between the two groups(P>0.05).Conclusion Ultrasonic osteotome has a definite effect in the extraction of complex impacted mandibular teeth.Its operation time is slightly longer,but the intraoperative blood loss is less.Meanwhile,it can reduce the cheek swelling and postoperative pain caused by tooth extraction,and reduce the postoperative inflammatory response,with a positive effect on prognosis and rehabilitation.