阻生牙拔除的为与不为

The do′s and don′ts in impacted tooth removal

随着牙及牙槽外科技术的进步,几乎所有的阻生牙在技术上都可以拔除。然而,近年来牙及牙槽外科的许多从业者对于阻生牙拔除呈现出一种激进与狂热的趋势——似乎所有阻生牙都应该拔除,牙及牙槽外科医师的能力就体现在阻生牙的难度上。阻生牙拔除的指征,尤其是预防性拔除的指征,往往被忽略。本文将回顾近年来阻生牙拔除指征相关的证据,从邻牙健康、口颌系统的健康、阻生牙保留的价值和种植治疗需求的转变等方面,结合笔者的临床经验,谈一谈阻生牙拔除的“为与不为”,以期为牙及牙槽外科医师提供参考。

Technically speaking,with advances in alveolar surgical techniques,almost all impacted teeth can be extracted.However,there is a trend in recent years that many practitioners of alveolar surgery are aggressive and fanatical about the extraction of impacted teeth.It seems that all impacted teeth should be extracted,and that the competence of the alveolar surgeon can only be reflected in the difficulty of the impacted tooth removal.Indications for the extraction of an impacted tooth,especially for the prophylactic extraction,are often overlooked.In this article,we reviewed the evidence on the indications for the extraction of impacted teeth in recent years,and discussed the“do′s and don′ts”in impacted tooth removal,from the perspectives of the health of both the adjacent teeth,and the maxillomandibular system,the value of retaining impacted teeth,and the shift in the demand for dental implant.Together with the clinical experience of the authors,it is expected to provide some reference for the alveolar surgeons.