龈沟内环形切口法用于下颌远中邻面暴露≥1/2的水平阻生第三磨牙拔除的研究

Study on extraction of horizontal impacted third molars with exposure≥1/2 of mandibular distal-proximal surface by intragingival crevicular circular incision

目的 探讨龈沟内环形切口法用于下颌远中邻面暴露≥1/2的水平阻生第三磨牙拔除的临床效果。方法 纳入2020年3月—2022年3月我院收治的180例需拔除下颌远中邻面暴露≥1/2的水平阻生第三磨牙的患者作为研究对象,采用随机数字表法分为观察组和对照组,每组90例。观察组采用龈沟内环形切口法,对照组采用标准封套法。比较两组术后2、7 d出血程度、疼痛程度、肿胀程度、最大开口度,术前与术后3个月下颌第二磨牙牙周探诊深度及并发症发生情况。结果 观察组术后2 d出血程度、疼痛程度、肿胀程度均轻于对照组(P<0.05),最大开口度大于对照组(P<0.05),两组术后7 d出血程度、疼痛程度、肿胀程度、最大开口度差异均无统计学意义(P>0.05);两组术后3个月下颌第二磨牙远颊位点、近颊位点、颊侧位点、远舌位点、近舌位点、舌侧位点牙周探诊深度较术前差异均无统计学意义(P>0.05),且两组组间差异无统计学意义(P>0.05);两组并发症总发生率差异无统计学意义(P>0.05)。结论 下颌远中邻面暴露≥1/2的水平阻生第三磨牙拔除术中采用龈沟内环形切口法,可减轻术后早期出血、疼痛及开口受限,缩短软组织恢复时间。

Objective To observe the clinical effects of intragingival crevicular circular incision on the extraction of horizontal impacted third molars with exposure≥1/2 of mandibular distal-proximal surface.Methods 180 patients with horizontal impacted third molars exposed to 1/2 of mandibular distal-proximal surface in the hospital from March 2020 to March 2022 were included as the research subjects,and they were divided into observation group and control group by random number table method,with 90 cases in each group.The intragingival crevicular circular incision method and standard envelope method were performed respectively.The bleeding degree,pain degree,swelling degree and maximum opening degree at 2 days and 7 days after surgery,periodontal probing depth of mandibular second molars and occurrence of complications before surgery and at 3 months after surgery were compared between the two groups.Results The bleeding degree,pain degree and swelling degree in the observation group at 2 days after surgery were milder than those in the control group(P<0.05),and the maximum opening degree was greater than that in the control group(P<0.05).There were no statistical differences in the degrees of bleeding,pain and swelling and maximum opening degree between the two groups at 7 days after surgery(P>0.05).The periodontal probing depths of distal buccal site,proximal buccal site,buccal site,distal lingual site,proximal lingual site,and lingual site of mandibular second molars at 3 months after surgery in both group were not significantly different from those before surgery(P>0.05),and there were also no statistical differences between the two groups(P>0.05).There was no statistical significance in the total incidence rate of complications between the two groups(P>0.05).Conclusion Intragingival crevicular circular incision in the extraction of horizontal impacted third molars with exposure≥1/2 of mandibular distal-proximal surface can relieve early postoperative bleeding,pain and opening restriction,and shorten the soft tissue recovery time.