角型切口与龈缘袋状切口拔除下颌水平阻生智齿的效果差异性研究

Study on Effect Difference between Triangular Incision and Envelope Incision in the Extraction of Horizontal Mandibular Impacted Wisdom Teeth

目的:比较龈缘袋状切口与角型切口拔除下颌水平阻生智齿对患者咀嚼功能、张口受限及疼痛肿胀的影响。方法:回顾性分析2021年11月—2023年2月于上海市东方医院吉安医院就诊的采用龈缘袋状切口进行拔除的下颌水平阻生智齿患者临床资料,随机选取38例(38颗患牙)纳入袋状组;回顾性分析同期于本院就诊的采用角型切口进行拔除的下颌水平阻生智齿患者临床资料,随机选取30例(30颗患牙)纳入角型组。对比两组手术指标(手术时间、术中出血量)、比较两组术后第7天张口受限、疼痛肿胀情况,比较两组术后1个月咀嚼功能(咬合力、咀嚼效率),统计两组术后1个月内不良事件发生情况。结果:袋状组与角型组手术时间、术中出血量比较差异均无统计学意义(P>0.05);术后第7天,袋状组疼痛肿胀、张口受限程度均高于角型组,差异均有统计学意义(P<0.05);术后1个月,袋状组咬合力、咀嚼效率均低于角型组,差异均有统计学意义(P<0.05);术后1个月内,袋状组不良事件总发生率(26.32%)与角型组(23.33%)比较差异无统计学意义(P>0.05)。结论:龈缘袋状切口与角型切口拔除下颌水平阻生智齿均可取得较好的临床治疗效果,均具有较好的安全性,角型切口拔除能有效缓解患者术后张口受限及疼痛肿胀情况,有利于患者咀嚼咬合能力的恢复。

Objective:To compare the effects of envelope incision and triangular incision for extraction of horizontal mandibular impacted wisdom teeth on masticatory function,mouth opening limitation,pain and swelling of patients.Method:The clinical data of patients with horizontal mandibular impacted wisdom teeth who underwent envelope incision for extraction in Ji’an Hospital,Shanghai Oriental Hospital from November 2021 to February 2023 were retrospectively analyzed,and 38 patients(38 affected teeth)were randomly selected and included in envelope group.The clinical data of patients who received triangular incision for extraction of horizontal mandibular impacted wisdom teeth in the hospital during the same period were retrospectively analyzed,and 30 patients(30 affected teeth)were randomly enrolled as triangular group.The surgical indicators(surgical time,intraoperative blood loss),limitation of mouth opening,pain and swelling on the 7th day after surgery and masticatory function(occlusal force,masticatory efficiency)at 1 month after surgery were compared between the two groups of patients,and the adverse events within 1 month after surgery were counted.Result:There were no statistically significant differences in the surgical time and intraoperative blood loss between envelope group and triangular group(P>0.05).On the 7th day after surgery,the pain and swelling and limitation of mouth opening in envelope group were severer than those in triangular group,with statistical differences(P<0.05).At 1 month after surgery,the occlusal force and masticatory efficiency in envelope group were lower than those in triangular group,with statistically significant differences(P<0.05).Within 1 month after surgery,there was no statistical significance in the total incidence rate of adverse events between the envelope group(26.32%)and the triangular group(23.33%)(P>0.05).Conclusion:Envelope incision and triangular incision in extraction of horizontal mandibular impacted wisdom teeth can achieve good clinical therapeutic effect and good safety.However,triangular incision for extraction can effectively alleviate postoperative limited mouth opening and pain swelling in patients,which is beneficial for the recovery of their chewing and biting abilities.