壳聚糖海绵填充用于下颌阻生齿拔除术后疗效及对术后并发症的影响

Effect of chitosan sponge filling on mandibular impacted tooth extraction and its influence on postoperative complications

目的 探讨壳聚糖海绵填充对下颌阻生齿拔除术后疗效及对术后并发症的影响。方法 选择2020年2月至2022年9月重庆大学附属三峡医院收治的下颌阻生智齿患者97例,以治疗方法不同将其分为研究组(50例)与对照组(47例)。两组均接受十字形分牙法拔牙,对照组不放置任何填充物,研究组于拔牙窝置入壳聚糖海绵填充。比较两组手术相关指标、术后肿胀程度、疼痛程度、生活质量、张口受限程度,比较两组术前及术后1 d炎症因子水平,记录两组并发症发生情况。结果 两组拔牙时间、术中出血量比较,差异无统计学意义(P>0.05)。研究组术侧口角到耳屏最下点的体表距离差值、视觉模拟评分法评分、症状严重程度量表评分均低于对照组(P<0.05)。研究组张口受限程度优于对照组(P<0.05)。术后1 d,两组血清白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α水平高于术前,且研究组高于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论 壳聚糖海绵填充可改善下颌阻生智齿患者术后肿胀、疼痛、张口受限等症状,减轻炎症反应,且可降低拔牙术后并发症发生风险。

Objective To investigate the effect of chitosan sponge filling on mandibular impacted tooth extraction and its influence on postoperative complications.Methods Ninety-seven patients with impacted mandibular wisdom teeth admitted to the Three Gorges Hospital,Chongqing University from February 2020 to September 2022 were selected and divided into study group(50 cases) and control group(47 cases) according to different treatment methods.The two groups underwent cruciform tooth extraction.The control group did not place any fillers,and the study group inserted chitosan sponge into the tooth extraction fossa.Surgical indicators,postoperative swelling,pain,quality of life,and mouth opening restriction were compared between the two groups,and the levels of inflammatory factors before and one day after surgery were compared between the two groups,and the occurrence of complications were recorded.Results There was no significant difference in extraction time and intraoperative blood loss between the two groups(P>0.05).The corner of mouth to tragus distance,the score of visual analogue scale and profile of severity of symptoms in the study group were all lower than those in the control group(P<0.05).The restriction degree of mouth opening in the study group was better than that in the control group(P<0.05).At one day after surgery,the serum levels of interleukin(IL)-6,IL-1β,and tumor necrosis factor-α in two groups were higher than those before surgery,and the those of study group were higher than those of the control group(P<0.05).The total complication rate of the study group was lower than that of the control group(P<0.05).Conclusion Chitosan sponge filling can improve postoperative swelling,pain,and mouth opening limitation in mandibular impacted wisdom teeth patients,reduce inflammatory response,and reduce the risk of complications after tooth extraction.