超声骨刀联合胶原蛋白海绵在下颌低位阻生智齿微创拔除术中的应用效果

The Application Effect of Ultrasound Bone Knife Combined with Gelatin Sponge in Minimally Invasive Extraction of Mandibular Low Impacted Wisdom Teeth

【目的】探讨超声骨刀联合胶原蛋白海绵在下颌低位阻生智齿微创拔除术中的应用效果。【方法】选取2020年1月至2022年10月在本院口腔科拔牙门诊就诊的210例下颌低位阻生智齿患者为研究对象,按治疗方法不同分为A组(采用涡轮钻拔牙)、B组(采用超声骨刀拔牙)和C组(采用超声骨刀联合胶原蛋白海绵拔牙),每组70例。比较三组患者拔牙术后30 min拔牙窝出血量、术后3 d视觉模拟评分法(VAS)评分、干槽症和下唇麻木发生情况。【结果】C组拔牙术后30 min拔牙窝出血率为11.43%(8/70),显著低于A组的37.14%(26/70)、B组的18.57%(13/70),差异有统计学意义(χ^(2)=23.342、6.389,P<0.05);B组拔牙术后30 min拔牙窝出血率显著低于A组,差异有统计学意义(χ^(2)=6.667,P<0.05)。C组患者术后72 h的VAS评分显著低于A组和B组;B组术后72 h的VAS评分显著低于A组,差异均有统计学意义(P<0.05);三组患者干槽症和下唇麻木的发生率比较,差异无统计学意义(P>0.05)。【结论】相对于单纯采用涡轮钻法或超声骨刀拔牙的方法,对下颌低位阻生智齿患者采用超声骨刀联合胶原蛋白海绵微创拔牙,虽不能减少术后干槽症和下唇麻木等并发症的发生率,但可以减少拔牙术后出血量,减轻术后疼痛,值得临床推广应用。

【Objective】To explore the application effect of ultrasound bone knife combined with Gelatin sponge in minimally invasive extraction of mandibular low impacted wisdom teeth.【Methods】A total of 210 patients with mandibular low impacted teeth who visited the dental extraction clinic of our hospital from January 2020 to October 2022 were selected as the study subjects.They were divided into group A(using turbo drill extraction),group B(using ultrasonic bone knife extraction),and group C(using ultrasonic bone knife combined with Gelatin sponge extraction)according to different treatment methods,with 70 cases in each group.Three groups of patients were compared in terms of bleeding volume in the extraction socket 30 minutes after tooth extraction,visual analogue scale(VAS)score 3 days after surgery,dry socket syndrome,and lower lip numbness.【Results】The bleeding rate of the extraction socket in Group C was 11.43%(8/70)at 30 minutes after tooth extraction,significantly lower than 37.14%(26/70)in Group A and 18.57%(13/70)in Group B,with statistical significance(χ^(2)=23.342,6.389,P<0.05).The bleeding rate of the extraction socket in Group B was significantly lower than that in Group A at 30 minutes after tooth extraction,with statistical significance(χ^(2)=6.667,P<0.05).The VAS score of Group C patients at 72 hours after surgery was significantly lower than that of Group A and Group B;The VAS score of Group B at 72 hours after surgery was significantly lower than that of Group A,and the differences were statistically significant(P<0.05);There was no statistically significant difference in the incidence of dry socket syndrome and lower lip numbness among the three groups of patients(P>0.05).【Conclusion】Compared to the simple use of turbo drill or ultrasonic bone knife for tooth extraction,using ultrasonic bone knife combined with Gelatin sponge minimally invasive tooth extraction for patients with mandibular low impacted wisdom teeth may not reduce the incidence of postoperative complications such as dry socket syndrome and lower lip numbness,but it can reduce postoperative bleeding and pain,and is worthy of clinical application and promotion.