bFGF联合超声骨刀在下颌阻生牙拔除中的应用研究

Application Study of bFGF Combined with Ultrasonic Bone Scalpel in Removal of Impacted Mandibular Teeth

目的:探讨使用重组牛碱性成纤维细胞生长因子(bFGF)联合超声骨刀在拔除下颌阻生牙中的应用效果。方法:根据简单随机分组法将2020年10月至2023年10月来本院进行治疗的下颌阻生牙患者105例分为对照组(n=52)和观察组(n=53);对照组予以bFGF联合常规涡轮钻法拔除,观察组采取bFGF联合超声骨刀法拔除;对比两组手术相关指标,临床治疗效果及术后、肿胀、张口受限恢复情况;对比两组患者龈沟液中炎性因子[肿瘤坏死细胞因子-α(TNF-α)、细胞间粘附因子1(ICAM1)和髓过氧化物酶(MPO)]表达水平及干槽症发生情况。结果:观察组手术时间及术中出血量均小于对照组(P<0.05);手术前后,观察组收缩压、舒张压、血糖水平改善幅度均低于对照组(P<0.05)。观察组治疗优良率为98.11%,高于对照组的82.69%(P<0.05)。两组术后肿胀程度及张口受限发生率比较,观察组均低于对照组(P<0.05)。手术前后,观察组TNF-α、ICAM1和MPO增加幅度均小于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。结论:bFGF联合超声骨刀治疗下颌阻生牙疗效确切,可改善龈沟液炎性反应,降低并发症发生风险。

Objective:To explore the application effectiveness of recombinant bovine basic fibroblast growth factor(bFGF)combined with ultrasonic bone scalpel in the removal of impacted mandibular teeth.Methods:A total of 105 patients with impacted mandibular teeth treated at our hospital from October 2020 to October 2023 were randomly divided into a control group(n=52)and an observation group(n=53)using simple random grouping.The control group underwent bFGF combined with conventional rotary drilling for extraction,while the observation group underwent bFGF combined with ultrasonic bone scalpel for extraction.Surgical-related indicators,clinical treatment outcomes,postoperative swelling,restricted mouth opening recovery,expression levels of inflammatory factors[tumor necrosis factor-alpha(TNF-α),intercellular adhesion molecule 1(ICAM1),myeloperoxidase(MPO)]in gingival crevicular fluid,and dry socket occurrence were compared between the two groups.Results:The operation time and intraoperative blood loss in the observation group were significantly lower than those in the control group(P<0.05).Before and after surgery,the improvement in systolic blood pressure,diastolic blood pressure,and blood glucose levels in the observation group was lower than that in the control group(P<0.05).The excellent and good treatment rate in the observation group was 98.11%,which was higher than 82.69%in the control group(P<0.05).Postoperative swelling and incidence of restricted mouth opening were lower in the observation group compared to the control group(P<0.05).The increase in TNF-α,ICAM1,and MPO levels in the gingival crevicular fluid was lower in the observation group than in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion:bFGF combined with ultrasonic bone scalpel for the treatment of impacted mandibular teeth is effective,improves inflammatory responses in gingival crevicular fluid,and reduces the risk of complications.