第三磨牙全周期健康管理刍议

Preliminary discussion on the whole life-cycle management of third molars health

第三磨牙阻生率越来越高,引起的临床问题越来越多、越来越严重。长期以来,第三磨牙的处理以直接拔除为主,治疗模式的系统性和多元性明显不足。笔者首次提出第三磨牙全周期健康管理的概念,并提出第三磨牙全周期健康管理的窗口应前移至牙胚期。对发现有严重风险的第三磨牙牙胚,应该及时进行必要的干预;对正常萌出的第三磨牙应尽力维护其健康,使第三磨牙长期行使功能。对无症状的阻生第三磨牙,应严密观察、慎重拔除,必要时可以通过正畸、自体移植等技术使其得到功能化利用。对有症状的阻生第三磨牙,应按照功能性牙槽外科原则,应用微创化技术和器械进行拔除,减轻手术创伤,防止术中及术后并发症。

The impaction rate of third molars is increasingly high,leading to more and more serious clinical problems.For a long time,the primary approach to managing third molars has been direct extraction,with a notable lack of systematic and diversified treatment methods.This article introduces,for the first time,the concept of whole life-cycle health management for third molars and suggests that the window for third molars life-cycle health management should be moved forward to the tooth germ stage.For tooth germs of third molars with severe risks,timely and necessary intervention should be administered.For normally erupting third molars,efforts should be made to maintain their health so they can function over the long term.For impacted third molars that have not caused related clinical symptoms,careful observation and cautious extraction should be considered.If necessary,techniques such as orthodontics and autotransplantation can be used to functionalize them.For impacted third molars that have caused clinical symptoms,functional oral surgical principles should be applied to reduce surgical trauma and prevent intraoperative and postoperative complications using advanced clinical techniques.