高速涡轮牙钻法在阻生智齿拔除术中的应用研究

Application of high speed turbine tooth in extraction of impacted wisdom teeth

目的探究高速涡轮牙钻法在阻生智齿拔除术中的应用效果。方法前瞻性选择2022年1月至2023年12月淄博市中西医结合医院收治的行阻生智齿拔除术患者102例,按随机数表法将其分为两组,每组各51例。对照组给予传统拔牙法,研究组给予高速涡轮牙钻法。观察两组的手术指标(手术时间、术中出血量、术后肿胀程度、术后张口受限度及拔牙完整性),比较两组手术前后的炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、细胞间黏附分子1(ICAM-1)]、应激指标[丙二醛、超氧化物歧化酶(SOD)]、疼痛指标[降钙素基因相关肽(CGRP)、前列腺素E2(PGE2)]水平,并比较两组术后并发症发生情况。结果研究组患者的手术时间为(17.13±3.09)min,短于对照组[(24.07±4.81)min],术中出血量为(4.06±0.75)mL,少于对照组[(5.39±0.98)mL],术后肿胀程度评分、术后张口受限度及拔牙完整性评分分别为(1.81±0.39)分、(4.85±1.17)mm、(1.69±0.38)分,均低于对照组[(3.19±1.01)分、(7.62±2.05)mm、(3.28±1.03)分],差异均有统计学意义(P<0.05)。术后,两组TNF-α、IL-6、ICAM-1水平均较术前升高,但研究组TNF-α、IL-6、ICAM-1水平分别为(31.34±5.25)pg/mL、(26.35±3.71)pg/mL、(148.15±15.26)ng/mL,均低于对照组[(40.19±6.71)pg/mL、(37.02±4.58)pg/mL、(181.04±18.66)ng/mL],差异均有统计学意义(P<0.05)。术后,两组丙二醛水平均较术前升高,SOD水平均较术前降低,但研究组丙二醛水平为(11.47±2.82)mmol/L,低于对照组[(15.61±3.14)mmol/L],SOD水平为(59.13±3.98)U/mL,高于对照组[(43.85±3.06)U/mL],差异均有统计学意义(P<0.05)。术后,两组CGRP、PGE2水平均较术前升高,但研究组CGRP、PGE2水平分别为(2.29±0.47)ng/mL、(140.71±11.82)pg/mL,均低于对照组[(3.31±0.69)ng/mL、(205.29±18.15)pg/mL],差异均有统计学意义(P<0.05)。研究组术后并发症总发生率7.84%,比对照组的23.53%低,差异有统计学意义(P<0.05)。结论高速涡轮牙钻法在阻生智齿拔除术中的应用效果确切,可明显改善患者术后炎症应激反应,减轻疼痛,减少术后并发症发生。

Objective To investigate the effect of high-speed turbine tooth in the extraction of impacted wisdom teeth.Methods A total of 102 patients who underwent impacted wisdom tooth extraction in Zibo Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023 were prospectively selected and divided into two groups according to random number table method,51 cases in each group.The control group was given traditional tooth extraction method,and the study group was given high-speed turbine tooth drill method.The surgical indexes(operation time,intraoperative blood loss,postoperative swelling degree,postoperative mouth opening limit and tooth extraction integrity)of the two groups were observed.The inflammatory indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),intercellular adhesion molecule-1(ICAM-1)],stress indexes[malondialdehyde,superoxide dismutase(SOD)],and pain indexes[calcitonin gene-related peptide(CGRP),prostaglandin E2(PGE2)]of the two groups were compared before operation and after operation.The postoperative complications of the two groups were compared.Results The operation time of the study group was(17.13±3.09)min,which was shorter than that of the control group[(24.07±4.81)min],the intraoperative blood loss was(4.06±0.75)mL,which was less than that of the control group[(5.39±0.98)mL],the postoperative swelling score,postoperative mouth opening limit and tooth extraction integrity score were(1.81±0.39)points,(4.85±1.17)mm and(1.69±0.38)points,respectively,which were lower than those in the control group[(3.19±1.01)points,(7.62±2.05)mm,(3.28±1.03)points],the differences were statistically significant(P<0.05).After operation,the levels of TNF-α,IL-6 and ICAM-1 in the two groups were higher than those before operation,but the levels of TNF-α,IL-6 and ICAM-1 in the study group were(31.34±5.25)pg/mL,(26.35±3.71)pg/mL and(148.15±15.26)ng/mL,respectively,which were lower than those in the control group[(40.19±6.71)pg/mL,(37.02±4.58)pg/mL,(181.04±18.66)ng/mL],the differences were statistically significant(P<0.05).After operation,the levels of malondialdehyde in the two groups were higher than those before operation,and the levels of SOD were lower than those before operation,However,the level of malondialdehyde in the study group was(11.47±2.82)mmol/L,which was lower than that in the control group[(15.61±3.14)mmol/L],and the level of SOD was(59.13±3.98)U/mL,which was higher than that in the control group[(43.85±3.06)U/mL],the differences were statistically significant(P<0.05).After operation,the levels of CGRP and PGE2 in the two groups were higher than those before operation,but the levels of CGRP and PGE2 in the study group were(2.29±0.47)ng/mL and(140.71±11.82)pg/mL,respectively,which were lower than those in the control group[(3.31±0.69)ng/mL,(205.29±18.15)pg/mL],the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the study group was 7.84%,which was lower than that in the control group(23.53%),the difference was statistically significant(P<0.05).Conclusion The application of high-speed turbine dental drilling in the extraction of impacted wisdom teeth is effective,which can significantly improve the postoperative inflammatory stress response of patients,reduce pain and reduce postoperative complications.