CBCT与PAN预测下颌近中低位阻生第三磨牙拔除术损伤水平的临床比较

Clinical comparison of CBCT and PAN in predicting the level of injury in mandibular third molar extraction surgery

目的:运用锥形束CT(CBCT)及口腔曲面断层片(PAN)引导拔除下颌近中低位第三磨牙,探讨CBCT作为术前预测手段是否存在优越性。方法:选取于2022年1月至2023年8月在石河子大学第一附属医院就诊的213例患者,分为PAN组和CBCT组,对两组患者分别进行拔牙手术,采集患者术前及术后龈沟液并采用酶联免疫吸附实验(ELISA)测定炎症及疼痛因子浓度;运用统计学方法对比两组在各类指标的差异性。结果:CBCT作为术前评估手段相较传统PAN在明确牙根与MC接触关系上具有优越性(P <0.05),且CBCT组手术时间短、手术并发症发生率低(P <0.05);通过ELISA测定结果得出CBCT组患者龈沟液中炎症因子及疼痛因子的术前术后浓度变化值相较PAN组浓度变化值低(P <0.05)。结论:CBCT相比PAN在评估牙根与下颌管(MC)接触关系这类风险因素方面具有优越性,且应用CBCT作为术前评估手段进行拔牙手术其手术时间短,并发症少,术后损伤小。

AIM:This study aims to investigate the superiority of cone beam computed tomography(CBCT)and Panoramic radiography(PAN)in the extraction of mandibular mesial and low third molars.METHODS:A total of 213 patients who attended the First Affiliated Hospital of Shihezi University from January 2022 to August 2023 were select-ed and divided into the PAN group and the CBCT group.The patients in the two groups underwent tooth extraction surgery,and the gingival crevicularfluid of the patients were collected before and after surgery,and the concentrations of the inflam matory and pain factors were determined by enzyme-linked immunosorbent assay(ELISA).Statistical methods were used to compare the differences between the two groups in the various types of indexes.RESULTS:CBCT as a preoperative assessment method was superior to traditional PAN in clarifying the contact relationship between the root and mandibular canal(MC)(P<0.05),and the CBCT group had a shorter operation time and a lower incidence of surgical complications(P<0.05);The results of ELISA showed that the preoperative and postoperative changes of concentration of inflammatory and pain factors in the gingival crevicular fluid of the CBCT group were lower than those of the PAN group(P<0.05).CON-CLUSION:CBCT is superior to PAN in assessing risk factors such as the root-MC contact relationship,and the use of CBCT as a preoperative assessment method for tooth extractions is associated with shorter operation time,fewer complica-tions,and less postoperative damage.