颊侧去骨法与传统拔牙术在上颌近中阻生智齿中的应用效果

Application Effect of Buccal Deboning Method and Traditional Tooth Extraction Surgery in Maxillary Mesio-impacted Wisdom Teeth

目的:观察颊侧去骨法与传统拔牙术在上颌近中阻生智齿中的应用效果。方法:回顾性选取2021年1月—2023年5月广东省第二中医院收治的70例上颌近中阻生智齿患者。根据手术方法的不同将其分为传统组和颊侧组,各35例。传统组采取传统拔牙术,颊侧组采取颊侧去骨法。比较两组围手术期指标,术后24 h疼痛程度,术后3 d张口受限及肿胀程度,术前、术后2周炎症因子及并发症。结果:颊侧组手术时间短于传统组,术中出血量少于传统组,拔牙完整性评分、视觉模拟评分法(VAS)评分均低于传统组,差异有统计学意义(P<0.05)。颊侧组张口受限程度明显优于传统组,肿胀程度低于传统组,差异有统计学意义(P<0.05)。术后2周,两组肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均高于术前,颊侧组TNF-α、IL-6、CRP水平均低于传统组,差异有统计学意义(P<0.05)。颊侧组并发症发生率低于传统组,差异有统计学意义(P<0.05)。结论:与传统拔牙术相比,颊侧去骨法在上颌近中阻生智齿拔出中的手术相关指标更优,能够减轻术后疼痛程度,术后张口程度受限、肿胀程度,能够有效降低炎症指标,并发症较少。

Objective:To observe the application effect of buccal deboning method and traditional tooth extraction surgery in maxillary mesio-impacted wisdom teeth.Method:A total of 70 maxillary mesio-impacted wisdom teeth patients admitted to the Guangdong Second Traditional Chinese Medicine Hospital from January 2021 to May 2023 was retrospectively selected.According to different surgical methods,the patients were divided into traditional group and buccal group,35 cases in each group.The traditional tooth extraction surgery was performed in the traditional group,and the buccal deboning method was performed in the buccal group.Perioperative indexes,pain degree 24 h after surgery,mouth opening limitation and swelling degree 3 d after surgery,inflammatory factors before and 2 weeks after surgery and complications were compared between the two groups.Result:The operation time of buccal group was shorter than that of traditional group,the amount of intraoperative blood loss was less than that of traditional group,and the score of extraction integrity and visual analog scale(VAS)were lower than those of traditional group,the differences were statistically significant(P<0.05).The limitation degree of buccal mouth opening was significantly better than that of traditional group,and the swelling degree was lower than that of traditional group,the difference was statistically significant(P<0.05).At 2 weeks after surgery,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were higher than those before surgery,and the levels of TNF-α,IL-6 and CRP in buccal group were lower than those in traditional group,the differences were statistically significant(P<0.05).The incidence of complications in buccal group was lower than that in traditional group,and the difference was statistically significant(P<0.05).Conclusion:Compared with traditional tooth extraction,buccal deboning method has better operationrelated indicators in maxillary mesio-impacted wisdom tooth extraction,which can reduce postoperative pain,limit postoperative mouth opening and swelling,effectively reduce inflammatory indicators and have fewer complications.