微创技术用于拔除阻生智齿对局部炎症反应及疼痛的影响
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摘要
目的探讨微创技术用于拔除阻生智齿对局部炎症反应及疼痛的影响。方法将2016年6月至2018年2月于我科拔除阻生智齿的110例患者按手术方法分为观察组(55例,微创拔除)和对照组(55例,常规骨凿劈冠拔除)。统计对比2组患者的手术情况、治疗前后龈沟中的炎症介质、疼痛介质水平及治疗效果。结果观察组手术时间短于对照组,术中出血量少于对照组,差异均具有统计学意义(P<0.05);观察组治疗后龈沟中血清五聚素3(PTX3)、细胞间黏附细胞因子1(ICAM1)、过氧化物酶(MPO)及前列腺素E2(PGE2)水平、疼痛介质5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)、P物质(SP)、甘丙肽(Gla)、三磷酸腺苷(ATP)水平低于对照组,差异均具有统计学意义(P<0.05);观察组的张口受限程度、面部肿胀程度及视觉疼痛模拟评分(VAS)低于对照组,差异均具有统计学意义(P<0.05)。结论与常规骨凿劈冠拔除阻生智齿技术相比,微创智齿拔除术后患者炎症反应及疼痛感减轻,临床治疗效果显著。
Objective To explore the effect of minimally invasive techniques for removing impacted wisdom teeth on local inflammation and pain.Methods A total of 110 patients with impacted wisdom teeth removed in our department from June 2016 to February 2018 were divided into observation group(55 cases,minimally invasive removal) and control group(55 cases,traditional chisel) according to the surgical method.The operative status,the inflammatory mediators and pain mediators in the gingival sulcus before and after the treatment,and the therapeutic effects of the two groups were compared.Results The operative time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that in the control group,the differences were significant(P<0.05).The levels of PTX3,cells in the gingival sulcus adhesion of cytokine 1(ICAM1),peroxidase(MPO),prostaglandin E2(PGE2) levels,pain mediator 5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP),substance P(SP),galanin(Gla) and adenosine triphosphate(ATP) in the observation group after treatment was lower than those in the control group,the differences were significant(P<0.05);The degree of mouth opening restriction,facial swelling and visual analog scale score(VAS) in the observation group were lower than those in the control group,the differences were significant(P<0.05).Conclusion Compared with traditional chisel in extraction of impacted wisdom teeth,the minimally invasive wisdom tooth extraction can relieve the inflammatory response and pain sensation of patients,and the clinical treatment effect is significant.
Objective To explore the effect of minimally invasive techniques for removing impacted wisdom teeth on local inflammation and pain.Methods A total of 110 patients with impacted wisdom teeth removed in our department from June 2016 to February 2018 were divided into observation group(55 cases,minimally invasive removal) and control group(55 cases,traditional chisel) according to the surgical method.The operative status,the inflammatory mediators and pain mediators in the gingival sulcus before and after the treatment,and the therapeutic effects of the two groups were compared.Results The operative time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that in the control group,the differences were significant(P<0.05).The levels of PTX3,cells in the gingival sulcus adhesion of cytokine 1(ICAM1),peroxidase(MPO),prostaglandin E2(PGE2) levels,pain mediator 5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP),substance P(SP),galanin(Gla) and adenosine triphosphate(ATP) in the observation group after treatment was lower than those in the control group,the differences were significant(P<0.05);The degree of mouth opening restriction,facial swelling and visual analog scale score(VAS) in the observation group were lower than those in the control group,the differences were significant(P<0.05).Conclusion Compared with traditional chisel in extraction of impacted wisdom teeth,the minimally invasive wisdom tooth extraction can relieve the inflammatory response and pain sensation of patients,and the clinical treatment effect is significant.
引文
[1]陈慧敏,江泳,许桐楷,等.下颌阻生智齿拔除仿头模模型的建立[J].实用口腔医学杂志,2016,3(2):244-247.doi:10.3969/j.issn.1001-3733.2016.02.019.
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[10]王立福.微创拔牙法在下颌近中阻生智齿拔除术中的临床应用[J].大家健康(旬刊),2016,10(5):12-13.doi:10.3969/j.issn.1003-1634.2011.04.017.
[11]李坤.微创拔牙刀结合高速涡轮牙钻拔牙法在下颌近中阻生智齿拔除术的效果分析[J].中国继续医学教育,2016,8(23):84-85.doi:10.3969/j.issn.1674-9308.2016.23.051.
[12]聂玲玲.高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术应用效果分析[J].全科口腔医学电子杂志,2018,5(29):85-86.doi:10.16269/j.cnki.cn11-9337/r.2018.29.050.
[13]王志莉.两种拔牙法拔除下颌水平阻生智齿的疗效评价[J].全科口腔医学电子杂志,2018,5(27):49-50.doi:10.16269/j.cnki.cn11-9337/r.2018.27.029.
[14]王启鹏,李发喜,曹婷,等.微创拔牙技术拔除下颌低位埋伏阻生智齿临床研究[J].当代医学,2018,24(26):162-163.doi:10.3969/j.issn.1009-4393.2018.26.073.
[15]刘智海,窦文涓.微创拔牙法在下颌近中阻生智齿拔除术中的临床应用[J].中国社区医师,2017,33(5):49.doi:10.3969/j.issn.1007-614x.2017.5.29.
[16]宋元玲,任辉,李晓刚,等.氟比洛芬酯联合地塞米松用于拔除下颌阻生智齿术后镇痛效果观察[J].现代中西医结合杂志,2016,25(24):2716-2718.doi:10.3969/j.issn.1008-8849.2016.24.035.
[17]陶怡.微创拔牙术在下颌阻生智齿拔除中的应用[J].全科口腔医学电子杂志,2017,4(3):30-31.doi:10.3969/j.issn.2095-7882.2017.03.019.
[18]Ikawa H,Yoshizawa K,Iguchi R,et al.A dentigerous cyst occupying the maxillary sinus with an impacted canine:a case report[J].Japanese Journal of Oral Diagnosis/Oral Medicine,2017,30(1):23-27.doi:10.15214/jsodom.30.23.
[19]Achiwa M,Takemoto T,Kurita K.A study of BIS index change of mandibular impacted wisdom tooth extraction surgery and intraoperative Stress[J].Japanese Journal of Oral Diagnosis/Oral Medicine,2016,29(3):109-113.doi:10.4317/medoral.22597.
[20]Kojima Y,Kojima M,Sakaguchi K,et al.A case of buccal abscess from an impacted wisdom tooth in an elderly person with malnutrition[J].Case Rep Dent,2016,2016:9437514.doi:10.1155/2016/9437514.
[21]邹弘驹,李永生.高速涡轮牙钻联合微创拔牙刀拔除阻生智齿后局部炎症应激反应及疼痛介质分泌的评价[J].海南医学院学报,2018,24(4):523-526.doi:10.13210/j.cnki.jhmu.20180129.016.
[22]姚旭飞.微创技术和传统技术在下颌阻生智齿拔除术中的对比分析[J].浙江创伤外科,2018,23(3):528-529.doi:10.3969/j.issn.1009-7147.2018.03.055.
[23]翟敏,吴益鸣,蔡建英.下颌双侧低位近中阻生第三磨牙微创与传统拔除的对照研究[J].口腔颌面外科杂志,2016,26(2):119-123.doi:10.3969/j.issn.1005-4979.2016.02.009.
[2]Adam N,Sandler J.NICE guidance on the extraction of wisdom teethtime for a rethink?[J].Orthodontic Update,2018,11(1):33-35.doi:10.12968/ortu.2018.11.1.33.
[3]尚将,宋健,许胜,等.种植牙相邻阻生智齿追踪观察1例[J].实用口腔医学杂志,2016,32(1):137-139.doi:10.3969/j.issn.1001-3733.2016.01.034.
[4]刘朝祥.口腔健康宣教对拔除阻生智齿患者牙科焦虑的影响[J].中西医结合心血管病电子杂志,2017,5(29):191.doi:10.3969/j.issn.2095-6681.2017.29.154.
[5]祝永涛.微创拔牙术在下颌阻生智齿拔除中的应用效果[J].中国社区医师,2016,32(8):74-75.doi:10.3969/j.issn.1007-614x.2016.8.44.
[6]顾春红.下颌阻生智齿拔除术的护理要点分析[J].中国伤残医学,2016,24(7):154-155.doi:10.13214/j.cnki.cjotadm.2016.07.115.
[7]刘琳,陈玉祥.微创拔牙术在下颌阻生智齿拔除中的应用效果[J].当代医学,2016,22(32):26-27.doi:10.3969/j.issn.1007-614x.2016.8.44.
[8]Tanidir AN,Atac MS,Karacelebi E.Informat Ion given by mult Imed Ia:influence on anxIety about extract Ion of impacted wIsdom teeth[J].Br J Oral Maxillofac Surg,2016,54(6):652-657.doi:10.1016/j.bjoms.2016.03.026.
[9]高丽,张斌,齐慧妮,等.微创拔牙术应用于下颌阻生智齿拔除的临床总结[J].现代口腔医学杂志,2016,30(2):112-113.
[10]王立福.微创拔牙法在下颌近中阻生智齿拔除术中的临床应用[J].大家健康(旬刊),2016,10(5):12-13.doi:10.3969/j.issn.1003-1634.2011.04.017.
[11]李坤.微创拔牙刀结合高速涡轮牙钻拔牙法在下颌近中阻生智齿拔除术的效果分析[J].中国继续医学教育,2016,8(23):84-85.doi:10.3969/j.issn.1674-9308.2016.23.051.
[12]聂玲玲.高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术应用效果分析[J].全科口腔医学电子杂志,2018,5(29):85-86.doi:10.16269/j.cnki.cn11-9337/r.2018.29.050.
[13]王志莉.两种拔牙法拔除下颌水平阻生智齿的疗效评价[J].全科口腔医学电子杂志,2018,5(27):49-50.doi:10.16269/j.cnki.cn11-9337/r.2018.27.029.
[14]王启鹏,李发喜,曹婷,等.微创拔牙技术拔除下颌低位埋伏阻生智齿临床研究[J].当代医学,2018,24(26):162-163.doi:10.3969/j.issn.1009-4393.2018.26.073.
[15]刘智海,窦文涓.微创拔牙法在下颌近中阻生智齿拔除术中的临床应用[J].中国社区医师,2017,33(5):49.doi:10.3969/j.issn.1007-614x.2017.5.29.
[16]宋元玲,任辉,李晓刚,等.氟比洛芬酯联合地塞米松用于拔除下颌阻生智齿术后镇痛效果观察[J].现代中西医结合杂志,2016,25(24):2716-2718.doi:10.3969/j.issn.1008-8849.2016.24.035.
[17]陶怡.微创拔牙术在下颌阻生智齿拔除中的应用[J].全科口腔医学电子杂志,2017,4(3):30-31.doi:10.3969/j.issn.2095-7882.2017.03.019.
[18]Ikawa H,Yoshizawa K,Iguchi R,et al.A dentigerous cyst occupying the maxillary sinus with an impacted canine:a case report[J].Japanese Journal of Oral Diagnosis/Oral Medicine,2017,30(1):23-27.doi:10.15214/jsodom.30.23.
[19]Achiwa M,Takemoto T,Kurita K.A study of BIS index change of mandibular impacted wisdom tooth extraction surgery and intraoperative Stress[J].Japanese Journal of Oral Diagnosis/Oral Medicine,2016,29(3):109-113.doi:10.4317/medoral.22597.
[20]Kojima Y,Kojima M,Sakaguchi K,et al.A case of buccal abscess from an impacted wisdom tooth in an elderly person with malnutrition[J].Case Rep Dent,2016,2016:9437514.doi:10.1155/2016/9437514.
[21]邹弘驹,李永生.高速涡轮牙钻联合微创拔牙刀拔除阻生智齿后局部炎症应激反应及疼痛介质分泌的评价[J].海南医学院学报,2018,24(4):523-526.doi:10.13210/j.cnki.jhmu.20180129.016.
[22]姚旭飞.微创技术和传统技术在下颌阻生智齿拔除术中的对比分析[J].浙江创伤外科,2018,23(3):528-529.doi:10.3969/j.issn.1009-7147.2018.03.055.
[23]翟敏,吴益鸣,蔡建英.下颌双侧低位近中阻生第三磨牙微创与传统拔除的对照研究[J].口腔颌面外科杂志,2016,26(2):119-123.doi:10.3969/j.issn.1005-4979.2016.02.009.
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