高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术中的应用效果
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摘要
目的探究高速涡轮牙钻及微创拔牙刀在阻生智齿拔除术中的应用效果。方法选取2016年12月至2017年12月行阻生智齿拔除术的患者70例,根据拔牙方法将患者分为对照组(35例)与微创组(35例),对照组采取常规拔牙方法,微创组采取高速涡轮牙钻及微创拔牙刀拔牙。比较两组的手术指标(拔牙完整性、张口受限度、肿胀度、手术时间)、疼痛程度、并发症发生情况和术后生活质量(心理职能、生理功能、躯体疼痛、活力)。结果微创组患者的拔牙完整性、张口受限度、肿胀度、手术时间4项手术指标均优于对照组(P均<0.05)。微创组和对照组患者治疗前的疼痛视觉模拟量表(VAS)评分差异无统计学意义(P>0.05),治疗后微创组VAS评分较对照组下降(P<0.05)。微创组并发症总发生率为11.43%(4/35),低于对照组[34.29%(12/35),P<0.05]。微创组术后3个月的心理职能等生活质量各项评分均高于对照组(P均<0.05)。结论阻生智齿拔除术中应用高速涡轮牙钻及微创拔牙刀可有效提高治疗效果、减少并发症发生。
Objective To explore the application of high-speed dental handpiece and original luxator in the impacted wisdom tooth extraction. Methods Seventy patients with impacted wisdom teeth, who underwent impacted wisdom tooth extraction between Dec. 2016 and Dec. 2017, were selected. The patients were divided into control group(n=35) and minimally invasive group(n=35) according to the surgical options. The patients in the control group received conventional tooth extraction, and the patients in the minimally invasive group received tooth extraction using high-speed dental handpiece and original luxator. The surgical parameters(extraction integrity, mouth restriction, swelling and operation time), pain extent,complications and the quality of life after operation(psychological function, physiological function, physical pain, vitality) were compared between the two groups. Results The surgical parameters, including extraction integrity, mouth restriction, swelling and operation time, were significantly better in the minimally invasive group than those in the control group(all P<0.05). There was no significant difference in the visual simulation scale(VAS) score before extraction between the two groups(P>0.05).After extraction, the VAS score was significantly lower in the minimally invasive group than that in the control group(P<0.05).The incidence of complications in the minimally invasive group was 11.43%(4/35), which was significantly lower than that in the control group(34.29% [12/35], P<0.05). At 3 months after extraction, the scores of psychological function and the other quality of life scores were significantly higher in the minimally invasive group than those in the control group(all P<0.05).Conclusion Application of high-speed dental handpiece and original luxator in impacted wisdom tooth extraction can significantly improve the treatment efficacy and reduce complication incidence.
Objective To explore the application of high-speed dental handpiece and original luxator in the impacted wisdom tooth extraction. Methods Seventy patients with impacted wisdom teeth, who underwent impacted wisdom tooth extraction between Dec. 2016 and Dec. 2017, were selected. The patients were divided into control group(n=35) and minimally invasive group(n=35) according to the surgical options. The patients in the control group received conventional tooth extraction, and the patients in the minimally invasive group received tooth extraction using high-speed dental handpiece and original luxator. The surgical parameters(extraction integrity, mouth restriction, swelling and operation time), pain extent,complications and the quality of life after operation(psychological function, physiological function, physical pain, vitality) were compared between the two groups. Results The surgical parameters, including extraction integrity, mouth restriction, swelling and operation time, were significantly better in the minimally invasive group than those in the control group(all P<0.05). There was no significant difference in the visual simulation scale(VAS) score before extraction between the two groups(P>0.05).After extraction, the VAS score was significantly lower in the minimally invasive group than that in the control group(P<0.05).The incidence of complications in the minimally invasive group was 11.43%(4/35), which was significantly lower than that in the control group(34.29% [12/35], P<0.05). At 3 months after extraction, the scores of psychological function and the other quality of life scores were significantly higher in the minimally invasive group than those in the control group(all P<0.05).Conclusion Application of high-speed dental handpiece and original luxator in impacted wisdom tooth extraction can significantly improve the treatment efficacy and reduce complication incidence.
引文
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[7]ACHAM S,KLAMPFL A,TRUSCHNEGG A,KIRMEIER R,SANDNER-KIESLING A,JAKSE N.Beneficial effect of methylprednisolone after mandibular third molar surgery:a randomized,double-blind,placebocontrolled split-mouth trial[J].Clin Oral Investig,2013,17:1693-1700.
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[10]郭红燕.微创拔牙器械和传统拔牙器械在下颌阻生齿拔除术中的临床应用比较[J/CD].全科口腔医学杂志(电子版),2016,3:5-6,8.
[11]YE Z X,YANG C,GE J.Adjacent tooth trauma in complicated mandibular third molar surgery:risk degree classification and digital surgical simulation[J/OL].Sci Rep,2016,6:39126.doi:10.1038/srep39126.
[12]CHRCANOVIC B R,CUSTóDIO A L.Considerations of mandibular angle fractures during and after surgery for removal of third molars:a review of the literature[J].Oral Maxillofac Surg,2010,14:71-80.
[13]RAJARAN J R,NAZIMI A J,RAJANDRAM R K.Iatrogenic displacement of high-speed bur during third molar removal[J/OL].BMJ Case Rep,2017,2017.pii:bcr-2017-221892.doi:10.1136/bcr-2017-221892.
[14]SIRORAJ A P,GIRI G V V,RAMKUMAR S,NARASIMHAN M.Extraction of impacted mandibular third molars―the effect of osteotomy at two speeds on peripheral bone:a histopathological analysis[J].Br J Oral Maxillofac Surg,2016,54:449-453.
[15]CAMPBELL J H,MURRAY R A.Handpiece speed and postoperative outcomes in third molar surgery[J].JIndiana Dent Assoc,2004,83:4-6.
[16]梁清军.两种方法拔除下颌阻生智齿的效果比较[J].口腔颌面外科杂志,2015,25:195-198.
[17]李功臣,陆永健,蒋丽萍.智齿冠切除术的手术方法及常见并发症[J].口腔医学,2015,35:153-156.
[18]CHANG H H,LEE M S,HSU Y C,TSAI S J,LIN C P.Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars[J].J Formos Med Assoc,2015,114:929-935.
[19]GOWANS K,PATEL M,LEWIS K.Surg i c a l emphysema:a rare complication of a simple surgical dental extraction without the use of an air-driven rotor[J].Dent Update,2017,44:217-218,220.
[20]DURUKAN P,SALT O,OZKAN S,DURUKANB,KAVALCI C.Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure[J/OL].Am J Emerg Med,2012,30:2095.e3-6.doi:10.1016/j.ajem.2012.01.006.
[2]TOEDTLING V,YATES J M.Revolution vs status quo?Non-intervention strategy of asymptomatic third molars causes harm[J].Br Dent J,2015,219:11-12.
[3]GUERRERO M E,BOTETANO R,BELTRAN J,HORNER K,JACOBS R.Can preoperative imaging help to predict postoperative outcome after wisdom tooth removal?A randomized controlled trial using panoramic radiography versus cone-beam CT[J].Clin Oral Investig,2014,18:335-342.
[4]PONCE P V,OGDEN A R.Ectopic lower third permanent molar within the mandibular condyle:an archaeological example[J].Int J osteoarchaeol,2013,23:367-369.
[5]SATWIK A,NAVEED N.Third molar impactionreview[J].Res J Pharm Technol,2014,7:1498-1500.
[6]朱成智,张国富,洪丽,陈芝翠.反角高速涡轮机牙钻在下颌阻生智齿拔除中的应用[J].全科口腔医学杂志,2017,4:18-19.
[7]ACHAM S,KLAMPFL A,TRUSCHNEGG A,KIRMEIER R,SANDNER-KIESLING A,JAKSE N.Beneficial effect of methylprednisolone after mandibular third molar surgery:a randomized,double-blind,placebocontrolled split-mouth trial[J].Clin Oral Investig,2013,17:1693-1700.
[8]CHRCANOVIC B R.Teeth in the line of mandibular fractures[J].Oral Maxillofac Surg,2014,18:7-24.
[9]杨映阳,杜胜男,吕宗凯.高速涡轮机头和微创拔牙刀在下颌阻生牙拔除术中的应用效果评价[J].上海口腔医学,2015,24:489-492.
[10]郭红燕.微创拔牙器械和传统拔牙器械在下颌阻生齿拔除术中的临床应用比较[J/CD].全科口腔医学杂志(电子版),2016,3:5-6,8.
[11]YE Z X,YANG C,GE J.Adjacent tooth trauma in complicated mandibular third molar surgery:risk degree classification and digital surgical simulation[J/OL].Sci Rep,2016,6:39126.doi:10.1038/srep39126.
[12]CHRCANOVIC B R,CUSTóDIO A L.Considerations of mandibular angle fractures during and after surgery for removal of third molars:a review of the literature[J].Oral Maxillofac Surg,2010,14:71-80.
[13]RAJARAN J R,NAZIMI A J,RAJANDRAM R K.Iatrogenic displacement of high-speed bur during third molar removal[J/OL].BMJ Case Rep,2017,2017.pii:bcr-2017-221892.doi:10.1136/bcr-2017-221892.
[14]SIRORAJ A P,GIRI G V V,RAMKUMAR S,NARASIMHAN M.Extraction of impacted mandibular third molars―the effect of osteotomy at two speeds on peripheral bone:a histopathological analysis[J].Br J Oral Maxillofac Surg,2016,54:449-453.
[15]CAMPBELL J H,MURRAY R A.Handpiece speed and postoperative outcomes in third molar surgery[J].JIndiana Dent Assoc,2004,83:4-6.
[16]梁清军.两种方法拔除下颌阻生智齿的效果比较[J].口腔颌面外科杂志,2015,25:195-198.
[17]李功臣,陆永健,蒋丽萍.智齿冠切除术的手术方法及常见并发症[J].口腔医学,2015,35:153-156.
[18]CHANG H H,LEE M S,HSU Y C,TSAI S J,LIN C P.Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars[J].J Formos Med Assoc,2015,114:929-935.
[19]GOWANS K,PATEL M,LEWIS K.Surg i c a l emphysema:a rare complication of a simple surgical dental extraction without the use of an air-driven rotor[J].Dent Update,2017,44:217-218,220.
[20]DURUKAN P,SALT O,OZKAN S,DURUKANB,KAVALCI C.Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure[J/OL].Am J Emerg Med,2012,30:2095.e3-6.doi:10.1016/j.ajem.2012.01.006.
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