2种翻瓣设计在下颌水平阻生第三磨牙拔除的效果比较

    Curative effects of two kinds of flap design in extraction of impacted mandibular third molars

    • 摘要:
      目的比较2种翻瓣设计在拔除下颌远中邻面暴露≥1/2的水平阻生第三磨牙的临床应用效果。
      方法选取有下颌远中邻面暴露≥1/2的水平阻生第三磨牙病人200例,随机分为A、B组。A组采取龈沟内环形切口法,B组采用标准封套法,比较2组间拔牙时间、术中和术后并发症以及软组织愈合的情况。分别记录手术前后各个参数并进行统计学分析。
      结果2组手术时间,术中并发症的发生率,术后1、3、7 d疼痛程度差异均无统计学意义(P>0.05)。2组病人术后面部肿胀程度均随着时间的增加而降低(P < 0.01);A组病人的肿胀、张口受限程度在术后1、3 d均轻于B组(P < 0.05~P < 0.01);在术后1 d,A组出血程度轻于B组(P < 0.05),术后2、7 d 2组差异无统计学意义(P>0.05)。术后7天,A组软组织愈合优于B组(P < 0.05)。
      结论下颌远中邻面暴露≥1/2的水平阻生第三磨牙采用龈沟内环形切口法可减轻病人术后反应,有利于邻近组织愈合,提高病人术后生活质量,值得在临床推广应用。

       

      Abstract:
      ObjectiveTo compare the clinical effects of the two flap design in the extraction of horizontal impacted third molars exposed to 1/2 of the distal mandibular adjacent surface.
      MethodsA total of 200 teeth were selected from patients with horizontal impacted third molars exposed to 1/2 of the distal and middle mandibular surfaces, and the patients were randomly divided into the group A and group B.The group A and group B were treated with intragingival crevicular incision and envelope incision, respectively.The time of tooth extraction, intraoperative and postoperative complications and soft tissue healing were compared between two groups.Each parameter was recorded before and after operation, and the data were statistically analyzed.
      ResultsThe differences of the operation time, intraoperative complications and pain degree after 1, 3 and 7 days of operation between two groups were not statistically significant(P>0.05).The degree of postoperative facial swelling in two groups decreased with the increasing of time(P < 0.01).The degree of swelling and mouth opening limitation in group A were lighter than those in group B after 1 and 3 days of operation(P < 0.05 to P < 0.01).After 1 day of operation, the bleeding degree in group A was slightly lower than that in group B(P < 0.05), and there was no statistical significance in the bleeding degree between two groups after 2 and 7 days of operation(P>0.05).After 7 days of operation, the healing of soft tissue in group A was better than that in group B(P < 0.05).
      ConclusionsIn the horizontal impacted third molars with distal adjacent surface exposure ≥ 1/2 of the lower jaw, the method of intra gingival crevicular incision can reduce the postoperative response of patients, facilitate the healing of adjacent tissues, and improve the postoperative life quality of patients, which is worthy of clinical promotion and application.

       

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