超声骨刀联合45°反角涡轮钻拔除下颌阻生智齿效果及预后分析

doi:10.19439/j.sjos.2025.03.014

摘要/Abstract

摘要： 目的: 探讨超声骨刀联合45°反角涡轮钻在下颌阻生智齿拔除中的临床效果。方法: 选择2022年6月—2024年6月收治的下颌中位水平阻生智齿患者146例,随机分为对照组和试验组,每组73例。对照组采用45°反角涡轮钻拔除,试验组采用超声骨刀联合45°反角涡轮钻拔除。观察两组治疗情况、术后疼痛、肿胀受限及术后并发症发生情况。结果: 两组手术时间相比无显著差异（P>0.05）,试验组术中出血量显著少于对照组（P<0.05）。术后1、3天,试验组疼痛视觉模拟评分（visual analogue scale, VAS）显著低于对照组（P<0.05）。术后即刻、1、3天,试验组血清C反应蛋白（C-reactive protein, CRP）显著低于对照组（P<0.05）。试验组面部肿胀程度得分及比例显著低于对照组（P<0.05）,开口度减小率及开口受限比例显著低于对照组（P<0.05）。两组患者术后舌麻木、下唇麻木、邻牙损伤、干槽症及牙根折断等并发症发生率相比无显著差异（P>0.05）。结论: 与单纯使用45°反角涡轮钻相比,联合超声骨刀拔除下颌中位水平阻生智齿创伤更小,术中出血更少,疼痛、开口受限及肿胀水平更低。

关键词: 超声骨刀, 反角涡轮钻, 下颌阻生智齿, 手术效果, 预后

Abstract: PURPOSE: To investigate the clinical effect of piezosurgery combined with 45°contra-angle turbine drill in extraction of impacted mandibular wisdom teeth. METHODS: A total of 146 patients with impacted wisdom teeth at the median mandibular level admitted from June 2022 to June 2024 were randomly divided into control group and experimental group, with 73 cases in each group. The wisdom teeth in the control group were simply removed using 45° contra-angle turbine drill, while those in the experimental group were removed using piezosurgery combined with 45° contra-angle turbine drill. The treatment outcomes, postoperative pain, limited swelling and incidence of postoperative complications of the two groups were compared. RESULTS: There was no significant difference in operation time between the two groups(P>0.05), and the amount of blood loss in the experimental group was significantly lower than that in the control group(P<0.05). The visual analogue scale(VAS) of pain in the experimental group was significantly lower than that of the control group on the 1st and 3rd day after surgery(P<0.05). Immediately, 1 day and 3 days after surgery, the serum C-reactive protein (CRP) in the experimental group was significantly lower than that in the control group (P<0.05). The score of facial swelling degree and proportion in the experimental group were significantly lower than those in the control group (P<0.05), the reduction rate of mouth opening degree and the proportion of mouth opening restriction in the experimental group were significantly lower than those in the control group(P<0.05). There were no significant differences in the total incidence of postoperative complications such as tongue numbness, lower lip numbness, adjacent tooth injury, dry socket and root fracture between the two groups(P>0.05). CONCLUSIONS: Compared with only using 45° contra-angle turbine drill, the combination of piezosurgery for impacted mandibular wisdom teeth extraction can help reduce intraoperative bleeding, alleviate pain and swelling,improve the degree of limited mouth opening.

Key words: Piezosurgery, Contra-angle turbine drill, Impacted mandibular wisdom teeth, Surgical effect, Prognosis

中图分类号:

R782.1

谢雪梅, 俞晓佳. 超声骨刀联合45°反角涡轮钻拔除下颌阻生智齿效果及预后分析[J]. 上海口腔医学, 2025, 34(3): 298-302.

Xie Xuemei, Yu Xiaojia. Effect and prognosis of piezosurgery combined with 45°contra-angle turbine drill in extraction of impacted mandibular wisdom teeth[J]. Shanghai Journal of Stomatology, 2025, 34(3): 298-302.

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