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中华口腔医学研究杂志(电子版) ›› 2014, Vol. 8 ›› Issue (03) : 252 -255. doi: 10.3877/cma.j.issn.1674-1366.2014.02.015

所属专题: 经典病例

综述

减轻下颌阻生第三磨牙拔除术后反应的手术措施
叶周熹1, 杨驰1,()   
  1. 1.200011 上海交通大学医学院附属第九人民医院口腔颌面外科,上海市口腔研究所,上海市口腔医学重点实验室
  • 收稿日期:2014-01-19 出版日期:2014-06-01
  • 通信作者: 杨驰

Surgical strategies to minimize postoperative reactions following impacted mandibular third molar extraction

Zhouxi Ye1, Chi Yang1,()   

  1. 1.Department of Oral and Maxillofacial Surgery Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Received:2014-01-19 Published:2014-06-01
  • Corresponding author: Chi Yang
引用本文:

叶周熹, 杨驰. 减轻下颌阻生第三磨牙拔除术后反应的手术措施[J/OL]. 中华口腔医学研究杂志(电子版), 2014, 8(03): 252-255.

Zhouxi Ye, Chi Yang. Surgical strategies to minimize postoperative reactions following impacted mandibular third molar extraction[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2014, 8(03): 252-255.

水肿、疼痛和张口受限是下颌阻生第三磨牙拔除术后患者必然产生的症状,受到包括手术难易程度、术者的临床经验和患者的全身状况等多种因素影响。 如何减轻术后反应获得口腔颌面外科领域广泛关注。 根据文献资料,减轻下颌阻生第三磨牙术后反应的方法包括药物治疗、物理治疗和手术技术的改进等。 其中,寻找更好的手术策略是口腔颌面外科领域的研究热点。 本文回顾了近3 年来关于不同手术策略影响术后反应程度的文献,其中的手术策略主要包括不同的翻瓣方式、新辅助手术技术和不同的缝合方法等三个方面。

Swelling, pain and trismus often occure in patients who received impacted mandibular third molar extraction. This postoperative reaction is influenced by various factors such as the difficulty of the surgical procedure, experience of the surgeon and the body condition of the patients.Recently, more researches have focused on a series of methods to minimize the postoperative reactions.According to previous published data, these methods involve pharmacological therapy, physiotherapy and surgical techniques. Among these researches, searching for a better surgical strategy is of great interest. This article reviews researches on how different surgical strategies affect the extent of postoperative reaction in the recent 3 years. These strategies include various flaps, new techniques and different closure methods.

图1 标准Ward 切口示意图[10]
图2 改良Ward 切口示意图[10]
图3 逗号形黏膜瓣示意图[10]
[1]
Sortino F, Cicc iù M. S trategies used to inhibit postoperative swelling following removal of impacted lower third molar [J].Dent Res J(Isfahan), 2011,8(4):162-171.
[2]
邱蔚六,张震康. 口腔颌面外科学[M]. 6 版. 北京:人民卫生出版社, 2011:52-104.
[3]
Guerrouani A, Zeinoun T, Vervaet C, et al. A four-year monocentric study of the complications of third molars extractions under general anesthesia: About 2112 Patients[J].Int J Dent, 2013(2013):763837
[4]
Oliveira Sierra S, Melo Deana A, Mesquita Ferrari RA, et al.Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial [J]. Trials, 2013(14):373.
[5]
Kim HR, Choi BH, Engelke W, et al. A comparative study on the extractions of partially impacted mandibular third molars with or without a buccal flap: a prospective study [J]. J Oral Maxillofac Surg, 2011,69(4):966-970.
[6]
Goldsmith SM, De Silva RK, Tong DC, et al. Influence of a pedicle flap design on acute postoperative sequelae after lower third molar removal [J]. Int J Oral Maxillofac Surg, 2012,41(3):371-375.
[7]
Koyuncu BÖ, Cetingül E. Short-term clinical outcomes of two different flap techniques in impacted mandibular third molar surgery[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013,116(3):e179-e184.
[8]
Dolanmaz D, Esen A, Isik K, et al. Effect of 2 flap designs on postoperative pain and swelling after impacted third molar surgery[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013,116(4):e244-e246.
[9]
Baqain ZH, Al-Shafii A, Hamdan AA, et al. Flap design and mandibular third molar surgery: a split mouth randomized clinical study [J]. Int J Oral Maxillofac Surg, 2012,41(8):1020-1024.
[10]
Saravana KB, Sarumathi T, Veerabahu M, et al. To compare standard incision and comma shaped incision and its influence on post-operative complications in surgical removal of impacted third molars[J]. J Clin Diagn Res, 2013,7(7):1514-1518.
[11]
Erdogan O, Tatlı U, Ustün Y, et al. Influence of two different flap designs on the sequelae of mandibular third molar surgery[J]. Oral Maxillofac Surg, 2011,15(3):147-152.
[12]
Borgonovo AE, Giussani A, Grossi GB, et al. Evaluation of postoperative discomfort after impacted mandibular third molar surgery using three different types of flap[J]. Quintessence Int,2014,45(4):319-330.
[13]
Goyal M, Marya K, Jhamb A, et al. Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a piezotome or a conventional handpiece: a prospective study[J]. Br J Oral Maxillofac Surg, 2012,50(6):556-561.
[14]
Bartuli FN, Luciani F, Caddeo F, et al. Piezosurgery vs high speed rotary handpiece:a comparison between the two techniques in the impacted third molar surgery[J]. Oral Implantol, 2013,6(1):5-10.
[15]
Pippi R, Alvaro R. Piezosurgery for the lingual split technique in mandibular third molar removal: a suggestion[J]. J Craniofac Surg, 2013,24(2):531-533.
[16]
Rullo R, Addabbo F, Papaccio G, et al. Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery:relationships between surgical difficulty and postoperative pain with histological evaluations [J]. J Craniomaxillofac Surg,2013,41(2):e33-e38.
[17]
Engelke W, Fuentes R, Beltrán V. Endoscopically assisted removal of a lingually displaced third molar adjacent to the inferior alveolar nerve [J]. J Craniofac Surg, 2013,24 (6):2171-2174.
[18]
Maria A, Malik M, Virang P. Comparison of primary and secondary closure of the surgical wound after removal of impacted mandibular third molars [J]. J Maxillofac Oral Surg,2012,11(3):276-283.
[19]
Chaudhary M, Singh M, Singh S, et al. Primary and secondary closure technique following removal of impacted mandibular third molars: A comparative study [J]. Natl J Maxillofac Surg,2012,3(1):10-14.
[20]
Khande K, Saluja H, Mahindra U. Primary and secondary closure of the surgical wound after removal of impacted mandibular third molars [J]. J Maxillofac Oral Surg, 2011,10(2):112-117.
[21]
Hashemi HM, Beshkar M, Aghajani R. The effect of sutureless wound closure on postoperative pain and swelling after impacted mandibular third molar surgery [J]. Br J Oral Maxillofac Surg,2012,50(3):256-258.
[22]
Osunde OD, Saheeb BD, Adebola RA. Comparative study of effect of single and multiple suture techniques on inflammatory complications after third molar surgery [J]. J Oral Maxillofac Surg, 2011,69(4):971-976.
[23]
Osunde OD, Adebola RA, Saheeb BD. A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery[J]. Int J Oral Maxillofac Surg, 2012,41(10):1275-1279.
[24]
Damodar ND, Nandakumar H, Srinath NM. Postoperative recovery after mandibular third molar surgery: a criteria for selection of type of surgical site closure [J]. Gen Dent, 2013,61(3):e9-e13.
[25]
Joshi AD, Saluja H, Mahindra U, et al. A comparative study:efficacy of tissue glue and sutures after impacted mandibular third molar removal [J]. J Maxillofac Oral Surg, 2011,10(4):310-315.
[26]
Ghoreishian M, Gheisari R, Fayazi M. Tissue adhesive and suturing for closure of the surgical wound after removal of impacted mandibular third molars: a comparative study [J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009,108(1):e14-e16.
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