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中华口腔医学研究杂志(电子版) ›› 2018, Vol. 12 ›› Issue (04) : 221 -226. doi: 10.3877/cma.j.issn.1674-1366.2018.04.004

所属专题: 文献

临床研究

两种微动力系统在上颌埋伏多生牙拔除术中应用的比较
许志杰1, 杨蕊2, 杜国勇1, 何奋军1, 余丽佳1, 吴纪楠1,()   
  1. 1. 528400 中山市人民医院口腔颌面外科
    2. 528400 中山市人民医院口腔种植科
  • 收稿日期:2018-04-04 出版日期:2018-08-01
  • 通信作者: 吴纪楠

Comparative study of effectiveness of two different micro power systems in removing the impacted supernumerary tooth in the maxilla

Zhijie Xu1, Rui Yang2, Guoyong Du1, Fenjun He1, Lijia Yu1, Ji′nan Wu1,()   

  1. 1. Department of Maxillofacial Surgery, Zhongshan City People′s Hospital, Zhongshan 528400, China
    2. Department of Dental Implant, Zhongshan City People′s Hospital, Zhongshan 528400, China
  • Received:2018-04-04 Published:2018-08-01
  • Corresponding author: Ji′nan Wu
  • About author:
    Corresponding author: Wu Ji′nan, Email:
引用本文:

许志杰, 杨蕊, 杜国勇, 何奋军, 余丽佳, 吴纪楠. 两种微动力系统在上颌埋伏多生牙拔除术中应用的比较[J]. 中华口腔医学研究杂志(电子版), 2018, 12(04): 221-226.

Zhijie Xu, Rui Yang, Guoyong Du, Fenjun He, Lijia Yu, Ji′nan Wu. Comparative study of effectiveness of two different micro power systems in removing the impacted supernumerary tooth in the maxilla[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2018, 12(04): 221-226.

目的

通过对比超声骨刀与涡轮手机去骨法拔除上颌埋伏多生牙的手术效果,探讨更为方便、安全、有效的拔牙方法。

方法

选取2013—2017年中山市人民医院口腔颌面外科拔除上颌埋伏多生牙且符合纳入标准的患者150例(共计190颗多生牙),通过抽签的方法随机分两组。术前均完善锥形束CT(CBCT)检查以定位埋伏多生牙,采用局部浸润麻醉方式,选择合适的切口入路,实验组采取超声骨刀去骨法拔牙,对照组采取涡轮反角手机去骨法拔牙。采用视觉模拟评分法(VAS)量化患者术后疼痛情况,采用SPSS 20.0软件以独立样本的t检验法对两组患者以及年满12周岁以上患者的手术时间、术后疼痛值进行对比分析。

结果

患者术后疼痛的VAS值范围为0 ~ 10(0为完全无痛,10为最为剧烈的疼痛),实验组VAS均值为4.2 ± 1.5,低于对照组的5.2 ± 1.6,差异有统计学意义(t=-4.072,P<0.001)。而对于12岁以上患者的疼痛VAS值分析,实验组均值为4.2 ± 1.5,亦低于对照组的5.1 ± 1.6,差异有统计学意义(t=-2.866,P= 0.005)。手术时间平均值,实验组为(48 ± 6)min,低于对照组的(51±8)min,差异有统计学意义(t=-3.014,P= 0.003)。而对于12岁以上患者的手术平均时间分析,实验组均值为(46 ± 6)min,亦低于对照组的(49 ± 7)min,但差异无统计学意义(t=-0.901,P= 0.060)。

结论

采用CBCT引导下超声骨刀拔牙法拔除上颌埋伏多生牙,疼痛少、时间短、舒适性好,是一种值得推广的拔牙方法。

Objective

To find a more convenient, safe and effective extraction method, via comparing the extraction operation effect of the embedded supernumerary teeth in maxilla by using piezosurgery osteotomy or contra-angle high speed turbines.

Methods

One hundred and fifty patients (with a total of one hundred and ninety supernumerary teeth) who had accepted the extraction operation of the embedded supernumerary teeth in maxilla at Zhongshan City People′s Hospital from 2013 to 2017 were included. They were divided into two groups randomly. All of the patients had accepted the cone beam computed tomography (CBCT) examination to locate the embedded supernumerary teeth. The experimental group underwent the teeth extraction with piezosurgery osteotomy; while the control group with contra-angle high speed turbines. The postoperative pain (quantitatively analyzed by VAS) , operation time were compared between the two groups. The data were processed and analyzed by SPSS 20.0, and the mean and standard deviation of two groups were analyzed by independent sample t test.

Results

The average VAS value in the experimental group is 4.2 ± 1.5, while the average VAS value in the control group is 5.2 ± 1.6. The postoperative pain in the experimental group is less than the control group significantly (t=-4.072, P<0.001) . In the groups of patients over 12 years old, the average VAS value in the experimental group is 4.2±1.5, while the average VAS value in the control group is 5.1±1.6. The postoperative pain in the experimental group is less than the control group significantly (t=-2.866, P= 0.005) . The average operation time of the experimental group is (48±6) min while the average operation time of the control group is (51±8) min. The operation time of the experimental group is less than the control group significantly (t=-3.014, P= 0.003) . While in the groups of patients over 12 years old, the average operation time of the experimental group is (46 ± 6) min while the average operation time of the control group is (49 ± 7) min. The difference of operation time between the two groups is not significant (t=-0.901, P= 0.060) .

Conclusions

Using the CBCT guided piezosurgery osteotomy to remove the impacted supernumerary tooth in the anterior maxilla, can lessen postoperative pain, shorten operation time, and provide more comfortable experience.

图1 典型病例1超声骨刀拔牙病例术前影像学检查
图2 典型病例1超声骨刀拔牙病例术中情况
图3 典型病例1超声骨刀拔牙病例术后情况
图4 典型病例2反角涡轮手机拔牙病例术前影像学检查
图5 典型病例2反角涡轮手机拔牙病例术中情况
图6 典型病例2反角涡轮手机拔牙病例术后情况
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