微创拔牙术拔除阻生智牙的临床效果及对VAS评分和应激反应的影响

doi:10.19438/j.cjoms.2020.03.014

摘要/Abstract

摘要： 目的探讨微创拔牙术拔除阻生智牙的临床效果及对VAS评分和应激反应的影响。方法选择2017年7月—2019年7月期间浦东新区人民医院口腔科收治的需要拔除阻生智牙的患者98例,随机分为对照组和实验组,每组49例。对照组采用常规拔牙方式,实验组采用微创拔牙术,术后对患者治疗效果进行评估,比较2组手术效果、龈沟液中炎症介质（PTX3、ICAM1、MPO、PGE2）、应激介质（PPARr、GPx、T-AOC、ROS、MDA）水平变化以及术后并发症发生情况。采用SPSS 18.0软件包对数据进行统计学分析。结果实验组手术时间、治疗后疼痛程度、肿胀程度、开口度均显著优于对照组（P<0.05）;实验组治疗后PTX3、ICAM1、MPO、PGE2含量显著低于对照组（P<0.05）;实验组治疗后PPARr、ROS、MDA含量显著低于对照组（P<0.05）,实验组治疗后GPx、T-AOC含量显著高于对照组（P<0.05）;实验组治疗后干槽症、开口受限、水肿、感染发生率显著低于对照组（P<0.05）。结论微创拔牙术在阻生智牙拔除中的临床效果显著,能够缩短手术时间,有助于减轻患者疼痛,减轻局部炎症应激反应,术后反应更加轻微,术后并发症减少,值得推广应用。

关键词: 微创拔牙术, 传统拔牙术, 阻生智牙拔除, 疼痛评分, 应激反应, 并发症

Abstract: PURPOSE: To explore the clinical effect of minimally invasive extraction on impacted wisdom teeth and its impact on VAS score and stress response. METHODS: A total of 98 patients in our hospital from July 2017 to July 2019 who needed to remove impacted wisdom teeth were selected and randomly divided into control group and experimental group, 49 cases in each group. Conventional extraction method was adopted in the control group, while minimally invasive extraction method was used in the experimental group. The surgical effect, changes in the levels of inflammatory mediators, stress mediators in the gingival crevicular fluid, and postoperative complications were compared. The data were analyzed using SPSS 18.0 software package. RESULTS: The operation time, pain, swelling and mouth opening degree of the experimental group were significantly better than those of the control group (P<0.05); the contents of PTX3, ICAM1, MPO, and PGE2 in the experimental group were significantly lower than those in the control group(P<0.05). After treatment, the contents of PPARr, ROS, and MDA in the experimental group were significantly lower than those in the control group(P<0.05); the contents of GPx and T-AOC in the experimental group were significantly higher than those in the control group(P<0.05). The incidences of symptoms, restricted mouth openings, edema, and infection of the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSIONS: Minimally invasive tooth extraction has significant advantages in the extraction of impacted wisdom teeth. It can shorten operation time, help reduce the pain of patients, reduce inflammatory stress response, postoperative response is milder, and postoperative complications were reduced.

Key words: Minimally invasive extraction, Traditional extraction, Impacted wisdom teeth extraction, Pain score, Stress response, Complications

中图分类号:

R782.1

常忠福, 卢立全, 姜丹丹, 张志荣, 蔡建英, 张丽华. 微创拔牙术拔除阻生智牙的临床效果及对VAS评分和应激反应的影响[J]. 中国口腔颌面外科杂志, 2020, 18(3): 260-263.

CHANG Zhong-fu, LU Li-quan, JIANG Dan-dan, ZHANG Zhi-rong, CAI Jian-ying, ZHANG Li-hua. Minimally invasive tooth extraction of impacted wisdom teeth and its impact on VAS score and stress response[J]. China J Oral Maxillofac Surg, 2020, 18(3): 260-263.

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